Recent studies have indicated that the probability of death from an out-of-hospital cardiac arrest can be reduced by the initiation of cardiopulmonary resuscitation. Since the majority of sudden deaths occur in the individual's home, CPR training of family members can be expected to have a significant impact on death due to sudden cardiac events. Preliminary research by the principal investigators, however, suggests that CPR training of family members may produce negative psychological and social outcomes, particularly for patients. Moreover, given such consequences, CPR training with family members may actually precipitate future cardiac events. The purpose of the proposed study is to initiate a multi-center prospective clinical trial that would randomize family members of high-risk cardiac patients into either a standard CPR training group or a CPR training group with structured psychological intervention. A third group of patient/families will receive no interventions (control group). The goals of the project are: to document the impact of family CPR training on mortality due to sudden death events; to determine the response of family members trained in CPR to a potential sudden death event; to determine any psychological risks and/or benefits of these interventions for family members and patients; to determine the degree of CPR skill retention by family members; and to develop an intervention to prevent or offset anxiety, depression and other adverse psychological effects of CPR training on both patients and family members.
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