COGNITIVE FRAMEWORKS HELP PARAMEDICS PROCESS THE DEATH OF PATIENTS
During the performance of their duties, paramedics encounter several stressful situations. They can handle them thanks to their emotional detachment and the ability to narrow their attention to the priorities of the situation at hand. Experimental psychologists from the Centre of Social and Psychological Sciences SAS (CSPV SAV, v. v. i.) investigated how paramedics manage arrivals on a scene that end in the death of the patient.
The Rallye Rejviz International Medical Rescue Competition provided a suitable space for researching the participants' psychological and communication skills. The research group was thus able to study the decision-making processes and emotions of rescue teams while performing assigned simulated tasks.
"The rescue crew received a report that the resuscitation of a newborn baby at home is in progress. The child had a birth defect incompatible with life, so resuscitation was not successful. The task of the crews was to find out the diagnosis of the child from the medical documentation and then, after the end of the resuscitation, adequately explain to the parents the cause of death and what will happen next," Branislav Uhrecký from the Institute of Experimental Psychology CSPV SAV explains the assignment.
For the emotional processing of trips that end in the death of the patient, experienced paramedics usually have cognitive frameworks that usually contain an accepting or almost fatalistic attitude towards death. The most frequently occurring cognitive framework could be expressed by the sentence: “If I did everything I could do for the patient at that moment and he still died, then his time has come.” But these frameworks do not mean that paramedics absolve themselves of guilt for their misconduct.
"In case of many trips with an unfortunate ending, we move in a grey zone, where possible scenarios can almost always be generated in which the misfortune could have been reversed. However, being overwhelmed by hypothetical ideas would mean for the rescuer that s/he would be at the mercy of feelings of guilt, and so such a way of framing is a necessity for building and maintaining psychological resilience," emphasizes the experimental psychologist.
In this simulated task, in addition to their own emotion regulation strategies, the research team identified several ways in which the crew chiefs regulated parents' emotions. Most of the participants adopted an empathetic attitude and tuned in to the parents´ emotional wavelength. They sympathized with their loss and understood the need for parents to have their own space for grieving and saying goodbye to their child, in which it is better not to interfere.
"When it comes to empathy, a distinction is usually made between cognitive and affective empathy. While cognitive empathy is based on understanding mental states, affective empathy also involves sharing them. Cognitive empathy is more important for health professionals, because emotional empathy can interfere with their concentration on solving the situation or the patient's problems," adds B. Uhrecký.
More information from the study are presented by the research team in a blog.
Edited by Katarína Gáliková
Foto: TASR/Milan Kapusta