Title:
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Family presence during CPR in adult critical care setting : hearing the voice of Jordanian health professionals and family members
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This study explores Jordanian health professionals' and family members' attitudes
towards FWR in adult critical care settings. Leininger's cultural care theory was used
as a theoretical framework for this study. The study was conducted in six hospitals in
two major Jordanian cities. A purposive sample of 31 health professionals from
several disciplines who had experience in critical care units in Jordanian hospitals,
and 5 family members, who had experience of having a resuscitated relative, was
recruited over a period of six months. An individual semi-structured interview was
utilised as the main data collection method in this study.
The study findings revealed three main categories: the health professionals' concerns
regarding FWR, whether health professionals allow families to witness CPR or not,
and hearing the voice of family members. Health professionals' concerns included
concerns regarding the impact ofFWR on the CPR team members, such as increasing
the level of stress, concerning ofbeing attacked, fearing that they would be distracted
when working, and concern regarding litigation. In the second category, the novelty
of this subject to Jordanian health professionals contributes to raising such factors
that might atTect professionals' attitudes, such as the impact of culture and religion.
To implement this issue in Jordan, health professionals suggested improving health
professionals' knowledge and skills, preparing family members by providing good
education and enough support, and focusing on organisational factors such as
guidelines and the state of the resuscitation room Three themes were raised under the
third category: the role of family members during CPR, families' needs, and barriers
to allowing FWR. Families' needs for information and proximity were their main
needs during CPR.
Generally, most of the healthcare professionals were against FWR. They raised
several concerns as a result of allowing this practice. Some of these concerns were
raised in the existing literature. However, using a qualitative design helped in
producing more details and explanations about these concerns. The findings of this
study show that fear of litigation as a result of allowing FWR is influenced by
presence of an etTective legal system. It was found that most of the professionals
underplayed the importance of litigation in the practice of FWR, as they have not
effective medical law. This study shows that most of the participants have concerns
of being verbally and physically attacked if they allow FWR. This is a unique and
original theme that was emerged in this study. The [mdings of this study parallel
[mdings of many studies that FWR is traumatic for family members. Despite this
consistency, my research explains that healthcare professionals particularly worried
about allowing highly emotional people from attending CPR. In contrast to the
findings of several studies, my research asserts that patient's privacy and
confidentiality are not invaded in case of allowing the close relatives to witness their
loved one's CPR. Despite the several concerns that were raised, many professionals
stated that FWR has several advantages. Uniquely, this study shows that FWR gives
family members the opportunity to practice their religious and cultural beliefs. This
was viewed beneficial by most of the healthcare professionals.
The findings of this study show that any FWR should consider the specific cultural
and religious dimensions. Despite the necessity of considering these dimensions, this
study shows that the influence of these dimensions was perhaps not as significant as
it might first appear. More importantly, the key issue to improve people's attitudes
toward FWR is simply the need for education and improving awareness. This study
includes several suggestions to facilitate FWR such as the importance of education
and presence of supporting staff. To implement FWR, it is essential to consider the
available resources, as FWR requires extra staff and a well-prepared environment.
All interviewed family members wanted the option to stay beside their loved one
during CPR. Distinctively, most of family members want this option for some
religious and cultural reasons such as praying and supplicating to support their loved
one. All family members expressed several needs at time of CPR. The need for
information about patient's condition was the most important need. Updating family
members about patient's condition would reduce their tension and improve their
acceptance for the end result of CPR.
This study emphasizes the importance of considering the cultural and religious
dimensions in any FWR programs. The study recommends that family members of
resuscitated patients should be treated properly by good communication and
involving them in the treatment process. The implications concentrate on producing
specific guidelines for allowing FWR in the Jordanian context.
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