Abstract Or111: Using mixed methods to refine a resilience intervention for cardiac arrest survivors and their caregivers, <i>Recovering Together after Cardiac Arrest</i>

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 problem, we are adapting a resilience intervention entitled Recovering Together after Cardiac Arrest ( RT-CA ). Aims: Refine RT-CA by assessing preliminary feasibility, acceptability, signals of improvement, and incorporating participant feedback. Methods: Single-arm feasibility trial of RT-CA with exit interviews between 9/2024-3/2025. We enrolled dyads of consecutively admitted CA survivors from an academic medical center and their family caregivers. Inclusion criteria: adult English speakers; at least one dyad member with emotional distress ( &gt; 8 on either subscale of the Hospital Anxiety and Depression Scale [HADS]); survivors able to meaningfully participate (Short Form Mini Mental State Exam &gt; 5). Procedure: Dyads participated in 6 weekly sessions with a psychologist (in person until discharge) focused on building mindfulness and coping skills. A priori feasibility and acceptability benchmarks were &gt;70% feasibility of recruitment, assessments, adherence, therapist fidelity, satisfaction, credibility, and expectancy. Dyads completed pre- and post-test psychosocial measures and exit interviews to provide feedback and contextualize their quantitative data. We calculated frequencies and proportions of our outcomes, conducted paired t-tests to examine changes in emotional distress, and performed explanatory-sequential mixed methods using a side-by-side joint display to integrate data sources. Results: We enrolled 7 of 8 eligible dyads. RT-CA exceeded all feasibility and acceptability benchmarks except expectancy. Participants experienced clinically meaningful reductions in HADS emotional distress (survivors: M = -10.6 [95% CI: -6.6, -14.6], caregivers: M = -6.6 [95% CI: -6.6, -14.6]). Exit interviews mainly confirmed quantitative outcomes ( Tables 1,2 ); participants attributed strong feasibility and acceptability to 1) staff setting clear expectations of procedures and utility of RT-CA , 2) remote participation after discharge, and 3) skills that reduced stress, improved dyadic coping, and communication. Refinements for future trials include: 1) reducing survey burden and 2) emphasizing utility of the program when dyads return home, and challenges become apparent. Conclusions: Mixed methods confirmed preliminary feasibility of RT-CA and identified refinements to study procedures.