Recent research has suggested that family presence during cardiopulmonary resuscitation (CPR) preformed on a loved one may have beneficial psychological effects, such as lower incidences of post-traumatic stress disorder (PTSD), depression, or anxiety symptoms. This topic has been discussed since the 1980s, however the vast majority of the available information is of opinion or anecdotal form. The purpose of this systematic review of literature is to gather and interpret the data derived from formal research studies in attempt to better understand if families who witness CPR experience fewer incidences of PTDS, depression, or anxiety symptoms after the incident.
An exhaustive search of available medical literature was performed using the databases MEDLINE-Ovid, CINAHL, Web of Science, PsychINFO, and Google Scholar. The keywords used for searching included family, cardiopulmonary resuscitation, psychological, and mental health. Also, the references of relevant articles were scanned for potential articles matching inclusion criteria.
Fifty-four articles were reviewed for relevancy. Three formal studies were found to meet inclusion criteria, including two RCTs and one observational study. One of the RCTs found significantly lower rates of PTSD and anxiety symptoms among family members who witnessed the resuscitation. (OR=1.7 95% CI 1.2-2.5, P=0.004; P=
The presence of psychological benefits such as reduction in rates of PTSD, depression and anxiety symptoms are not yet certain. The evidence available to date is inconclusive. However, the evidence does strongly support a lack of harm to the family members who are present, as well as less than anticipated stress on the staff and absence of medicolegal grievances. Perhaps giving family members a choice to be present does help with bereavement time, coping, and acceptance. However, even though further research is needed, this review along with numerous other informal and formal studies collectively reinforce the conclusion that family witnessed resuscitation likely can be beneficial, and almost certainly, isn’t harmful, indicating that it may be time to reconsider policy regarding family member presence during resuscitation.
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