Lived experiences of surviving in-hospital cardiac arrest

Scand J Caring Sci. 2019 Mar;33(1):156-164. doi: 10.1111/scs.12616. Epub 2018 Oct 17.

Abstract

Background: Out-of-hospital cardiac arrest survivors suffer from psychological distress and cognitive impairments. They experience existential insecurity and vulnerability and are striving to return to a life in which well-being and the meaning of life have partly changed. However, research highlighting the experiences of in-hospital cardiac arrest survivors is lacking. This means that evidence for postresuscitation care has largely been extrapolated from studies on out-of-hospital cardiac arrest survivors, without considering potential group differences. Studies investigating survivors' experiences of an in-hospital cardiac arrest are therefore needed.

Aim: To illuminate meanings of people's lived experiences of surviving an in-hospital cardiac arrest.

Design: An explorative, phenomenological hermeneutic method to illuminate meanings of lived experiences.

Method: Participants were identified through the Swedish national register of cardiopulmonary resuscitation and recruited from two hospitals. A purposive sample of eight participants, 53-99 years old, who survived an in-hospital cardiac arrest 1-3 years earlier, was interviewed.

Findings: The survivors were striving to live in everyday life and striving for security. The struggle to reach a new identity meant an existence between restlessness and a peace of mind, searching for emotional well-being and bodily abilities. The search for existential wholeness meant a quest for understanding and explanation of the fragmented cardiac arrest event and its existential consequences. The transition from hospital to home meant a transition from care and protection to uncertainty and vulnerability with feelings of abandonment, which called for a search for security and belonging, away from isolation and loneliness.

Conclusion: Surviving an in-hospital cardiac arrest can be further understood by means of the concept of hospital-to-home transition. Following hospital discharge, patients felt vulnerable and abandoned when pending between denial and acceptance of the 'new' life. Hence, the healthcare system should play a significant role when it comes to facilitate cardiac arrest survivors' security during hospital-to-home transition.

Keywords: cardiac arrest; hospitals; lived experiences; nursing; phenomenological hermeneutics.

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Aged, 80 and over
  • Female
  • Heart Arrest / psychology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Quality of Life / psychology*
  • Stress, Psychological*
  • Survivors / psychology*
  • Sweden