Current controversy exists about the value of community programs designed to teach cardiopulmonary resuscitation techniques (CPR) to the lay public. Even more issues surround the targeting of family members of patients at high risk for sudden death for CPR instruction. On the one hand, family CPR instruction can be viewed as a critical component of a treatment plan for this high risk group, a component that might well increase a patient's survival following a witnessed cardiac arrest. This position is supported by statistics that indicate individuals are most likely to arrest in their own home and that survival is inversely proportional to the time when CPR is initiated. On the other hand, research data indicate that CPR training may effect both patients and families negatively by challenging the denial frequently used to reduce the specter of sudden death resulting in increased anxiety and depression. Therefore, the objective of this research has been to evaluate the consequences of teaching CPR to family members of high risk cardiac patients. The goals of the project include: 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 document 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.
These aims are being addressed in a multi-center prospective clinical trial. Patients and family members are randomized into one of the following groups: a CPR training group that is similar to current community CPR; a CPR training group with structured psychological intervention; or a control group. Only family members receive the CPR training. To meet the project objectives, continuation funds are being requested to enlarge the sample size and provide an 18-month follow-up on all subjects.
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