Aim

Cardiac arrest survivors are at risk of long-term cognitive impairment. Patients with cognitive impairments do not always have cognitive complaints and vice versa. Not reporting cognitive complaints could be caused by a lack of awareness. We hypothesized that caregivers report more cognitive failures than patients, indicating patients’ lack of insight into cognitive functioning.

Methods

This is a secondary analysis of the Activity and Life After Survival of Cardiac Arrest study on survivors of cardiac arrest and their caregivers. They were assessed at two weeks, three months, and one year after cardiac arrest. At each time point, the patient and the caregiver filled out the cognitive failure questionnaire (CFQ) regarding the patient. We analysed the correlation, intraclass correlation, and self-proxy discrepancy between patients and caregivers on the CFQ over time.

Results

One-hundred-and-nineteen cardiac arrest survivors (mean age = 60, 85 % male) and their caregivers were included. The CFQ scores of the patients and caregivers were equally low. The correlation (T1 r = 0.31; T2 r = 0.40; T3 r = 0.55) and intraclass correlation (T1 r = 0.48; T2 r = 0.56; T3 r = 0.71) between patient and caregiver increased over time.

Conclusion

This study does not support a lack of awareness of cognitive impairments by long-term cardiac arrest survivors. Future research may focus on alternative explanations for why patients have less cognitive complaints than expected based on the frequency of cognitive impairments. Possible explanations include a response shift.

中文翻译：

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改变观点？关于为什么患者在心脏骤停后可能不会主观报告认知障碍的探索性研究

目的

心脏骤停幸存者面临长期认知障碍的风险。患有认知障碍的患者并不总是有认知问题，反之亦然。不报告认知问题可能是由于缺乏意识造成的。我们假设护理人员比患者报告更多的认知失败，这表明患者缺乏对认知功能的了解。

方法

这是对心脏骤停幸存者及其护理人员的心脏骤停生存后活动和生活研究的二次分析。他们在心脏骤停后两周、三个月和一年进行评估。在每个时间点，患者和护理人员填写有关患者的认知失败问卷（CFQ）。我们分析了随着时间的推移，患者和护理人员在 CFQ 上的相关性、组内相关性和自我代理差异。

结果

119 名心脏骤停幸存者（平均年龄 = 60 岁，85% 为男性）及其照顾者被纳入其中。患者和护理人员的 CFQ 评分同样低。患者和护理人员之间的相关性（T1 r = 0.31；T2 r = 0.40；T3 r = 0.55）和组内相关性（T1 r = 0.48；T2 r = 0.56；T3 r = 0.71）随着时间的推移而增加。

结论

这项研究并不支持长期心脏骤停幸存者缺乏对认知障碍的认识。未来的研究可能会集中于基于认知障碍频率的替代解释，解释为什么患者的认知抱怨比预期的要少。可能的解释包括反应转变。