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Randomized Controlled Trial
. 2013 Apr 22:13:8.
doi: 10.1186/1471-227X-13-8.

Impact of a stress coping strategy on perceived stress levels and performance during a simulated cardiopulmonary resuscitation: a randomized controlled trial

Sabina Hunziker  1 , Simona Pagani, Katrin Fasler, Franziska Tschan, Norbert K Semmer, Stephan Marsch
Affiliations
Randomized Controlled Trial

Impact of a stress coping strategy on perceived stress levels and performance during a simulated cardiopulmonary resuscitation: a randomized controlled trial

Sabina Hunziker et al. BMC Emerg Med. .

Abstract

Background: Cardiopulmonary resuscitation (CPR) causes significant stress for the rescuers which may cause deficiencies in attention and increase distractibility. This may lead to misjudgements of priorities and delays in CPR performance, which may further increase mental stress (vicious cycle). This study assessed the impact of a task-focusing strategy on perceived stress levels and performance during a simulated CPR scenario.

Methods: This prospective, randomized-controlled trial was conducted at the simulator-center of the University Hospital Basel, Switzerland. A total of 124 volunteer medical students were randomized to receive a 10 minute instruction to cope with stress by loudly posing two task-focusing questions ("what is the patient's condition?", "what immediate action is needed?") when feeling overwhelmed by stress (intervention group) or a control group. The primary outcome was the perceived levels of stress and feeling overwhelmed (stress/overload); secondary outcomes were hands-on time, time to start CPR and number of leadership statements.

Results: Participants in the intervention group reported significantly less stress/overload levels compared to the control group (mean difference: -0.6 (95% CI -1.3, -0.1), p=0.04). Higher stress/overload was associated with less hands-on time. Leadership statements did not differ between groups, but the number of leadership statements did relate to performance. Hands-on time was longer in the intervention- group, but the difference was not statistically significant (difference 5.5 (95% CI -3.1, 14.2), p=0.2); there were no differences in time to start CPR (difference -1.4 (95% CI -8.4, 5.7), p=0.71).

Conclusions: A brief stress-coping strategy moderately decreased perceived stress without significantly affecting performance in a simulated CPR. Further studies should investigate more intense interventions for reducing stress.

Trial registration: NCT01645566.

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Figures

Figure 1
Figure 1
Flow chart of randomisation groups. N denotes number of participants.
Figure 2
Figure 2
Overall stress/overload at different time points during the CPR scenario. Median lines are depicted; boxes represent the 25th to 75th percentile range and whiskers represent 5th and 95th percentiles.
Figure 3
Figure 3
Effect of intervention on hands-on time in different subgroups. Coefficient relates to results of linear regression analysis including interaction terms for each subgroup. CI denotes confidence interval. Numbers refer to seconds of hands-on time within the first 120 seconds.
See this image and copyright information in PMC

References

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