Single-arm feasibility trial of a resilience intervention for cardiac arrest survivors and their family caregivers, Recovering Together after Cardiac Arrest.

Abstract

BACKGROUND: Emotional distress is common in cardiac arrest (CA) survivors and their family caregivers and undermines long-term health and quality of life. To address this, we adapted a resilience intervention for survivors and their caregivers, entitled Recovering Together after Cardiac Arrest (RT-CA). METHODS: We conducted a single-arm feasibility trial of RT-CA between 09/2024-03/2025. We enrolled dyads of consecutively admitted CA survivors at Massachusetts General Hospital and their primary family caregivers. INCLUSION CRITERIA: adult English speakers, survivors must have ability to meaningfully participate (Short Form Mini Mental State Exam ≥5), one dyad member must have emotional distress (≥8 on either subscale of the Hospital Anxiety and Depression Scale [HADS]). PROCEDURE: Dyads participated in six weekly sessions with a clinical psychologist focused on building mindfulness and coping skills. Feasibility outcomes were feasibility of recruitment, assessments, adherence; acceptability outcomes were satisfaction, credibility, expectancy. Dyads completed pre- and post-test psychosocial measures and participated in exit interviews. We calculated frequencies and proportions of our outcomes, conducted exploratory paired t-tests to examine initial signals of changes in psychosocial measures, and performed explanatory-sequential mixed methods to integrate data sources. RESULTS: We screened 12 dyads and enrolled 7. RT-CA exceeded most feasibility and acceptability benchmarks (>70 % on 7 of 8). In exploratory analyses, participants experienced preliminary, yet meaningful reductions in emotional distress (HADS anxiety survivors: mean [95 % CI] = -5.4 [-3.4, -7.5], p < 0.001; depression survivors = -5.1 [-2.2, -8], p < 0.01; anxiety caregivers = -3.1 [-0.8, -5.5], p < 0.05; depression caregivers = -3.5 [-8, 1.1], p > 0.05). Mixed-methods analysis indicated general concordance between quantitative and qualitative data. CONCLUSION: Results support preliminary feasibility of RT-CA. Further testing in a randomized controlled trial is now required. TRIAL REGISTRATION: Clinicaltrials.gov #NCT06517394.