title: Survivors' quality of life after cardiopulmonary resuscitation: an integrative review of the literature.
abstract: BACKGROUND
  The incidence of cardiac arrest and cardiopulmonary resuscitation continues to increase worldwide largely due to greater awareness of the symptoms of cardiac events and increased attention to cardiopulmonary resuscitation training in the community. Globally, predicted survival rates after cardiopulmonary resuscitation have remained at 10% for decades and although patient outcome remains unpredictable, there is a positive trend in life expectancy. For a resuscitation attempt to be classed as successful, not only survival but also quality of life has to be evaluated.
  
  
  OBJECTIVE
  The aim of this review was to examine literature that explores the quality of life (QOL) for survivors' after CPR and the influence cognitive impairment, anxiety, depression and post-traumatic stress disorder (PTSD) has had on their QOL.
  
  
  METHODS
  This review follows Whittemore and Knafl's framework for an integrative literature review. Electronic databases EBSCO, Ovid, PubMed and EMBASE were searched. After application of the inclusion and exclusion criteria, thirty-six papers published from January 2000 to June 2015 were included in this review.
  
  
  RESULTS
  These papers represent a broad spectrum of research evaluating quality of life for survivors of cardiopulmonary resuscitation. The heterogeneous research methods and vast number of different research tools make it challenging to compare the findings. The majority of papers concluded that quality of life for survivors of cardiac arrest and cardiopulmonary resuscitation was generally acceptable. However, studies also described survivors' experience of anxiety, depression, post-traumatic stress and cognitive dysfunction.
  
  
  CONCLUSIONS
  A majority of papers reported an acceptable quality of life if the patient survived to hospital discharge. The heterogeneity in quantitative papers was noticeable and indicates a marked variance in patient outcomes. This review highlights the absence of specialized tools used to investigate survivors' experience of the event. Further exploration of the impact cardiopulmonary resuscitation has on the individual may improve ongoing rehabilitation and quality of life levels for survivors.
authors.affiliation: Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Gunilla
authors.identifier: http://orcid.org/0000-0002-9245-8363
authors.initials: G
authors.lastname: Haydon
authors.affiliation: Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Pamela
authors.initials: P
authors.lastname: van der Riet
authors.affiliation: Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Maguire
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000523:psychology*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology*
keywords: cardiac arrest; cardiopulmonary resuscitation; experience; integrative literature review; quality of life; sudden cardiac death; survivor