Home Automatic external Defibrillator Training

家用自动体外除颤器培训

• 批准号: 7227481
• 负责人: THOMAS D REA
• 金额: $ 43.08万
• 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 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7227481
• 关键词: Achievement; Affect; Automated External Defibrillator; Behavioral; Belief; Cardiac; Cardiopulmonary Resuscitation; Cessation of life; Cost Savings; Data; Emergency Situation; Enrollment; External Defibrillator; Family; Family member; Goals; Health; Health Benefit; Health Professional; Health behavior; Heart Arrest; Heart Diseases; Home environment; Hospitals; Instruction; Intervention; Investigation; Life; Measures; Medical; Medical Technology; Methods; Operative Surgical Procedures; Outcome; Outcome Measure; Patients; Persons; Pilot Projects; Psychological adjustment; Public Health; Publishing; Randomized; Range; Readiness; Reporting; Research Personnel; Resources; Risk; Self Efficacy; Simulate; Surveys; Technology; Testing; Time; Training; Training Programs; Training Technics; Well in self; Writing; acute coronary syndrome; base; emergency service responder; improved; innovation; mortality; programs; psychologic; skills; skills training; theories

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）：院外心脏骤停构成了一个主要的公共卫生挑战，每年造成美国数十万人死亡。家庭应急计划是一种降低死亡率的创新方法，在该计划中，心脏骤停高危人群的家庭成员配备并接受自动体外除颤器（AED）培训。虽然可以挽救生命，但AED的成功操作需要技术技能的成就。此外，考虑到心脏骤停的极端情况，AED可用于增强或削弱患者和/或家人的心理健康。从外行救生技能培训的研究的行为理论和经验证据表明，AED的培训方法，包括自我效能和感知控制的原则可能会产生有利的影响技能保留和心理状态。为了验证这一假设，300名（组）心脏骤停高危患者及其家属将被随机分配到四个AED培训项目之一：1）教学视频，2）自我效能视频，3）自我效能面对面指导，4）自我效能和感知控制面对面指导。具体目的是确定哪种AED培训计划能够在心脏病患者及其家属中实现最佳的技能保持和心理调整。患者及其家属将在急性冠脉综合征出院后不久入组。在入组后9个月，将使用经验证的技能指标在模拟“意外”心脏骤停中评估家庭成员的AED技能。将在基线（随机化前）以及3个月和9个月后使用经验证的心理和功能健康调查工具评估家庭成员和患者的心理调整。在最初的6个月里，调查人员将获得审查委员会的批准，最后确定评估和培训资源，并雇用工作人员。在随后的3年中，将招募受试者，并评估基线和结局指标。将在研究的最后12个月内分析数据并编写报告。这项研究有超过80%的能力来检测训练组之间的临床重要差异。虽然这些计划涵盖了从精简到个性化和密集的范围，但每种方法都构成了一种潜在的真实，可推广的AED培训方法。如果训练是增强自我效能和感知控制是上级，更多的培训资源可能需要最大限度地提高健康效益的家庭急救AED计划。或者，如果名义上的视频方法取得了类似的成果，培训工作可以精简，节省大量费用，减少分发和传播的障碍。