Home Automatic external Defibrillator Training

家用自动体外除颤器培训

• 批准号: 6912611
• 负责人: THOMAS D REA
• 金额: $ 44.51万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6912611
• 关键词: behavioral /social science research tag; biomedical automation; clinical research; computer assisted instruction; data collection methodology /evaluation; education evaluation /planning; electric countershock heart resuscitation; emergency care; family medicine; functional ability; health education; heart arrest; home health care; human subject; implantable defibrillators; locus of control; longitudinal human study; outcomes research; patient care management; patient care planning; performance; portable biomedical equipment; psychological adaptation; psychological tests; quality of life; questionnaires; videotape /videodisc

DESCRIPTION (provided by applicant): Out-of-hospital cardiac arrest constitutes a major public health challenge responsible for hundreds of thousands of deaths annually in the U.S. A family responder program, where family members of a person at high risk of cardiac arrest are equipped and trained with an automated external defibrillator (AED), is an innovative method to reduce mortality. Although lifesaving, the successful operation of the AED requires achievement of technical skill. Moreover given the extreme circumstances of cardiac arrest, the AED may serve to enhance or erode the psychological well-being of the patient and/or family. Behavioral theory and empirical evidence from studies of lifesaving skills training of laypersons suggest that an AED training approach that incorporates tenets of self-efficacy and perceived control may favorably impact skills retention and psychological status. To test this hypothesis, 300 (sets of) patients at high-risk of cardiac arrest and their family members will be will be randomized to one of four AED training programs: 1) instructional video, 2) video with self-efficacy, 3) face-to-face instruction with self efficacy, 4) face-to-face instruction with self-efficacy and perceived control. The specific aims are to determine which AED training program achieves optimal skills retention and psychological adjustment among heart disease patients and their family members. Patients and family members will be enrolled shortly after hospital discharge for an acute coronary syndrome. AED skills of family members will be assessed in a simulated "surprise" cardiac arrest 9 months following enrollment using a validated skills measure. Psychological adjustment of family members and patients will be assessed at baseline (prior to randomization) and 3 and 9 months later using validated survey instruments for psychological and functional health. During the initial 6 months, the investigators will gain review board approval, finalize assessment and training resources, and hire staff. For the subsequent 3 years, subjects will be enrolled and baseline and outcome measures will be assessed. Data will be analyzed and reports written during the final 12 months of the study. The study has greater than 80 percent power to detect clinically important differences between training groups. Although the programs span the spectrum from streamlined to personalized and intensive, each approach constitutes a potential real-word, generalizable AED training method. If training that is enhanced in self-efficacy and perceived control is superior, more training resources may be required to maximize the health benefits of a family responder AED program. Alternatively, if nominal video-based approaches achieve comparable outcomes, training efforts can be streamlined at considerable cost savings with fewer impediments for distribution and dissemination.

描述（由申请人提供）：院外心脏骤停是一项重大的公共卫生挑战，每年在美国造成数十万人死亡。家庭急救人员计划是一种降低死亡率的创新方法，在该计划中，心脏骤停高危患者的家庭成员配备并接受了自动体外除颤器（AED）的培训。虽然能挽救生命，但成功使用AED需要一定的技术水平。此外，考虑到心脏骤停的极端情况，AED可能有助于增强或削弱患者和/或家属的心理健康。行为理论和外行人救生技能培训研究的经验证据表明，结合自我效能和感知控制原则的AED培训方法可能有利于技能保留和心理状态。为了验证这一假设，300（组）心脏骤停高危患者及其家属将被随机分为四组：1)教学视频，2)自我效能视频，3)自我效能面对面教学，4)自我效能和感知控制面对面教学。具体目的是确定哪种AED培训方案在心脏病患者及其家属中达到最佳的技能保留和心理调整。患者及其家属将在急性冠状动脉综合征出院后不久登记。家庭成员的AED技能将在登记9个月后使用经过验证的技能测量方法在模拟“意外”心脏骤停中进行评估。家庭成员和患者的心理调整将在基线（随机分配之前）和3个月和9个月后使用有效的心理和功能健康调查工具进行评估。在最初的6个月里，调查人员将获得审查委员会的批准，最终确定评估和培训资源，并雇用工作人员。在接下来的3年里，受试者将被招募，基线和结果测量将被评估。在研究的最后12个月，将对数据进行分析并撰写报告。该研究有超过80%的能力来检测训练组之间的临床重要差异。尽管这些项目涵盖了从简化到个性化和集约化的范围，但每种方法都构成了潜在的现实世界，可推广的AED培训方法。如果增强自我效能和感知控制的培训是优越的，那么可能需要更多的培训资源来最大化家庭应对AED项目的健康效益。或者，如果名义上基于视频的方法取得类似的结果，培训工作就可以精简，节省大量费用，分发和传播方面的障碍更少。