Patient and public involvement and engagement with cardiac arrest survivors.

Alison Coppola, Caroline Halliday, Mark Jones, Richard Houghton, Mark Johnson, Nigel Sillis, Michelle Johnson, Debra Sillis, Ruth Endacott
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Abstract

Background: Patient and public involvement and engagement (PPIE) with cardiac arrest survivors is an essential component of research to strengthen development, design, delivery and dissemination to ensure research priorities are in the public interest and patient friendly. Cardiac arrest survivors and their relatives were engaged in PPIE to help develop the methods of a research study that aims to reduce individual and care process variation during paramedic-led resuscitation.

Methods: This research methodology paper represents the views of seven PPIE representatives and the authors. PPIE representatives included five cardiac arrest survivors and two relatives. Content for the paper was generated by discussion using audio or video call. Notes were taken by the author which included direct quotations generated by the PPIE process.

Results: The PPIE representatives considered research surrounding the decisions made by paramedics to be important. From their first-hand experiences, survivors and their relatives felt that a future research study should focus on patient survival. The decision-making of paramedics was identified as most important to explore. Quality of life before the cardiac arrest was considered important as this may help to inform best-interest decisions. The neurologic recovery of patients was important; however, rehabilitation may be extensive and therefore unachievable within the study timeframe. Relatives highlighted that while incorporating their views during resuscitation was important, gaining consent for research participation was not appropriate.

Conclusion: PPIE added value and helped to develop a future study to reduce variation in the resuscitation decisions made by paramedics. The group identified what is important to survivors and their relatives and the factors they would like paramedics to consider when making a resuscitation decision. By identifying these factors, the PPIE process has helped to drive the research methods where both quantitative and qualitative designs would be appropriate. Issues in gaining research consent during resuscitation were highlighted.

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心脏骤停幸存者的患者和公众参与。
背景:心脏骤停幸存者的患者和公众参与(PPIE)是研究的重要组成部分,可加强研究的开发、设计、实施和传播,确保研究重点符合公众利益并对患者友好。心脏骤停幸存者及其亲属参与了 PPIE,以帮助制定一项研究的方法,该研究旨在减少辅助医务人员主导的复苏过程中的个体差异和护理流程差异:本研究方法论文代表了七位PPIE代表和作者的观点。PPIE 代表包括五名心脏骤停幸存者和两名亲属。论文内容通过音频或视频电话讨论产生。作者做了记录,其中包括PPIE过程中产生的直接引语:PPIE 代表认为,围绕护理人员所做决定的研究非常重要。根据他们的亲身经历,幸存者及其亲属认为,未来的研究应重点关注患者的存活率。辅助医务人员的决策被认为是最需要探讨的问题。他们认为心脏骤停前的生活质量很重要,因为这可能有助于做出最有利的决定。患者的神经功能恢复也很重要;但是,康复可能很广泛,因此无法在研究时间框架内实现。亲属强调,虽然在复苏过程中听取他们的意见很重要,但获得同意参与研究并不合适:PPIE增加了价值,并有助于开展未来研究,以减少护理人员在做出复苏决定时的差异。该小组确定了什么对幸存者及其亲属是重要的,以及他们希望辅助医务人员在做出复苏决定时考虑的因素。通过确定这些因素,PPIE 流程帮助确定了研究方法,其中定量和定性设计都很合适。强调了在复苏过程中获得研究同意的问题。
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