scholarly journals How are ambulance personnel prepared and supported to withhold or terminate resuscitation and manage patient death in the field? A scoping review

2019 ◽  
Vol 16 ◽  
Author(s):  
Natalie Anderson ◽  
Julia Slark ◽  
Merryn Gott
Keyword(s):  
Coping Strategies ◽  
Scoping Review ◽  
Medical Futility ◽  
The United States ◽  
Patient Death ◽  
Ambulance Personnel ◽  
Breaking Bad ◽  
The United Kingdom ◽  
Death Notification ◽  
And Coping

IntroductionResearch shows that ambulance personnel can find it challenging to withhold or terminate resuscitation and manage patient death in the field. This scoping review provides a synthesis of published research that has addressed three main questions. Each relates to ambulance personnel enacting decisions to withhold or terminate resuscitation and manage patient death: How are they prepare; what supports and coping strategies are utilised; and what preparation and support needs have been identified?MethodsUsing Arksey and O’Malley’s five-stage scoping review framework this review identifies what is known and what further research is needed in this area.ResultsSixteen methodologically heterogenous papers were located. Half of the studies were conducted in the United States, with the remainder in Canada, Singapore, Spain, Sweden and the United Kingdom. Ambulance personnel receive little formal training and feel unprepared to manage situations where resuscitation is unsuccessful or unwarranted, particularly communicating with family, breaking bad news and managing death scenes. These aspects of termination of resuscitation are so challenging that distancing and avoidance are sometimes used as coping strategies, even when medical futility has been established. In addition to formal counselling for personal loss and stressors, ambulance personnel value downtime and informal peer debriefing, following difficult resuscitation decisions and patient deaths.ConclusionAmbulance personnel feel inadequately prepared to withhold or terminate resuscitation and manage patient death in the field. They want more opportunities to learn about death notification, communication with bereaved families and safe, sensitive management of death scenes. More research is needed to determine how best to prepare and support ambulance personnel for the challenges of resuscitation decision-making and patient death.

scholarly journals Unsuccessful, Unwanted, and Unwarranted Resuscitation: Exploring Ambulance Personnel Preparation and Support for Death in the Field

2019 ◽  
Vol 34 (s1) ◽  
pp. s54-s55 ◽  
Author(s):  
Natalie Anderson ◽  
Julia Slark ◽  
Merryn Gott
Keyword(s):  
Clinical Education ◽  
Personnel Preparation ◽  
Patient Death ◽  
Ambulance Personnel ◽  
Managerial Support ◽  
Opportunities For Learning ◽  
Death Notification ◽  
Support Mechanisms ◽  
Pastoral Support ◽  
And Coping

Introduction:In many countries, ambulance personnel are authorized to start or stop resuscitation efforts in accordance with clinical guidelines. Research shows that decisions to withhold or terminate resuscitation and manage patient death scenes can be particularly challenging.Aim:To identify preparation and support mechanisms for ambulance personnel who are authorized to withhold or terminate resuscitation efforts, and manage patient death in the field.Methods: A scoping review provided an overview of international research in this area. A qualitative exploratory study was then undertaken. Focus groups were held with senior ambulance personnel currently working in clinical education, managerial, or pastoral support roles across New Zealand.Results:Well-supported clinical experiential learning and resolved personal experiences with grief and death were considered most useful to increase self-efficacy and coping with patient death. Participants felt some of the personal and interpersonal skills needed to manage death in the field were difficult to teach. Relatively little time is spent preparing ambulance personnel for the non-technical skills associated with resuscitation decision-making, particularly communicating with family and bystanders. Ambulance personnel responses and support-needs during or after the event are idiosyncratic. Ambulance personnel appear to primarily rely on colleagues and managers checking in and offering informal debriefing.Discussion:Results from this study identify opportunities for improvement in the preparation and support of ambulance personnel faced with managing patient death in the field. Clinical experience with supportive mentoring may provide the best opportunities for learning, but novices may not get exposure to patient death in this context. Ambulance personnel may benefit from training, which includes opportunities to role-play death notification and communication with family and bystanders at the scene of a patient death. Ambulance employers should allow downtime to facilitate personalized peer and managerial support where needed.

scholarly journals Analyzing the Research Evolution in Response to COVID-19

2021 ◽  
Vol 10 (4) ◽  
pp. 237
Author(s):  
Weirong Li ◽  
Kai Sun ◽  
Yunqiang Zhu ◽  
Jia Song ◽  
Jie Yang ◽  
...  
Keyword(s):  
Psychological Health ◽  
Early Stage ◽  
The United States ◽  
Growth Trend ◽  
Related Research ◽  
The United Kingdom ◽  
Control And Prevention ◽  
Cyclical Trend ◽  
And Coping ◽  
Number Of Authors

In order to understand how these studies are evolving to respond to COVID-19 and to facilitate the containment of COVID-19, this paper accurately extracted the spatial and topic information from the metadata of papers related to COVID-19 using text mining techniques, and with the extracted information, the research evolution was analyzed from the temporal, spatial, and topic perspectives. From a temporal view, in the three months after the emergence of COVID-19, the number of published papers showed an obvious growth trend, and it showed a relatively stable cyclical trend in the later period, which is basically consistent with the development of COVID-19. Spatially, most of the authors who participated in related research are concentrated in the United States, China, Italy, the United Kingdom, Spain, India, and France. At the same time, with the continuous spread of COVID-19 in the world, the distribution of the number of authors has gradually expanded, showing to be correlated with the severity of COVID-19 at a spatial scale. From the perspective of topic, the early stage of COVID-19 emergence, the related research mainly focused on the origin and gene identification of the virus. After the emergence of the pandemic, studies related to the diagnosis and analysis of psychological health, personal security, and violent conflict are added. Meanwhile, some categories are most closely related to the control and prevention of the epidemic, such as pathology analysis, diagnosis, and treatment; epidemic situation and coping strategies; and prediction and assessment of epidemic situation. In most time periods, the majority of studies focused on these three categories.

HIV-Infected Adolescents With Hemophilia: Adaptation and Coping

PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 459-463
Author(s):  
Larry K. Brown ◽  
Janet R. Schultz ◽  
Rod A. Gragg ◽  
Keyword(s):  
Coping Strategies ◽  
Risky Behaviors ◽  
The United States ◽  
Significant Degree ◽  
Hiv Status ◽  
Self Blame ◽  
Alcohol And Drugs ◽  
Immunodeficiency Virus ◽  
Passive Strategies ◽  
And Coping

Objective. It is estimated that 70% of individuals with factor VIII deficiency hemophilia who received blood products before 1985 are infected with human immunodeficiency virus (HIV). The goal of the current study was to assess how adolescents with hemophilia cope with reminders of their HIV status, because adaptation is likely to have implications for these individuals' quality of life and adherence to safer sex recommendations. Methods. Participants included 297 HIV-positive adolescents with hemophilia who were recruited from 11 sites across the United States. Adolescents reported on the use and effectiveness of strategies for coping with reminders of their HIV status. Results. A significant degree of distress was reported in response to such reminders, with anger being the most commonly reported emotion. Although a wide variety of coping strategies had been tried, participants reported using resignation (80.9%), self-calming (78.8%), and distraction (76.4%) most frequently in their attempts to cope with reminders of HIV. Self-blame (3.6%), engaging in risky behaviors (22.2%), thinking about sex (25.4%), and drug/alcohol use (29.1%) were used least. These adolescents tended to rate more active cognitive and behavioral coping strategies (eg, cognitive restructuring, seeking social support, physical activity) as most effective, whereas passive strategies (eg, wishful thinking, blaming others) were reported to be least helpful. Those individuals who reported being distressed by reminders of HIV endorsed most of the coping strategies significantly more often than the nondistressed group, although ineffective strategies were commonly chosen. Sexually active adolescents were more likely than their abstinent peers to cope by thinking about sex, engaging in risky behaviors, or using alcohol and drugs. Conclusion. In this population of adolescents who have known their serostatus for several years, distress about everyday reminders of HIV appears to be associated with ineffective coping strategies.

scholarly journals Music in Mood Regulation and Coping Orientations in Response to COVID-19 Lockdown Measures Within the United Kingdom

2021 ◽  
Vol 12 ◽  
Author(s):  
Noah Henry ◽  
Diana Kayser ◽  
Hauke Egermann
Keyword(s):  
United Kingdom ◽  
Coping Strategies ◽  
Positive Emotions ◽  
Online Survey ◽  
Mood Regulation ◽  
The United Kingdom ◽  
Negative Effect ◽  
Individual Use ◽  
Positive Outlook ◽  
And Coping

Music is a tool used in daily life in order to mitigate negative and enhance positive emotions. Listeners may orientate their engagement with music around its ability to facilitate particular emotional responses and to subsequently regulate mood. Existing scales have aimed to gauge both individual coping orientations in response to stress, as well as individual use of music for the purposes of mood regulation. This study utilised pre-validated scales through an online survey (N = 233) in order to measure whether music’s use in mood regulation is influenced by coping orientations and/or demographic variables in response to the lockdown measures imposed in the United Kingdom, as a consequence of the COVID-19 pandemic. Whilst factor analyses show that the existing theoretical structure of the COPE model has indicated a poor fit for clustered coping orientations, a subsequent five-factor structure was determined for coping orientations in response to lockdown. Analyses include observations that positive reframing and active coping (Positive Outlook) were strong predictors of music use in mood regulation amongst listener’s coping strategies, as was Substance Use. Higher Age indicated having a negative effect on music’s use in mood regulation, whilst factors such as gender were not seen to be significant in relation to the use of music in mood regulation within this context. These results provide insight into how individuals have engaged with music orientated coping strategies in response to a unique stressor.

Coping in patients with pancreatic cancer: a scoping review and narrative synthesis

2021 ◽  
pp. bmjspcare-2021-003266
Author(s):  
Patrick Ristau ◽  
Claudia Oetting-Roß ◽  
Andreas Büscher
Keyword(s):  
Pancreatic Cancer ◽  
Coping Strategies ◽  
Scoping Review ◽  
Publication Date ◽  
Rapid Progression ◽  
Narrative Synthesis ◽  
The Usa ◽  
Cancer Experience ◽  
And Coping ◽  
Disease Specific

IntroductionPancreatic cancer is a malignant disease with one of the highest cancer-specific mortality rates. Coping with it probably differs from other malignant diseases. This scoping review was intended to explore and characterise academic literature related to the coping in patients with pancreatic cancer.MethodsEight databases were searched for primary and secondary studies and reviews reporting on coping with pancreatic cancer (adenocarcinoma) in adults in English or German language, regardless of publication date or study design, which were then analysed and summarised by narrative synthesis.ResultsOf 1472 publications identified, 9 articles and book contributions published from 1989 to 2020 in the USA, Europe and Australia met the inclusion criteria. The two main aspects covered were the confrontation with coping tasks, and the reciprocally associated coping with these challenges. In particular, the coping tasks revealed some pancreatic cancer-specific features, such as an increased incidence of depression and anxiety or certain digestive problems, whereas applying of coping strategies seems to be more like the coping behaviours known from the literature for other severe or cancer diseases.ConclusionsPatients with pancreatic cancer experience various health issues and face various quality of life changes and coping tasks. Disease-specific contextual factors, usually consisting of late diagnosis at an advanced stage, rapid progression and often poor prognosis, as well as disease-specific challenges are major differences compared with other malignancies or serious illnesses. However, the coping strategies applied do not seem to differ in principle. Currently, no pancreatic cancer-specific coping model exists.

Thriving, burnout, and coping strategies of early and later career counseling center psychologists in the United States

2016 ◽  
Vol 29 (4) ◽  
pp. 382-404 ◽  
Author(s):  
Wonjin Sim ◽  
Gina Zanardelli ◽  
Mary Jo Loughran ◽  
Mary Beth Mannarino ◽  
Clara E. Hill
Keyword(s):  
United States ◽  
Coping Strategies ◽  
Career Counseling ◽  
Counseling Center ◽  
The United States ◽  
And Coping

Multigenerational Conflicts and New Immigrants: An Indo-American Experience

1998 ◽  
Vol 79 (4) ◽  
pp. 410-423 ◽  
Author(s):  
Gregory L. Pettys ◽  
Pallassana R. Balgopal
Keyword(s):  
United States ◽  
Coping Strategies ◽  
The United States ◽  
Immigrant Group ◽  
Family Ties ◽  
American Experience ◽  
New Immigrants ◽  
And Coping ◽  
Depth Interviews

Indo-Americans are one the fastest growing Immigrant groups in the United States. Unlike earlier immigrant groups, this growing Immigrant group has access to technologies which make communication with family in India more practical. With this comes both maintenance of family ties as well as multigenerational conflicts. These conflicts were explored through in-depth interviews with thirty Indo-American families, including eleven grandparents residing in India. Major conflicts, the role of grandparents, and coping strategies used by these families are reported. The findings of this article have heuristic value for counselors in working with all the emerging ethnic groups in the United States.

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