Psychological and Cognitive Support after Cardiac Arrest: a Systematic Review

Abstract

Background: Adult survivors of cardiac arrest (CA) with favourable neurological recovery often experience persistent cognitive and psychological difficulties that impact quality of life and functional independence. However, post-discharge interventions remain heterogeneous, and evidence to support the prioritisation and implementation of specific cognitive and psychological interventions is limited. Objective: To systematically review the evidence on psychological and cognitive support interventions delivered after hospital discharge in adult CA survivors with good neurological recovery. Methods: A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO CRD420251267160). Eligible studies included adults surviving CA with favourable neurological recovery who received structured post-discharge interventions. Outcomes were assessed across multiple domains, including psychological well-being; cognitive performance; functional status and participation; health-related and global quality of life; and feasibility and implementation. Results: Six studies (n=352 survivors) were included: two randomized controlled trials, two feasibility/pre-post studies, one single-case experimental design, and one process evaluation. Interventions varied in content and delivery (face-to-face, remote, home-based) and included nurse-led follow-up, psychotherapy, cognitive rehabilitation, and mindfulness-based strategies. Small improvements were observed in anxiety, depression, post-traumatic stress symptoms, and selected health-related quality-of-life domains, whereas cognitive, functional, and participation in daily and social activities showed limited or short-term gains in small uncontrolled studies. Interventions were feasible and well-tolerated. Conclusions: Post-discharge psychological and cognitive interventions are feasible and associated with modest improvements in psychological well-being and selected quality-of-life domains. Further rigorous research using standardised outcomes is needed.