Recovery after Cardiac Arrest: The Brain is the Heart of the Matter

van Til, J. A. (Examiner)

Activity: Examination

Description

Bachelor thesis Lois Folkert Lieneke Klaver

Period	1 Feb 2021 → 6 Jul 2021
Examinee	Lois Klaver & Lieneke Klaver
Examination held at	Health Sciences
Degree of Recognition	International

Documents & Links

Background: Over the past decades survival after out-of-hospital cardiac arrest (OHCA) has improved. However, neurological outcome after OHCA has improved only marginally. About half of the survivors of an OHCA suffer from long-term cognitive impairments. These impairments can have a serious impact on daily functioning, societal participation, and quality of life. Despite recommendations of recent literature and the Dutch and European guidelines, cognitive impairments are addressed infrequently and not systematically after cardiac arrest. Therefore, this research aimed to identify barriers and facilitators for implementation of systematic cognitive screening and rehabilitation in cardiac rehabilitation programs for patients after an OHCA in the Netherlands. Methods: Sixteen semi-structured stakeholder interviews were conducted. Eleven healthcare professionals, two managers, three policy makers, and one health insurer were interviewed. The Tailored Implementation in Chronic Diseases (TICD) checklist was used to guide the data collection and analysis. Based on the emphasis, the expected impact, and frequency of codes the most relevant factors were determined. Results: Barriers towards implementation are lack of practical instruction in the current cardiac rehabilitation guideline, lack of evidence supporting the intervention for inclusion, lack of awareness and knowledge about cognitive consequences, and lack of structural cooperation. The factors that facilitate implementation are compatibility, availability of local protocols and a positive attitude towards the intervention. Conclusion: To solve the main barrier lack of evidence, we recommend performing research at hospitals where the intervention is already implemented. This will also facilitate the inclusion of a practical instruction in the guideline cardiac rehabilitation. In addition, the lack of awareness and knowledge can be overcome by training. The last main barrier about structural cooperation can be improved by a multidisciplinary consultation.