Is it beneficial to allow the patient's family to attend cardiac resuscitation: Different cultural perspectives? A scoping review

Background: Family presence during resuscitation (FPDR) is a controversial issue that remains unresolved in contemporary practice. Although there are many research studies on FPDR and several published statements and guidelines supporting FPDR by international organizations, no conclusive position guides clinicians in making a decision. A scoping review was conducted to discuss the different healthcare professionals (HCPs) and cultural perspectives toward family presence during CPR is conducted. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, we screened 797 studies published between 2000 and 2022 from the databases including Springer Link, MEDLINE, Pro-Quest Central, CINAHL Plus, and Google Scholar. All articles were filtered using inclusion criteria to eliminate redundant, irrelevant, and unnecessary content. Results: A total of 34 studies that fulfill the eligibility criteria reported that there are multiple perspectives from HCPs and families about FPDR. HCPs felt that their performance had improved during resuscitation and received family support in breaking the bad news of death. Family relatives who attended cardiopulmonary resuscitation (CPR) had less stress, less anxiety, more positive grieving behavior, and enhanced family members’ decision-making. Contrastingly, some HCPs were against FPDR because they were concerned about the family's misinterpretation of resuscitation activities, psychological trauma to the family members, increased stress levels among staff, and worry about an unexpected response from the distressed family. Conclusions: It is important to consider the culture and awareness of families when deciding on FPDR. It is the responsibility of HCPs to assess family members’ willingness and the benefits they attain from attending CPR. The decision should be based on the given situation, cultural context and beliefs, and current policy to guide practice.