Home Automatic external Defibrillator Training

描述(申请人提供)：院外心脏骤停构成了一个重大的公共卫生挑战，每年导致美国数十万人死亡。家庭响应器计划为心脏骤停高危患者的家庭成员配备自动体外除颤器(AED)并进行培训，是降低死亡率的创新方法。虽然是救命的，但AED的成功运作需要具备技术技能。此外，考虑到心脏骤停的极端情况，AED可能会增强或削弱患者和/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，结合自我效能感和知觉控制原则的AED培训方法可能会有利地影响技能保持和心理状态。为了验证这一假设，300名(组)心脏骤停高危患者及其家人将被随机分配到四个AED培训计划中的一个：1)教学视频，2)自我效能视频，3)自我效能面授，4)自我效能面授和自我控制。具体目的是确定哪个AED培训计划在心脏病患者及其家庭成员中实现最佳的技能保留和心理调整。患者和家属将在出院后不久登记为急性冠脉综合征患者。家庭成员的AED技能将在登记后9个月的模拟“意外”心脏骤停中使用有效的技能测量进行评估。家庭成员和患者的心理适应将在基线(随机之前)以及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个月内，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。在接下来的三年里，将对受试者进行登记，并对基线和结果衡量标准进行评估。在研究的最后12个月期间，将对数据进行分析并撰写报告。这项研究有超过80%的能力来检测训练组之间临床上重要的差异。虽然这些计划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一种潜在的、可推广的AED培训方法。如果在自我效能感和控制感方面得到加强的培训更好，则可能需要更多的培训资源，以最大限度地发挥家庭响应者AED计划的健康益处。或者，如果名义上以视频为基础的方法取得了类似的结果，则可以简化培训工作，节省大量费用，减少传播和传播的障碍。

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.