Abstract
Regarding the concept of end-of-life care or end-of-life, many of the previous studies were unable to accurately make a clear definition. However, several authors have attempted to provide a succinct definition of this phrase. These two descriptions appear to be general and ambiguous. It seems tough to come up with an accurate or comprehensive description of end-of-life care. The findings of these studies revealed that there are overlapping perspectives and perceptions about the predicted effects of enabling family-witnessed resuscitation (FWR). The bulk of the research analyzed show that the members of the family would desire to attend cardiopulmonary resuscitation (CPR) for their loved ones. This is one of their rights, according to many of them. The majority of patients thought FWR was convenient and would help the resuscitated patient. Nevertheless, a few patients raised concerns about the effect of this presence on the competence of health personnel, including the impact on the resuscitated patient. In research that deal with the examination of health professionals’ views and opinions about FWR, the results were mixed. Several researches have shown that FWR has significant benefits for family members, patients, and health care providers. However, numerous studies have identified concerns about this presentation, such as the psychological impact on family members, the additional stress that this presence may cause for health professionals, and the potential for legal action in consequence of this presence.
Keywords: End-of-Life Care; Attachment; Death; Grieving; Social Factors
Background to the Study
There is a huge distinction between death occurrences and
believes in the past and that of the present. The level of death
occurrence in the present is increasing compared to the past, and it
is influenced by population increase, globalization, global warming,
internet penetration, and various discoveries. According to Carlet
et al (2004), death is frequently a private, religious or spiritual
event with a group of family members and friends gathered
around the victim. However, as death becomes a topic of public
concern and more technical procedures are introduced to avoid
or facilitate dying, the picture of death is changing [1]. End-of-life
care for families and their patients has been a hot topic for the past
two to three decades. This could be in consequence of a variety of
factors, such as the shifting away from a solely medical perspective
and toward a more holistic approach to caring. [2], for example,
said that the early 1970s saw a transition away from a strictly
biomedical survival perspective and toward a dual perspective.
This includes focusing care on saving lives and enhancing medical
identities, as well as taking care of family members and developing
numerous social identities. Supporting life procedures and modern
technology introduced to the treatment process contribute to
hospitalized patients’ disease becoming more severe [3].
Most significantly, in today’s healthcare environment, families
and their patients expect to be included in the treatment process
as well as in the decision-making process [4]. The majority of the literature fails to define end-of-life or end-of-life care precisely.
However, several authors have attempted to provide a succinct
definition of this phrase. These two descriptions appear to be
general and ambiguous. It seems to be difficult to establish a precise
or comprehensive description of end-of-life care. End-of-life care in
the intensive care unit (ICU) was detailed in detail by Alhalaiqa, et
al. [5]. Alhalaiqa, et al. [5] pointed out that while delivering endof-
life care, there are no set processes or stages to follow, making
it difficult to assess the effectiveness of any end-of-life programs.
However, talking about death and end-of-life care, as well as
having open dialogues about these topics, may contribute to the
development of guidelines for healthcare professionals to provide
high-quality end-of-life care [6]. End-of-life care is also implemented
differently depending on a variety of criteria, including the patients’
conditions and the departments. Cardiopulmonary resuscitation of
victims and their relatives in acute settings is the focus of this study.
Literature Review
Stages of the Crisis at a Duration of Unexpected Death
There are four stages of crisis during a sudden death. They
are recognized and listed in order of difficulty from the least
challenging to the most challenging crisis. If any of these stages
are not addressed, a person may progress from one to a more
challenging one.
First stage: The presence of a threat that could harm patients’
family members is included in the first stage. This threat may cause
stress or tension among the relatives. This stage may entail family
members’ fears that something dangerous has occurred to their
loved one in the case of cardiopulmonary resuscitation (CPR). The
routine coping mechanism, according to Wright (1996), may be able
to settle this stage. Wright also stressed the necessity of previous
experience in minimizing the effect of this stage. Surprisingly, many
studies revealed that most of family members who have previously
watched family-witnessed resuscitation (FWR) wish to be present
again.
Second Stage: Failure to treat persons in this stage may result
in their illness worsening and sending them to the second stage,
according to Wright (1996). The failure of previous experience to
tell people how to deal with this new situation may have resulted
in the second stage. Feelings of helplessness and hopelessness may
intensify throughout this stage. People at this stage, according to
Wright [7,8], try to find alternatives. Wright revealed that relatives
can utilize the trial-and-error method to figure out the most
acceptable response to the situation. Allowing FWR was supposed
to increase death acceptance and assist bereaved families [9]. This
would hasten the grief process and make it easier to accept death
as a natural result of CPR.
Third Stage: Intense activity, disorder, and disarray
characterize the third stage; old fears resurface, preoccupation
with trivia, and make-or-break action are all present. This stage,
according to Wright, might be overcome by changing the focus.
Wagner. Several studies have found that family members prefer
to attend their loved one’s CPR because it allows them to acquire
information more rapidly. This would also lessen family tensions
and reduce the likelihood of inappropriate behavior.
Fourth Stage: The patient’s relatives may be unable to cope
with the situation in the fourth stage, and they may retreat and feel
gloomy. Wright recommended taking various actions to manage this
stage, including addressing the relatives’ comfort requirements,
listening to them without passing judgment, creating a quiet
environment, and taking a break from the problem-solving effort.
These interventions were suggested in the literature as a way to
satisfy the requirements of the patients’ relatives during CPR.
The necessity of treating families as soon as possible would
be highlighted if healthcare providers considered these stages
and recognized each one. This prevents families from progressing
to a more mature level. Individuals do not, however, necessarily
progress through all of these stages. Some people may skip the
early stages and proceed straight to the advanced stages, while
others may adjust to abrupt death and recover swiftly without
experiencing any of the preceding stages. The determinants of grief
and the elements that affect bereaved individuals during sudden
death are discussed in the next section.
Causal Factors of Grieving
In general, there was no systematic study of the elements that would affect families’ reactions and feelings during and after CPR, especially if the CPR resulted in death, in the literature. It might be worthwhile to go over these points again. Several elements were thought to play a role in creating the powerful feelings, reactions, and grief experienced by people who died suddenly. Six elements, according to Wright (1996), have a significant part in deciding how families grieve when a cherished person dies suddenly. These factors include:
a. Manner of Death
The patient’s condition at the time of death should be known
to healthcare personnel. It was generally assumed that natural
(normal) death would cause less grief than unnatural (abnormal)
death. The natural deaths are usually unavoidable, while the
unnatural deaths are usually avoidable. The avoidable deaths are
mostly caused by either human or mechanical faults. Parkes, who
worked as a psychiatrist, noted that all of the bereaved people
he had visited had experienced extremely traumatic kinds of bereavement. It has been stated that healthcare professionals who
deal with CPR in consequence of injuries and accidents are more
rigorous about allowing family members to participate in CPR. The
majority of these health care providers raised serious worries about
the presentation’s potential adverse effects on family members.
Helmer, et al. (2000) revealed that comparing trauma patients
to those with medical disorders is problematic. It would be more
difficult to blame others if the death was caused by natural causes
such as disease, according to Wright (1996). Family members, on
the other hand, may blame healthcare experts, health organizations,
culture, or society, as well as themselves for not being able to
do more than they did. The sadness of losing a loved one will be
magnified if he or she was far away from home or family members,
according to Wright (1996). This demonstrates the importance of
family members being present during CPR.
b. The Identity of that Person (victim)
The depth of the grieving process is influenced by the patient’s status in the family [10]. Wright (1996), on the other hand, cautioned against making assumptions based on this characteristic. For instance, if a breadwinner dies unexpectedly, such person will be mourned for a long time because of the significant position that the person occupied in the family. Furthermore, the loss of one of the parents would have an impact on other susceptible family members’ feelings of stability and safety.
c. Manner of Attachment
The loss of a key individual is usually the most distressing. This can involve the death of someone with whom one has had a close relationship. As a result, the stronger the link between the grieving individual and the deceased person, the more severe the adverse effects on the departed relatives are expected. This, however, is not a rule. A father or a mother, for example, may have various amounts of attachment to their sons. To determine the strength of this relationship, a series of questions should be asked. This includes questions like, “What does this loss represent?” and “What security or safety aspects might be jeopardized in consequence of this loss?” Wright (1996) noted that the provision of answers to the following questions would aid in determining the bereaved person’s level of vulnerability. Another essential aspect of the attachment’s nature is the security and safety difficulties that arise in consequence of the relationship (Wright, 1996). For example, losing a father who is the family’s sole source of money might increase tension among family members.
d. Past Precursor
Wright (1996) emphasizes the importance of previous crisis experience, particularly abrupt death, in coping with the new crisis. When people have a positive experience, Wright says, it helps them cope with the new incident, and vice versa. To put it another way, what one person considers a loss may not be considered a loss by another. It’s possible that being exposed to the crisis will help people build skills and experience in dealing with similar situations in the future. It was discovered that family members with prior FWR experience were more confident in their attitudes during CPR. Furthermore, those who had been exposed to a comparable situation or had died suddenly were more cooperative with medical personnel performing CPR. They also provide assistance and comfort to the other families.
e. Individual Characteristics
Personal qualities have a vital influence in determining how people react when they are dying or receiving CPR. People react to abrupt death in different ways, according to Wright (1996). Wright also discovered that the personality of a patient’s relatives has an impact on how they search for a healthy grieving resolution. Emotional and physical well-being, according to Walsh and Crumbie (2007), provides people with more resources to cope with losses. As a result, healthcare providers should be prepared to cope with people who have a wide range of mental and physical resources for coping with loss, as well as diverse levels of social support. It appears that assessing people’s personalities or evaluating the differences between patients’ families is challenging during CPR. It appears critical to emphasize that not only personal traits influence people’s reactions, but also other elements such as family preparation, healthcare preparation, and environmental preparation. Family members should, for example, be accompanied by trained staff during CPR [11], and they should be given a suitable location to sit and observe the treatment [11].
f. Social, Cultural and Religious Factors
When people lose a loved one, social, cultural, and religious
variables may have a big impact on their feelings and reactions
[12]. The availability of social assistance would help to mitigate the
crises’ impact on patients’ families. In a survey done by Al-hassan
and Hweidi (2004), relatives of Jordanian patients rated their need
for assistance as the lowest. Jordanians, it was revealed, rely on
other family and friends for the majority of their support. Jordanian
people in critical care units were assessed in this study, which was
conducted in Jordan. However, the goal of this study was to look at
the needs of critically sick patients’ families, not their needs at the
time of death.
Some religions and cultures, according to Wright (1996), assist
the bereaved by providing support and confirmation of their worth.
Some religions, such as Christianity, are commonly thought to be
helpful and supportive in the event of a sudden death, according
to Wright. Jordanians’ opinions and behavior on matters such as
health and death are heavily influenced by religion and culture. People in Jordan, for example, rely on their relatives for financial
and psychological support rather than relying on other resources
such as hospital professionals. As a result, Jordanian patients
frequently have a significant number of visitors. The task of
healthcare professionals is made more difficult by the fact that they
must deal with a huge number of visitors.
In conclusion, these six criteria appear to be critical to consider
when devising any remedy to lessen the harshness of the grieving
process. Understanding these characteristics will aid healthcare
providers in identifying the issues that patients may need to
address in order to begin the grieving process. The following
discussion looks at a suitable plan for treating bereaved family
members appropriately.
Dealing with Bereaved Relatives at the Time of Sudden Death and During CPR
In the work of literatures, there is no mention of FWR in
relation to end-of-life care. According to Kubler-Ross, grievers go
through five stages (1969). Denial or a sense of isolation may be
felt by grievers at first. This means that grievers may say things
like “don’t say that” or “no, he didn’t die” to indicate their disbelief.
Wright (1996) suggested a number of methods for coping with this
emotion, including finding a polite way to inform family members of
the bad news. According to Davidhizar and Newman-Eiger, nurses,
on the other hand, should comprehend the value of denial (1998).
They claimed that denial is one of the safest strategies to deal with
the unfathomable.
Second, grievers may have a sense of rage. They might
start saying things like ‘why me?’ or ‘why now?’ as a form of
protest. Kubler-Ross warned that grievers might start blaming
the healthcare experts for the lack of justice. Nurses and other
professionals may take this personally (Wright, 1996). Bereaved
people may begin haggling with healthcare providers. They might
try to put off the inevitable. Healthcare practitioners, according
to Wright (1996), should accept this and endeavor to reach an
agreement with grievers to prove the death. Bereaved people
may experience depression. When grievers can no longer deny or
relocate, they enter this stage.
Grievers may experience feelings of sadness and crying at this
stage as they begin to recognize reality. Withdrawal, stillness, and
helplessness may be observed by bereaved people. As grievers
reach the acceptance stage, they stop striving to ignore or avert the
unavoidable death. Grievers begin to comprehend the concept of
death at this point, and they begin to relax and feel at ease. Research
by Brysiewicz, et al. [13] employed a semi-structured interviews
to examine the ED healthcare personnel’ capability to handle the
situation of sudden death. The study reacted to findings of previous
studies that was conducted by Brysiewicz [14]. A model was
created to give healthcare personnel guidance on how to cope with
unexpectedly bereaved families before, during, and after death.
This approach instructs healthcare providers on how to cope
with family members while performing CPR. This would also
make it easier for families to accept their loved one’s death. Before
the happiness of death, the first half of this paradigm includes
instructions for dealing with bereaved families. This comprises
implementing two ways to improve the department’s performance,
as well as enhancing the department’s culture and guaranteeing
enough resources. The model’s second section contains suggestions
for coping with bereaved relatives after they have died. This involves
making the caring process more efficient. Three ways are expected
to do this. Proximity, sensitive communication, and sensitive deathtelling
are the three.
The model’s final piece includes advice for dealing with bereaved
families when a loved one has passed away. This entails giving
family members the best possible support. It was recommended
that two approaches be taken. Assisting and supporting medical
professionals, as well as assisting mourning families, are among
these responsibilities. Once this paradigm was established, ED
professionals’ capacity to communicate with families at the time of
a loved one’s death was stated to improve [13]. Data from a prior
study was used to develop this model. The use of qualitative design
allows researchers to gain valuable insight into the perspectives and
recommendations of families and healthcare providers. However,
because of the small size of the original study’s sample and the fact
that the data was taken from a single institution, the findings are
limited in their generalizability. This model was implemented in ED.
The current study, on the other hand, adopts a different approach.
Regarding the effects as influenced by technology, the majority
of studies and reviews focused on FWR in emergency departments,
according to a review of the literature. The current study, on the
other hand, is concerned with the views of healthcare workers and
family members in adult critical care settings. As a result, it appears
that some light should be shed on nature and the characteristics of
the critical care environment. In terms of the rate of CPR, patient
conditions, and work environment, Demir [15] highlighted that
there are certain distinctions between the ED and critical care units.
Critical care units (CCUs) are specialized units for patients with lifethreatening
illnesses [16]. During the care of a critically ill patient,
healthcare workers are expected to face numerous physiological
and psychological problems.
Furthermore, critical care specialists are increasingly expected
to provide psychological and emotional support to the families
of critically sick patients [17]. Critical care workers, according
to Offord [18], are expected to deal with dying patients and
bereaved relatives more than experts in other departments [19]. The conditions of patients in critical care units differ from those
in other departments. In critical care settings, CPR is a regular
technique. Hadders [20] found that ICU clinicians are frequently
unsure regarding the resuscitation results of their patients.
According to Hadders, individuals who receive CPR either survive
or recover completely. After CPR, most survivors rely on machines
and technology to keep them alive. According to Benner, et al. [17],
the necessity of providing psychological and emotional care for
patients and their relatives in critical care settings is undervalued.
More than anything else, this was intended to result from a focus on
the patient’s biological demands. It should be noted, however, that
the presence of a family member in one of the critical care units will
upset established family roles and will frequently throw a family
into disarray [21].
Moving forward, a number of studies have demonstrated the
necessity of assisting critically ill patients’ families and include
them in patient care [22]. The critical care environment differs
from other hospital departments in that it typically contains
skilled healthcare staff as well as advanced technology [16]. In
these situations, multiple machines and monitors must be present
surrounding each patient. Professionals encounter a number of
obstacles in this context. Medical experts had to learn how to use all
of the new machines and technologies to begin with [16]. Dealing
with technology should not prevent healthcare workers from
considering other patients’ and family members’ psychological
needs [16]. Sundin-Huard (2005) noted that critical care personnel
are frequently obsessed with their patients’ immediate physical and
technological needs [23]. To ensure patient survival, technology
should be employed to provide maximal patient benefit while also
considering the needs of other patients and their families [16].
Mosenthal, et al. [10] noted that people are increasingly
seeking death dignity without unnecessary using life-prolonging
gadgets, but they equally value high technology’s promise of
cure and spectacular lifesaving measures. As a result, it appears
that providing technical assistance to critically sick patients and
their families, as well as describing the role of each machine in
the patient’s environment is enhanced. In a critical care setting,
Hadders [20] explained how critically ill patients and their families
felt about being reliant on technology. FWR has been reported to
be more acceptable in the ED than in critical care settings in the
literature. According to Bennun [16], critical care specialists place
a greater emphasis on technology than on providing psychosocial
treatment to patients and their families.
Because critical care specialists are so focused on technology,
they overlook other parts of care, such as family-centered care [24].
This was also assumed to be the reason why critical care workers
resisted allowing family members to participate in treatments
like CPR [25]. The current investigation takes place in a critical
care setting. The majority of the literature, however, is based on
evidence from ED settings. As a result, it appears that the findings
of these investigations must be taken into account. However, the
mind should be awakened to consider the contrasts between the
emergency department and critical care settings.
Empirical Review
Mcmahon-Parkes et al. (2009) examined the opinions of
patients who survived CPR and those who were not resuscitated.
Patients were indifferent about compromising confidentiality in
consequence of FWR, according to the researchers. Redley, et al.
[26] noted that the ethical principles surrounding FWR should
be further discussed. The importance of a qualitative approach
in studying FWR would provide a broader perspective on these
principles and their impact on healthcare professionals’ and
families’ perceptions. Several questions must be answered, such as
“who is the person that will be authorized to witness CPR?’ How
many people should be present while CPR is performed?’ How
about the other family members? Who will look after them? Would
additional relatives be willing to stay outside the resuscitation
room with you?” All of these questions should be addressed with
consideration for the culture of the responders.
A qualitative approach would reveal more information about
what family members wish to accomplish while in the resuscitation
chamber. Allowing FWR, for example, could affect the public’s trust
in the medical profession, according to Rosenczweig [27]. However,
the manner in which this would occur was not specified. Other
topics are expected to be examined more if a qualitative approach
is used. Fulbrook, et al. [11] stressed the importance of recognizing
the differences in healthcare systems between countries, which can
have an impact on outcomes. In addition, it was identified that the
role of self-assurance in accepting or rejecting FWR be investigated
[28-30]. They found that nurses’ opinions toward FWR are
unaffected by previous experience with the procedure. This finding
differs from that of other studies, which found a link between a
lack of experience with FWR and unfavorable or doubtful attitudes
[31,32]. Fulbrook, et al. [11] advocated for more research into the
aspects that influence how people make decisions about the FWR.
Many studies about FWR were evaluated by Redley, et al. [26]. They
claimed that FWR might infringe on a patient’s privacy. Because
there is a scarcity of information about ethical principles from the
perspective of patients, these principles may be questioned.
Ardley, et al. [9,33-36] discovered that the majority of the
research used quantitative designs. These findings are consistent
with other studies that analyzed numerous empirical investigations
on FWR. However, it is agreed that this is insufficient rationale for
choosing a qualitative approach. As a result, other flaws in using
a quantitative technique to examine FWR should be identified. In
general, quantitative research is thought to be reductionist [37]. This means that using a quantitative approach will leave some
variables unaddressed. As a result, using a qualitative method
should provide a more holistic view of the subject under inquiry
[38,39]. Fulbrook, et al. [11] investigated the opinions of European
Nurses that are saddled with the responsibilities of critical care
concerning FWR. Furthermore, some researchers acknowledged
the influence of culture and religion on people’s opinions toward
FWR [40-42]. These topics, in contrast require further investigation
and debate. To do this, healthcare professionals and the general
public must be encouraged to engage in open debate and free
discussion on FWR [43,44]. Most of the above problems could be
explained by using a qualitative design.
Specific Literature Review on FWR and Research Gaps
In the study of Axelsson, et al. [45], six studies were undertaken
in the United States, four in the United Kingdom, one in Australia,
and one in Sweden. Alhalaiqaa, et al. [46] identified that only two
studies were conducted from a Western point of view, and that all
these studies may not have considered the views of emergency
situation professionals. Also, none of them were conducted in
Africa, and none of them supported FWR. However, cultural
differences are expected to emerge inside Western countries as
well [47]. Fulbrook, et al. [11] examined the attitudes of critical care
nurses concerning FWR in Europe. In their studies, they noticed
that there were certain differences between British nurses and
nurses from other European countries. Walker [36] noted that the
global movement to study FWR should focus on cultural differences
not only between nations, but also inside the local and national
healthcare systems.
Davidson, et al. [23] also noted that the impact of spiritual and
religious beliefs on patients’ healthcare decisions has not been
extensively investigated in the works of literature. This also implies
that the impact of religion on people’s opinions toward FWR was
not sufficiently examined in literature. According to MacKenzie, et
al. [48], highly religious and spiritual people believe in prayer and
divine intervention to promote health, but they also seek healing
and care from healthcare experts. According to Davidson, et al. [23],
the severity of the illness has an impact on the patients’ motivation
to care spiritually and religiously. One of the most critical situations
is CPR. Furthermore, Ong, et al. [40] conducted four studies in
Turkey, and two studies in Singapore. Five of the studies looked
at healthcare workers. Similarly, in all of these investigations,
the majority of healthcare professionals were opposed to FWR.
In a unique Asian study, roughly 73 percent of family members
preferred FWR and believed it would help them cope with their
bereavement [28,47]. It’s crucial to note that all the six research
employed a survey research design.
This may impede your ability to achieve a wider understanding
of the issue. This could also explain why there isn’t much evidence
about the impact of religion and culture on FWR in this research.
More crucially, the majority of these research either used a survey
that had already been used in a Western study or created their own
survey questionnaire based on existing literature. This may limit
the ability to attribute negative sentiments about FWR to specific
cultural or religious factors. Four of the six studies listed above
were conducted in Turkey. The majority of Turks are Muslims, as
is well known. Turkey has closer connections with Arab countries.
Some of this research suggested that religion and culture play a
role in influencing healthcare professionals’ opinions toward FWR.
However, none of this research looked into these difficulties in
depth.
For example, Badir, et al. [41] and Demir [42] suggested that
cultural and theological factors could explain the disparity in
attitudes between Turkish healthcare workers and their Western
counterparts. However, the word “cultural differences” is used
here in a broad sense without specifying what kind of cultural
differences are being discussed. Nurses and doctors are likely to be
opposed to FWR because they are afraid of being harmed by family
members, particularly if the patient dyes [42,48]. Demir suggested
that further research be done on the impact of cultural problems
on people’s attitudes toward FWR. Nigeria and Turkey do share
significant parallels, particularly in terms of the majority of their
populations being Muslims.
There are, nevertheless, some distinctions between the two
countries. In Turkey, for example, the general system is secular. At
this time, the Turkish people follow the Western countries in that
they distinguish between religion and other parts of life. In Nigeria,
however, the situation is somewhat different. The Nigerian people
incorporate religion into every area of their lives, though Nigeria’s
medical industry is not regulated based on the derivatives of Islamic
religion. But there are some believes that shapes the mentality of
Nigerian Muslims; for instance, they believe that life is a divine trust
and Islam does not allow a person to die voluntarily [7,49]. This
implies that in Muslim countries, orders like “do not resuscitate”
(DNR) are controversial.
Sharp and Frederick (1989) observed that since 1998, all US
acute and chronic care hospitals have been required to establish
policies that affirm the patient’s right to determine DNR orders.
The United Kingdom and Australia have issued similar policies
[50]. In Muslim countries, the situation is considerably different.
The DNR order is incompatible with Islam’s principles [51,31,32].
Stopping supportive therapies when a patient is terminally or
seriously sick is a contentious issue [46,52]. It may be claimed
that family members would request to observe CPR in order to
ensure that their loved one receives the finest possible treatment
and that everything possible is done for them. All of the foregoing
arguments illustrate that Western and Nigerian cultures have some cultural differences. It was also emphasized that there is a need to
considering culture and religion while making healthcare decisions.
An examination of the literature also suggests that other factors
may influence people’s perceptions toward FWR are education,
training, and experience [53-60].
In the literature, the social dimension has also gotten a lot
of attention. FWR implementation demands enough resources
as well as a set budget. As a result, the economic component
must be considered when starting any FWR endeavor [61-70].
Furthermore, this study will be place in critical care facilities with
high-tech environs. It is important to think about how modern
technology will affect healthcare practitioners and their families.
To take into account all of the preceding aspects, in addition to the
fact that this study is unique in Nigeria, a conceptual or theoretical
framework is required to better explain the function of all of these
factors in forming people’s opinions toward FWR. While looking for
nursing theories, it was discovered that Leininger’s cultural care
theory might address all of these concerns. Furthermore, applying
this theory is supposed to demonstrate the distinctions between
Western and Nigerian cultures. This would aid in obtaining
the advantages of the existing literature. At the same time, this
hypothesis will not overlook Nigerian’s unique characteristics [71-
73].
Conclusion
Despite the fact that much has been published on FWR, it remains a difficult, debatable, and diverse topic. The findings of the earlier studies showed that there are overlapping ideas and perceptions about the predicted outcomes of allowing FWR. The bulk of these research revealed that family members would desire to attend CPR for their loved ones. The majority of patients thought FWR was convenient and would help the resuscitated patient. Nonetheless, a few patients raised concerns about the impact of this presence on the competence of health personnel, and also on the impact on the resuscitated patient. In researches that concerned the examination of health professionals’ views and opinions about FWR, the results were usually mixed. Several researches have shown that FWR has significant benefits for family members, patients, and health care workers. However, numerous studies have identified concerns about this presentation, such as the psychological impact on family members, the additional stress that this presence may cause for health professionals, and the potential for legal action in consequence of this presence.
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