Final Quali .. 1

DR. YANGA’S COLLEGES, INC.
Life Restarted: Lived Experiences of Post-Cardiac Arrest Patients Who have been Resuscitated Multiple
Times
Life Restarted: Lived Experiences of Post-Cardiac Arrest Patients Who Have Been
Resuscitated Multiple Times
A Thesis Study Presented to the Faculty Members of

College of Health Sciences,
Dr. Yanga’s Colleges, Inc.,
In Partial Fulfilment of the Requirements

For the degree of Bachelor of Science in Nursing
Ballesteros, Ma. Ayla B.
Bernabe, Cheska Marie P.
Doria, Lailani Kim C.
Gravador, Janelle G.
Lardero, Crisan Joy S.
October 2018
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ACKNOWLEDGEMENT
In this point, the researchers would like to show and reflect their deepest gratitude
to the people who have helped in the success of this study.
OUR FAMILIES for being the most supportive people in times of need and
uncertainty. Also, who continued to be understanding regardless of the circumstances of
the situation.
PROF. REGIE DE JESUS who have been enthusiastic and considerate in giving
advises and suggestions for the betterment of the paper.
THE INFORMANTS for being cooperative and persevered to be part of the
study. Moreover, their honesty and transparency are very much appreciated.
ANA MAY S. CANCINO for lending her knowledge in editing the paper in
order to be more comprehensive for the readers.
GOD in foreseeing the success and the struggles of the study. Providing strength
and wisdom in order to achieve the goal of the researchers.

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ABSTRACT
Cardiac arrest is the sudden stopping of the heart from beating due to electrical
malfunctions. One of the main management for this condition is CardioPulmonary
Resuscitation which consists of chest compressions and providing oxygenation through
the mouth. Unfortunately, poor prognosis of this condition had been the most common
cause of death in the Philippines and as well as the low survival rate for CPR. Survivors
may suffer from different draw backs of this condition. Thus, these difficulties may affect
the patients in a variety of aspects. Emphasizing in this study, are the experiences of
survivors who have agonised through the same management and condition repeatedly.
The similarities, differences and change in severities or improvements with regards to the
level of their health. Setting-up criteria for gathering samples through purposive sampling
method, informants are screened and selected. Information are collected by conducting
interviews with the informants using guide questions and personal assessments of the
interviewer and researchers without implying any ideas to the informants. This semi-
structured interview has been the main instrument in collecting and elaborating the
experiences of the informants. Moreover, in order to secure a valid and reliable data the
informants are only required to provide first-hand data.Experiences from the informants
are compared from their first times and after multiple resuscitations. Thus, this study has
revealed that informants have more serious complications rather than those who had been
resuscitated once. In addition to this, efforts exerted by the informants to regain, improve
and maintain their levels of health especially the health of their heart are much more
compared to those first timers. Moreover, the informants were not just affected physically
by the changes but also psychologically. Due to the differences in coping and adaptation
some had positive realizations like valuing their life more and living life better but others
have been more depressed due to the incapacity to perform old duties. This study have
revealed and concluded that with multiple resuscitations in a single individual, this can
affect them in all aspects of their life. Incapacitation can lead to depressions and anxiety.
Also, the more the condition reoccur the draw backs are getting more severe making the
survivors feel depressed and anxious. The domino effect of their condition on how a
single aspect has affected other portions of their being are elaborated and observed as
well as their coping to each difficulty.
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TABLE OF CONTENTS
Title Page………………………………………………………………………….i
Approval Sheet…………………………………………………………………….ii
Certificate of Originality……………………………………………………………iii
Acknowledgement…………………………………………………………………..iv
Abstract………………………………………………………………………………v
Table of Contents……………………………………………………………………..vi
List of Tables………………………………………………………………………… vii
List of Figures……………………………………………………………………….. viii
Chapter I: THE PROBLEM AND ITS BACKGROUND
Introduction…………………………………………………………………….. 4
Theoretical Framework…………………………………………………………..6
Statement of the Problem………………………………………………………..11
Assumption …………………………………………………………………..…11
Scope and Limitation……………………………………………………………11

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Significance of the study……………………………………………………..…12
Definition of Terms…..........................................................................................13
Review of Related Literature and Studies…………………………...………….13
Synthesis………………………………………………………..……………….18
CHAPTER II: RESEARCH METHODS
Research Design………………………………………………...………………19
Research Locale…………………………………………………………………20
Research Informants…………………………………………….………………20
Research Instrument……………………………………………………………..21
Data Gathering Procedure……………………………………………………….21

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a) Data Analysis……………………………………………………………..…22
b) Ethical Consideration………………………………………………………..24
CHAPTER III: RESULT AND DISCUSSION
Finding and Discussion……………………………………………………..2
Table 1 First Onset of Attack……………………………………………….29
Table 2 Reccurence of Attack………………………...…………………….39
CHAPTER IV: Summary, Conclusions and Recommendations
Conclusions…………………………………………..……………………..63
Recommendations…………………………………………………………..64
REFERENCES………………………………………………………………………67
APPENDICES
Appendix A: Letter of intent
Appendix B: Letter of consent
Appendix C: Consent Form
Appendix D: Signed Consent Form
Appendix E: Editing Certificate
Appendix F: Extracts
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Appendix G: Transcript
Appendix H: Curriculum Vitae

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Chapter 1
The Problem and its Background
Cardiac arrests happen when the heart actually stops beating along with electrical
malfunctions in the heart and patient suddenly stops breathing or gasps. It should not be
confused with heart attack because it is when coronary arteries are blocked and the heart
continues to beat though there is depletion with the blood supply in the heart muscles.
(ACLC medical training, 2018)
Cardiac arrest is one of the most common causes of death in the Philippines along
with stroke and cancer according to the Philippine Daily Inquirer (Buban, 2015).It is also
responsible for almost 20% of all deaths according to Department of Health Statistics.
For elder patients it is also found out that CPR often has poor outcomes than in younger
patients (Jegtvig, 2014).
Survival of patients who are having cardiac arrest depend on how efficient and
fast CPR was performed. A delay in resuscitation can decrease the chances for survival
by 10% every minute (Philippine Heart Association, 2018). Resuscitation is defined as
the act of reviving from apparent death according to Merriam Webster in 2018. CPR or
Cardio Pulmonary Resuscitation is a life-saving procedure that consists of chest
compressions and breathing for the patient through the mouth. It is also the standard care
for cardiopulmonary arrest and this is usually performed by health care professionals
(Mayoclinic, 2018). American Heart association have acknowledged that most people
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who receive CPR have higher risk on surviving morbidities and advised
physicians to include in the chart if CPR is not performed due to the presence of a DNR
order. In 2016, there has been more than 350,000 incidence of cardiac arrest and the
overall survivor rate is 10.6% out of the hospital while incidence of cardiac arrest inside
the hospital is 209,000 with a survival rate of 25.5% (American Heart Association, 2018).
The survival rate for CPR remains poor. CPR is labelled as a traumatic and aggressive
procedure done to patients having cardiac arrest because it is painful due to the
compressions in the chest which may also cause additional health problems. Failure to
perform CPR can result to death and the little chance to survive from CPR can also cause
serious and irreversible damage to the brain (Ebell, Jang, Shen and Geocadin, 2013).
Aside from the physiological damages to the brain, cardiac arrest may also inflict
psychological imbalances to the individual. According to the study of Magdalena et al.
(2016), out of 30 patients who suffered from sudden cardiac arrest 46.67% developed
mild depression after at least one month and not more than 6months from the incidence
of arrest while 36.67% developed moderate anxiety. It is also mentioned in the study that
the arrest can be a significant stressor to the individual in which may complicate heart
diseases and also led to post-traumatic stress disorder and impairment in functioning.
This near death experience may affect them physically and emotionally making
most patient’s road to recovery difficult as mentioned above due to the changes they
underwent. It will be more problematic if this process is repeated to a single patient for
multiple times moreover; undergoing change after change with each resuscitation. Thus,
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this research aims to understand difficulties of patients who had been revived multiple
times from cardiac arrests.
Theoretical Framework
Kubler Ross stages of Grief
According to Elisabeth Kubler-Ross as cited in Holland (2014), a Swiss
psychiatrist and an advocate for end-of-life care, she was influenced by her experience in
the World War II as a relief worker. She published books about issues of life and death
and one of her books which contain her 5 stages of grief is On Death and Dying in 1969.
These 5 stages are the reactions of terminally ill patients toward their impending deaths
and they often have difficulty in accepting their situation.
Grief can be explained in a variety of experiences and situations. Mostly it is
caused by relationships, substance abuse or grieving over an impending death. The 5
stages of grieving in 1969 that is popularly known as DABDA or the Denial, Anger,
Bargaining, Depression and Acceptance served as a guide for understanding grief and its
development. However, it is possible for people to not undergo the stages or can only
have passed two or three of the stages (Gregory, 2018).
In postcardiac arrest grieving can also happen due to their impending deaths and
may undergo these stages. Some article stated that these patients can attain acceptance
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after having depression or with the term they used as feeling of “being dead” (Forslund et
al., 2013)
Postcardiac arrest patients can also undergo stages of grief due to their losses
when it comes to the changes that happen in their life after having cardiac arrests. Some
of the changes can be alterations with the diet plan wherein there is restriction
with some type of foods these patients used to eat. This change can make them feel upset
and they may grieve from the diet plan they used to have or from the lifestyle they used
to have. These changes to postcardiac arrest patients can be their loss that they grieve on.
Grief theory of Erich Lindemann
As cited by Whats’s Your Grief (2017), Erich Lindemann a psychiatrist and
researcher was able to determine symptoms of grief through his research in the Coconut
Grove tragedy in 1942. He stated that the symptoms of grief are 1) somatic distress which
is most likely to make the patient have difficulty in breathing, losing appetite or lack of
motivation 2) preoccupation with the images of the deceased 3) guilt 4) hostile reactions
and 5) loss of pattern of conduct or patients find basic activities hard to complete.
Lindemann also introduced how the “grief work” progress. He explained that in order to
reduce the symptoms of grief, you have to follow the 3 tasks of grief work which are
emancipation, re-adjustment and formation of new bonds. In emancipation, since people
have strong bonds to the deceased they have to cut ties with the person or object. The
second step, which is re-adjustment patient needs to adjust to the environment and own
routines. Lastly, in the formation of new relationship the patient is able to accept and
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make new bonds. If the patient is able to reach the last step he has successfully coped
with the conflict of his/her situation (Whats’s Your Grief, 2017).
These steps by Lindemann can also be done by postcardiac arrest patients who
have different type of losses depending on the change they have undergone. In the
situation of postcardiac arrest patients, it is important that they emancipate from their past
lifestyles for example and they should also re-adjust their selves to the changes.
Eventually, they should also form new bonds or new commitments with their new
lifestyle or the change that has occurred.
Psychosocial theory by Erik Erikson
As cited by McLeod (2018), Erik Erikson is an ego psychologist who developed
the 8 stages in psychosocial development and his theory is highly influenced by Sigmund
Freud’s psychosexual theory. Erikson believed that the development of personality has
series of stages and experience in social interaction affects the development. Each stage
has two qualities and if a person fails to develop a psychological quality he/she may not
develop the skill to strengthen the sense of self however if a person developed the quality
he/she may have higher chances of overcoming conflicts. Mastery of each stage is not a
requirement in advancing to the next stage and the outcome of every stage is reversible
and can be developed or modified by experiences (McLeod, 2018).
Failure to develop a psychosocial development of patient can highly affect the
quality of life the person leads. Between the ages of 20-39 years old this falls to the
intimacy vs isolation stage wherein the major virtue to be developed is love. Love for the
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significant other is a good sign of a strong support system thus promoting intimate
relationships with people and therefore reducing the chance of having depression after
traumatic events or during a disease. Postcardiac arrest patients aged 20 to 39 years old
may develop this characteristic to effectively cope with their experience. Conversely, if
patient has weak support system and is lacking of love from significant other he/she may
not recognize self-worth, may seem hopeless and helpless, eventually patient will
isolate himself/herself.
For the adults aged 40 to 64 years old, in the generativity vs stagnation stage, the
main virtue is care. In these years, a person focuses on the ability to be productive and
efficient to the society through accomplishments in work, establishing family and being
financially stable and if a person is not able to recognize the sense of generativity or
productivity there will be a feeling of stagnation for not being able to help te society. For
postcardiac arrest patients it is possible to not achieve generativity due to the interference
of their condition with their activities in life specifically in their work or their role as a
family member. In contrast, if a patient is well-motivated and able to cope positively
there will be productivity in life, achievements and stability thus achieving the sense of
generativity.
For the ages 65 years old and above, the main virtue is wisdom which falls under
the ego integrity vs despair stage. In this stage the final task is retrospection wherein
people tend to go back and re-evaluate their lives and their ability to acquire wisdom. In
postcardiac arrest patients, if they are unable to see the productivity of their life they may
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develop the feeling of not being able to be at their best caused by the adjustments and
effects of their condition and lead them to the feeling of despair. On the other hand, if
they are able to feel satisfaction with their lives postcardiac patients may develop wisdom
and integrity.
The Adaptation Model of Nursing by Sister Callista Roy
This theory was first presented in an article in Nursing Outlook in 1970 with the
title of “Adaptation: A Conceptual Framework for Nursing”. The aim of this theory is to
explain the nursing science and its role in assisting adaptation of patients and also to
show that a person is a holistic being with different aspects. It defines the human’s ability
to think and re-adjust to the stimuli from the environment, to cope with stress, disease
and death and the role of nursing in the promotion of positive coping mechanisms using
the four adaptive modes: physiological-physical, self-concept group identity, role
function and interdependence. In physiological-physical mode, its goal is to address the
basic needs of a human being such as nutrition, oxygenation, activity and rest. While the
self-concept group identity mode emphasizes the sense of purposefulness and unity. Role
function mode on the other hand is about determining the roles of a person which he
occupies in the society whether it is primary, secondary and tertiary role. Lastly, in the
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interdependence mode, its aim is on attaining the integrity in relationships through giving
and receiving of love.
According to Roy, adaptation is a “process and outcome whereby thinking and
feeling persons as individuals or in groups use conscious awareness and choice to create
human and environmental integration”. As nurses being the facilitator of adaptation is
important so that people will be able to eliminate negative coping mechanisms and be
able to manipulate stimuli concerning their adaptation. Improving adaptation during
disease is the main goal of nursing and this is attainable through the help of nursing
process (Vera, 2014 ). For post cardiac arrest patient, it is also necessary to
acquire positive coping mechanisms that would improve their quality of life. The
physiological and psychological effects of cardiac arrest and resuscitation are their
external stimuli to adapt. With the aid of adaptation theory, nurses would be able to
facilitate positive adaptation of the patients to stress and diseases.
Statement of the Problem
This study aims to explore and have in-depth understanding about the difficulties
of patients who have been revived multiple times from cardiac arrests. Particularly, this
study aims to answer the following questions:
1. What are the difficulties of post cardiac arrest patients after multiple
resuscitations?
2. How do they cope with this traumatic event?

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3. How may the lived experiences of post-cardiac arrest patients who have
been resuscitated multiple times be summarized through themes?
Assumptions
The researchers assumed that post cardiac arrest patients can be
physiologically and psychologically affected by the cardiac arrest and resuscitation
experience because it is a traumatic event. Changes after cardiac arrest and resuscitation
when it comes to different aspects can be difficult for patients to cope with. Thus, if a
single patient undergoes same procedures for multiple times adjustments will be greater
and harder to achieve.
Scope and Limitations
There are physiological and psychological effects of cardiac arrest to the
survivors but this study focuses on those changes and how they are able to handle their
circumstances along with the problems that have been inflicted to the patients ages
greater than 30 years old who had been resuscitated multiple times from cardiac arrest
regardless if the resuscitation was performed inside or outside the hospital nor in a single
hospitalization. Interviews with the patients will be the main source of data of this study.
The researchers will focus on patients admitted in hospitals around Bulacan area that
would pass the inclusion criteria for the participants.
Significance of the Study

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This research will be able to give to benefits to the following groups of people:
 Nurses, this study will be able to provide more elaborated information about the
difficulties of post cardiac arrest patients after multiple resuscitations and for
them to be able to formulate interventions on how to improve the patient’s
emotional well-being
 Families of the patients, to be able to have a deeper understanding about the
patient’s condition and his/her feelings and perceptions toward his situation and
be able to help and guide the patient in coping with his present condition.
 Community people, to be able to gain knowledge about the experiences of
people facing the circumstances of post-resuscitated patients especially multiple
times and also to gain the proper attitude in communicating with these kinds of
people.
Definition of terms
Phenomenology: a philosophical movement that describes the formal structure of
awareness from any claims concerning existence
Post cardiac arrest patients: people who have undergone and survived a
Cardiopulmonary resuscitation twice or more and have an age of 30 and above.
Cardiac Arrest: it is when the patient suddenly collapse because the heart stopped.
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Resuscitation: a series of interventions attempting to prevent death from happening like
defibrillation and CPR
Do-Not-Resuscitate order: an order made by the physician and patient and/or significant
other which states that the patient will not be resuscitated if he/she had an arrest.
Review of Related Literature and Studies
Local Related Literature
Effects of Cardiac arrest
According to Mcgough as cited by Lunas (2016) many people don't realize that this is as
threat to the worldwide population. Due to its sudden manifestation of its symptoms such
as chest pains, irregular or absence of heartbeats, the events of cardiac arrest are often
 unexpected. Hence, causing psychological and emotional burden to patients
affecting their day to day activities in life. (Philippine Heart Association, 2018).
What is cardiac arrest?
According to Makati Medical Center as cited by Manila Standard Lifestyle (2018)
it is the irregular heartbeat and malfunction of the heart, cardiac arrests may be
triggered by other medical conditions. Every year 170,000 filipinos die from
suffering cardiovascular diseases. In additional, Department of Health stated that
it is now known to be the number one killer worldwide as cited by Manila
Standard (2018).
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Cardiopulmonary resuscitation
In achieving the goal of the 64th president of the Philippine Heart Association,
Dr. Alex Junia which is preserving the cardiac health of the filipino people. He
had led the advocacy of making the Philippines a CPR-ready country (Philippine
Heart Association, 2015). According to Dr. Lavapie as cited by Uy (2014), CPR
is the most important treatment for cardiac arrest and it should be done within 4-6
mins because brain cells starts to die without oxygen. The main goal is to
maintain neurological function as it should be. According to Dr. Lapitan of
Makati Medical Center as cited by Manila Standard (2018), once the patient does
not respond, pulseless and does not breathe, a trained first-aider must perform a
“hand-only” CPR while waiting for the ambulance.
International Related Literature
Managements for cardiac arrests
ICD (Implantable Cardio-verter Defibrillator) therapy is believed to lower the
increasing number of sudden cardiac arrest in selected patients though it is observed to be
not very efficient on elderly patients due to higher rate of pulseless electrical activity or
nonarrhythmic causes of cardiac arrest in this age group (Borne,. Et al. 2017). Aside from
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ICD, the classic and standard approach to cardiac arrest is CPR. Cardiopulmonary
Resuscitation is a series of steps to prevent death when the heart suddenly stops pumping
and it is a policy in hospitals to perform CPR on patient whose heart suddenly stops
beating but this policy can be affected when there is a presence of DNR order. (Johnson
and Cardiol, 1998)
Respect for the patient’s autonomy
The concept of Do-Not-Resuscitate order was included in the Patient Self
Determination Act of 1991 to emphasize the patient’s right for making decisions
regarding their end-of-life care or make advanced care directives. If the patient cannot
express his/her wishes there are two ways to approach the situation. First is following the
patient’s advance care plan wherein patient was able to provide advanced decisions
regarding the plan of care he/she will undergo but if advance care plan was not made,
patients significant others can make the request by filing a legal document that would
state their wishes. (Braddock and Clark, 1998).
Experiences of post cardiac arrest patients
Some studies focus on the life experiences of post cardiac arrest patients and
highlighted their near-death experience. Aaccording to an article in CBC News (Canada)
people who survived cardiac arrest and have been resuscitated had memories of how they
were revived and it has also been reported by a respondent that he saw himself left his
body and watched the medical personnel resuscitate him.

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According to Forslund et al. (2017) on the first year of survival patients stated
that they still have this feeling of “being dead” but as they go along they have concluded
and have come to the realization that they have been given a second chance to enjoy life
and also according to Horizon Research Foundation (2007), the quality of life after a near
death experience of a cardiac arrest has no difference from being discharged from an
ICU.
Effects of Cardiac Arrest to Mental state of patients
27% of post cardiac arrest patients suffer from a psychological disorder such as
post-traumatic stress disorder and depression. Patients develop this disorder because they
are unable to cope up with their near death experience and other disabilities that have
been caused by the sudden cardiac arrest. It is also stated by the Horizon Research
Foundation that 20-50% of the survivors develop long term memory impairment and also
have difficulties in recalling and concentrating.
A phenomenon called “post cardiac arrest syndrome” which includes clinical
manifestations happens after cardiac arrest due to ischemia-reperfusion and spontaneous
return of circulation which also increases the risk for infection. 40-50% of CA survivors
develop acute renal and respiratory dysfunctions. The most severe component of this
syndrome is the cardio circulatory dysfunctions which eventually lead to multiple organ
dysfunctions. The intensity of the complication is highly dependent to the delay of initial
treatment towards cardiac arrest.

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The treatment for post cardiac arrest syndrome has two main goals: initial
management for shock and organ failure and cerebral protection. (Mongardon et al,
2011).
In addition to the effects of cardiac arrests and resuscitation, a research study in
Netherlands by Wachelder (2009) states that, approximately 38% of people who have
survived, suffers from anxiety and depression. Another element in the experiences of post
resuscitated patients is their anxiousness toward anticipated loss. According to American
Heart Association (2018), it is normal to be afraid for not having full control over one’s
own life but through positive self-talk and proper understanding to own condition it could
lessen its symptoms. In chronic patients it was found that these types of patients have
more often and intense thoughts about their deaths. (Khawar, 2013). In line with this, the
Terror Management Theory in 1986 by Greenberg, Solomon and Pyszczynski as cited by
Heflick, there is a theory that proposed fear of death can trigger more positive behaviour
to people suffering from it. Therefore encouraging them to preserve life may increase
self-esteem. (Heflick, 2012). Statistically, 80% of people who suffered a near death
experience have claimed that this made a significant difference in their lives in various
aspects. In addition these patients have developed a notion to focus on what
he/she has now rather than stressing out over the past experiences. (Atwater, 2017)
Physiological changes experienced by post cardiac arrest patients

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According to a study, a lot of patients who have cardiac conditions often
experience difficulties in performing diverse activities and there is a decrease in their
capacity to perform activities, (Duruturk et al, 2015) and there is a feeling of fatigue on
patients even with small activities alone. After surviving cardiac arrests it was found out
that most patients experience significant impairments in their level of functioning. Up to
50% of patients who suffered cardiac arrests have complained of chronic fatigue
(Wachelder, 2009) Patients may commonly experience fatigue after surviving an arrest.
Chronic fatigue with these types of patients can be addressed by planning activities,
simplifying tasks and asking for assistance. (Kim YJ et al, 2017)
The American Heart Association proposed few dietary adjustments that should be
applied in order to avoid heart attacks and improve the health of the heart. It is suggested
that avoiding salt, transfat, saturated fats and added sugars can reduce the risks being
included in the 326,000 people who underwent cardiac arrests in a year. (2018)It also
shows that along with proper diet and healthy habits it is also important to allot time for
proper exercise. For people with heart conditions it is important that exercise should be
kept in moderation and gradually increase level of exercise because extensive exercises
can stress out the heart. (Chest Heart and Stroke Scotland, 2018) It was advised by the
American Heart Association (2015) through their Cardiac Rehabilitation program that
one of the major elements affecting cardiac health is proper exercise. There has
been a study focusing on how muscle strengthening activities could help reduce risk to
acquiring CVD. Moreover, Physical activities are good predictators of the health status of
an individual. (Artero et al,2013).

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Along with diet it is also important to make a few adjustments in the lifestyle
especially removing unhealthy habits such as alcohol drinking and tobacco use because
this can add to the risks of developing cardiovascular diseases. (Mukamal, n.d) In
addition to this, The American Heart Association (2014) has advised people not to drink
alcohol if they have not started drinking yet because alcohol drinking can lead to increase
in blood pressure and could branch out into different heart diseases. The lack of
commitment to a healthy lifestyle is a major contributor for the increasing risks of
developing heart problems in the United States. (American Heart Association, 2015) A
program called Cardiac Rehabilitation is designed to improve the current condition of the
heart and there are three major elements that would reduce all modifiable risks: Exercise,
healthy lifestyle and stress reduction. (AHA, 2016). Aside from this, according to Sandee
LaMotte in CNN Philippines (2018) there is no amount of alcohol consumption that is
good for the health and it is better not to drink at all. Therefore, total eradication of
alcohol from their diets can significantly improve their health conditions and it is a
responsibility of nurses to point this out to patients having problems to alcohol
consumptions.
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Synthesis
The researches and journals mentioned in the review of related literature will help
the researchers to understand possible factors affecting postcardiac arrest patient’s
psychological status. Also, according to the review of related literature, researchers will
be able to elaborate more comprehensively the feelings and experiences that the patients
have been through. In addition, it will also aid the researchers to identify the quality of
lives that patients may lead and be able to conceptualize a deeper understanding on what
have driven them to lead their lives and how, as nurses, will be able to improve their
well-being. According to the literatures that was reviewed by the researchers, they
discovered that there are managements can be done for post-cardiac patients. Implantable
cardio-verter defibrillator therapy is used to lower the sudden cardiac arrest of the patient.
Cardio pulmonary resuscitation can be perform to prevent death. For the patient
autonomy Do-Not-Resuscitated can be requested by the patients. According to them their
experiences for the first year after attack they felt like dead. There is a phenomenon
called “Post Cardiac Arrest Syndrome” where in some of the patient’s organ becomes
ischemic due to prolong cardiac arrest. They may also develop post-traumatic stress
disorder and depression because of feeling of death and loss. Some patient’s develop
positive outlook, they became more time oriented because for them the remaining time
they have must be productive and helpful to all. Effects would vary to every individual
and these can highly suggest what type or quality of life the patient may live. The known
knowledge in the experiences of post-cardiac arrest patients which has been revealed
through extensive researching of literatures regarding the topic, will be furtherly

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discussed by this study by analysing and interpreting data that would be gathered from
the actual informants.

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Chapter 2
Research Methods
This chapter will present the methods used by the researchers in order to further
elaborate the answers to the questions the research aims to provide. Also included in this
chapter is the area where the study will be conducted along with how the informants are
going to be selected and what are the instruments that are going to be utilized in gathering
data. Analysis of data that have been gathered is also included.
Research Design
A qualitative phenomenological type is used by the researchers to comprehend,
characterize and elaborate the experiences of post cardiac arrest patients that have been
resuscitated many times. This study also explores the new angle that focuses on the life
experiences of post cardiac arrest patients who have undergone multiple cardiac arrests
and have been resuscitated successfully several times and the factors affecting them in
coping with their current condition. Phenomenological studies aims to gain a deeper
understanding regarding the point of view of the people about a particular phenomenon
and provide facts to support a phenomenal event. Also, to understand and analyse the
data given by the informants with consideration to their variations in beliefs, perceptions,
attitudes and coping abilities. In line with this, the researchers find the qualitative
phenomenological design appropriate in gaining a deeper and more comprehensive

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understanding from the informant’s lived experiences and also to be able to arrange the
data thematically.
Research Locale
The study is conducted within the area of Bulacan. Researchers tracked down post
cardiac arrest patients in primary, secondary and tertiary hospitals around Bulacan. In
Bulacan Medical Center at the Intensive Care Unit 3 out of 10 patients are being
resuscitated per shift and 1 out of 100 resuscitated patients have recovered successfully.
(M. Vanson, Personal communication, Aug. 3, 2018)
Research Informants
The researcher used non-probability sampling methods which are purposive,
snowball and convenience sampling. The first category is purposive sampling because
researchers set criteria that are satisfied by the informants. The informants should at least
have three successful resuscitation from cardiac arrest regardless of the location of the
resuscitation nor if it is performed in a single or multiple hospitalizations, aged 30 years
old and above. The second category is convenience sampling wherein samples that are
chose are close at hand. As it happened, one of the informants is a friend of a researcher
which is conveniently interviewed by the researchers. These methods aid the screening of
informants that would provide necessary information relevant to the study. The third is
snowball method, wherein one of the informants recommended an acquaintance that also
satisfied the inclusion criteria (Polit and Beck, 2017).

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Research Instrument
In order to extract information from the informants the researchers made a semi-
structured interview and formulated questions that would serve as guide in obtaining
precise data. Also, to explore more ideas brought during the interview other secondary
questions are also asked to elaborate experiences and ideas. Informants are expected to
provide first-hand information to ensure validity and reliability of data. The following are
the guide questions used by the researchers:
1. What are their lived experiences upon having been resuscitated several times from
cardiac arrest?
2. What are their insights about the process of resuscitation?
3. What are the difficulties they have identified after being resuscitated multiple
times?
4. How did it influence their quality of life?
Data Gathering Procedure

Semi-structured interview
Orientation of informants Consent signing
conducted by researchers
End of interview
providing tokens of
appreciation
The researchers held an orientation for each participant discussing the benefits,
risks, their rights and how can they cooperate in the study. Researchers provided consents
had the participants express their concerns before signing. After the orientation and
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securing of consents, researchers conducted an interview with their guide questions
tackling about the experiences of postcardiac arrest patients that were resuscitated
multiple times while avoiding questions that may lead the informant’s answers to what or
may contaminate the data. The entire interview was audio recorded and few points were
jotted down by co-researchers. There were no personal info taken from the informants
and they would be allowed to decide if the interview will be audio/video recorded or not.
As the interview was ended the researchers extended their gratitude by handing their
tokens of appreciation to the informants. The duration of each interview is between 30
minutes to 1 hour. The researchers used non-probability sampling method which are
purposive and convenience sampling wherein researchers pick their informants based on
their own judgment keeping in mind the purpose of the study. Convenience sampling is
when the researchers choose their informants as per the accessibility of the informant and
convenience of the researchers (Showkat and Parveen, 2017)
Data Analysis
In order to comprehensively analyse information gathered from the interview with
the informants, data are thematically arranged and grouped according to the
interpretations of their experiences and the likeliness of their situations. Informants are
subjected to interview for data gathering and extracted information are used in the study
for a deeper understanding with the process of the phenomenon and how it affected the
informants. The researchers have analysed the data, summarized and arranged it with
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regards to the elements of the experiences. The thematic analysis method has phases as
cited by Bueno et al. (2018) according to the University of Auckland:
1. First, the researchers will familiarize themselves with the data that have been
gathered and should be able to identify patterns and themes.
2. Information is arranged thematically and reoccurring patterns are organized in
order to collect relevant data.
3. Themes and patterns that have been identified are reviewed. Irrelevant
information themes are removed to obtain precision of data.
4. Researchers will then provide facts that would support the themes or patterns that
have occurred within the informant’s experiences which are still clustered
thematically.
5. Clustered data are identified with regards to how it would affect the processes of
the study and its relevance.
6. Thematically clustered data are now finalized and narrowed down in which will
contribute new concepts to the study.
Also, patterned with Giorgi’s four-phase phenomenological data analysis, the
researchers used this phase to analyse and elaborate the phenomenon that is being
investigated in this study which is multiple cardiac resuscitation on a single patient. The
four phases include the following steps in order to provide further understanding
regarding the experiences of the informants:

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1. Reading and analysing transcripts several times in order to familiarize and
arranged the experiences
2. Interpreting and formulating meaning with regards to the experiences of the
informants
3. Formulated meanings from the experiences verbalized and shared by the
informants are grouped or clustered thematically with regards to the
representation of the experiences.
4. Through the clustered themes and meanings that were formulated from the
experiences of the informants, synthesizing is done to describe the phenomenon.
Ethical Considerations
As this study concentrates on the lived experiences of post cardiac arrest patients
that are resuscitated several times, researchers intended to emphasize that during the
progression of the study’s confidentiality and respect to the informant’s rights are
observed properly.
Before the conduction of the interview and during the first contact between the
informants, the researchers ensure the informants that they are not forced to participate,
researchers secured consents from the informants as well as giving them the choice to
remain anonymous or they may indicate their names along with their consents.
During the interview, researchers have also ensured that all informants have
answered the same set of questions and that there are no offensive questions asked during
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the interview to avoid an invasive approach. Transparency is also considered to be able to
remain unbiased and precise.
Conveniences of the informants are also given full attention considering their
schedules and availability. The researchers have ensured that the schedule or the duration
of the interview have not compromised them with regards to their daily activities and
work. These considerations will be strictly followed and considered by the researchers for
it values the rights of the informants.

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Chapter 3
Findings and Discussions
This study focuses on the lived experiences of post-cardiac arrest patients who
have been resuscitated several times. These experiences include the struggles after the
resuscitation such as alterations in diet, intolerance to activity, depression and anxiety.
Informants have highlighted these difficulties in which they remain to face for the rest of
their lives.
Moreover, due to these problems encountered by the patients it had affected them
in different aspects. Thus, promoting a holistic approach for these type of patients
because as addressing the complaints of these patients they must be viewed as a holistic
being that has different qualities in order to function properly and be considered as a
healthy human being. Stressful as it is, informants are able to verbalize on ways in
accepting and coping with the difficulties they tackled along their journey of challenging
experiences.
With the uniqueness of every individual, each informant had various ways in
coping. Some viewed the matter as a challenge and faced it head on but some chose to
just go with the flow and see what’s at the end of the road. Most patients started a new
life after several times of resuscitation and are able to follow treatment regimens as well
as acceptance of their condition. To sum it all, the experiences of the patients are gives
and takes. In order to gain something for themselves there must be a trade-off. This
phenomenon has been summarized by the researchers through highlighting the
comparison of the experiences between single resuscitation and multiple resuscitations.

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Below are the following themes that would clarify and interpret meanings from the
statements provided by the informants.
Table 1. Theme clusters and Formulated Meanings under the emergent theme
“First Onset of Attack”
Theme clusters Formulated meanings

Denial to present condition  unable to accept illness and adjustments
 forcefully tries to return with normal routines
Requires assistance with  necessitate support from significant others
activities
Incompliance to medical advises  does not take medications regularly
and regimens  uninterested with treatment regimens and
recovery procedure
Adjustments in Food Choices  attempts in eating a well-balanced diet
Decrease in vices  reduction in consumption of vices
As presented in table 1, the first emergent theme focuses on discussing
experiences of post-resuscitated patients that have undergone resuscitation for once only.
Under the emergent theme “First Onset of Attack” theme clusters are devised by the
researchers to classify their experiences according to what aspect of their lives have been
affected by this phenomenon.
First theme cluster Denial to Present Condition conveys how the post-resuscitated
patients handled their situation at their first attack and how it affected them emotionally.
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Secondly, Requires Assistance with Activities shows that post-resuscitated patients are
having difficulties in performing daily tasks after having their first attack. The next theme
cluster which is Incompliance to Medication deals with the experiences of patients who
are in denial of their condition and refuses to follow medical advises. Another theme
cluster which is Adjustments in Food Choices states the differences post-resuscitated
patients made in their food habits to compensate with their disease. Lastly, the Decrease
in vices wherein the informants stated that ever since their first attack they try to limit
their consumption of vices as much as possible.
Denial to Present Condition
This theme cluster pertains to the initial reaction of the informants after having
their first attack and most of them are unable to accept their condition because of the
sudden onset of their disease. This predicament is imparted by the informants through
their following statements:
“ Nung una di ko talaga maisip na mangyayare saken yung ganito para bang
tinatanggi ng isipan ko yung sitwasyon. Masakit kasi isipin na biglaan eh.”
[PCAP4 line 12-15]
(I couldn’t really believe that this would happen to me. It was like my mind is
refusing to accept my situation. It hurts me because it happened so suddenly.)
“Nagising ako sinabi saken ng asawa ko yung tungkol sa kondisyon ko di ako

nakasalita. Ayoko eh. Ang naisip ko agad …bakit? Bakit ako?” [PCAP5 line 17-
19]
(I woke up and my wife told me about my condition. I was speechless. I don’t want
to. I thought to myself… Why? Why me?)

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As the informants clearly stated that, it had been difficult for them to understand
and accept their condition. Denial to clinical realities is the main cause of delay to
patient’s treatment progress and mostly because they choose not to participate in
treatment as they view the the treatment unnecessary (Covino et al, 2011), grief is a
person’s initial response to loss. It can be manifested through sadness over different kinds
of reasons such as death of significant others, job loss and/ or change in lifestyle like
from moving out and chronic diseases (DerSarkissian, 2016). According to Kubler-Ross
(1969) in her 5 Stages of Grieving famously known as DABDA wherein the first stage of
grieving is denial. The informants may be experiencing grieving, most specifically
anticipatory grieving, and have already proceeded to the first stage of grieving wherein
they try to deny and refuse to accept their current condition. Anticipatory grieving is
when a person is grieving before the occurrence of loss. It is usually a death expected
from either the person himself or from a loved one (Medicinenet, 2016). The informants
are unable to deal with their current situations, because they are not prepared to the
changes occurred. Changes that affect not only parts of their lives but the whole of them.
Also some of the changes are not that easy for them to accept, and that’s the reason why a
lot of the survivors of the first attack are not complying to the treatments. In line with
this, health providers must listen to the patient’s opinion, show empathy to the situation
that they are experiencing. Help the patients and relatives to understand the patients’
current situation and the importance for them to comply with the needed treatment.
In line with this, informants have also stated that due to their inability to accept
their situation they tried to normalize themselves and get back to their normal routines.
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” Yung unang beses ko kahit papaano sumubok ako ng mga trabaho sa bahay
pero yung katawan ko ba eh parang umaayaw kasi ramdam ko kaagad ang
pagod.” [PCAP3 line9-13]
(On my first attack I tried doing my usual chores at home but I felt my body is not
as active as before and I got tired easily)
“Bale inatake ako ng unang beses talagang nagtrabaho pa din ako sa bahay.
Naglalaba, nagluluto, naglilinis pero noon eh ramdam ko na ang
panghihina.”[PCAP1 line 84-88]
(So when I had my first attack I still tried to work at home. Washing the laundry,
cooking and cleaning but with these activities I already felt the weak.)
As stated by the informants, these patients have attempted to get back to their
daily routines and past active and dynamic lifestyles. In their attempt, it was stated that
they fail to regain their old routines due to feelings of powerlessness and lack of strength.
This attempt to avoid their condition and regaining their past activities is the patient’s
response to their stressor or can be called their coping mechanism. Coping mechanism is
a person’s approach to stressor in order to solve, manage or adapt. One of the two types
of coping mechanism is Maladaptive Coping Mechanism. This is wherein on a stressful
situation rather than solving the problem it only reduces the symptoms and doesn’t
address the cause of stress as well as limits the functioning (Williams, 2018). One type of
maladaptive coping mechanism is avoidance. This is when a person tries to escape from
their stressors (Sincero, 2012). In contrary, a study shows that Maladaptive Coping can
be considered to be a functional coping because if a person tends to use avoidance for
example, they are more likely to escape victimization (Wadsworth, 2015). In the
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Adaptation theory of Callista Roy (1970) she stated that there are 4 different adaptive
modes and the coping mechanism mentioned above falls on the self-concept group
identity mode wherein it highlights a person’s sense of purpose. These patients are unable
to return to their past perceived purpose.
Requires assistance with Activities
The second theme cluster is also one of the main experiences verbalized by the
informants. The theme cluster Requires Assistance with Activities was formulated for
the reason that post-resuscitated patient are unable to resume their past daily activities, it
had been verbalized by the informants that more often their basic activities are
compromised and mostly requires them to call for assistance.
“Sa mga gawain nga kaunti na lang mga gawain sa bahay di gaano yung mga
simple kaya ko pa naman kasi madalas akong nagpapatulong kay ate kasi siya
yung bantay ko palagi” [PCAP3 line 57-62]
(When it comes to house chores I am only able to perform simple tasks. I can still
do some of them because my sister helps me with them and she stays me most of
the time.)
“Kahit maglaba pupunta pa yung anak ko siya pa ang maglalaba. Pati pagluluto
di na ko makapagluto ng maano” [PCAP4 line 55-57]
(Even when doing the laundry my daughter will have to visit me and do it for me
and also cooking. Cooking has been also difficult for me.)
As the informants emphasized their worries regarding their inability to perform
their tasks alone they have also recognized asking for assistance in their activities is
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inevitable. According to a study, a lot of patients who have cardiac conditions often
experience difficulties in performing diverse activities and there is declining in their
ability to perform activities. (Duruturk et al, 2015) Patients may commonly experience
fatigue after surviving an arrest. Chronic fatigue with these types of patients can be
addressed by planning activities, simplifying tasks and asking for assistance (Kim et al.,
2017). Relating to this, healthcare providers should collaborate with the patients. Help
them to perform their usual task like before. Also provide rest between activities to
conserve patient's energy and secure the patients safety to prevent further complications.
Incompliance to Medical Advises
The informants also emphasized their difficulties in taking and following
treatments which leads us to another theme cluster which is Incompliance to Medical
Advises. This theme focuses on the experiences of patients that states difficulties in
adjusting to treatment regimens. Aside from denial to their condition, the sudden changes
to their lifestyle have also been a factor for them to find treatment regimens to be difficult
as verbalized by the informants through their interview:
“Kumbaga naiinom lang ako ng gamot kapag may nararamdaman ako. Di ko

naman talaga nasusunod yang mga maintenance na yan. Mahirap kasi di naman
ako nasanay sa mga gamot na yan tsaka di ba ika nga ng iba masama yung
marami kang naiinom na gamot.”[PCAP1 line 100-107]
(I only take my medicines when I feel symptoms. I don’t really take them
regularly. It’s difficult because I am not used to taking medicines and as other
people say taking too much medications could be harmful to health.)

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“Kasi nung una kong binigyan ng maintenance ininom ko lang siya ng tatlong
taon tapos inistop ko nung inistop ko dun na siya umatake. Tapos uminom ako ulit
so nung mga nakaginhawa ako umistop na naman ako. Nung umokay na ko
inistop ko na yun.” [PCAP4 line 84-89]
(When my doctor prescribed me some maintenance drugs I only took them for 3
years and I eventually stopped. When I stopped taking my meds I started feeling
symptoms which made me resume taking them better again. Then again when I
felt better I stopped taking my medicines)
The statements have shown that following medication schedules have been
difficult on these patients and would only take them after feeling relief from symptoms.
Informants are not allowing themselves to rely on medications because for them
medication might lead them for more complications and may worsen their condition.
According to a study titled Dosing Frequency and Medication Adherence in Chronic
Diseases, dosing frequency has inverse relationship with adherence in medication. It has
been discussed that patients suffering from chronic diseases who have drug maintenance
find it more difficult to follow drug schedules as frequency dosing of their drug increases.
(Coleman et al., 2012) Aside from medications informants also highlighted that on their
first onset of attack they find some medical procedures are not necessary. Informants
have been uninterested with procedures of treatment because they haven’t recognized the
severity of their condition which was verbalized by the informants:
Una kong atake sabi ng doctor pwede daw akong magpaopera pero baka daw di
ko kayanin. Naisip ko naman na madadaan pa naman to sa pag-iingat at siguro
sa gamot kung sakali kaya di din ako pumayag. Nagpauwe na ko sa mga anak ko
nun.[PCAP4 line 35-39]
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(The the first time it happened my doctor recommended an operation but this
operation has low chance of survival. I decided not to take this offer because I
thought that my condition can be controlled through medication and careful
lifestyle)
“Pero nung sa unang beses ko di ako nakakapagpa-check up ng madalas kung

kelan lang sipagin ganon. Kasi ang ano ko naman kampante ako dahil di naman
ako nakakaramdam ng kung ano ano.”[PCAP1 line140-145]
(I don’t attend to check-ups regularly I just go whenever I feel like it. I went to
check-ups every time I feel symptoms but I rarely had them that’s why I’m
confident not to attend check-ups.)
Moreover, discharge and medical treatment have been neglected by the
informants. Informants are also unable to recognized severity of their condition and it is a
role of a nurse to explain and help them understand it. Health education is important in
promoting optimum level of health of a patient and prevention of disease occurrence
(Rodriguez, 2018) That’s the reason why some of the informants are not complying to the
treatment or operation. In line with this, nurses must clearly explain the importance of the
treatment recommended for them. Teach the relatives that complying with the said
treatment can help improve the patient’s health status and provide information is easy for
them to understand.
Adjustments in Food Choices
The theme cluster Adjustment in Food Choices pertains to the changes the post-
resuscitated patients done with regards to their diet. As stated by the World Health
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Organization (2018) unhealthy food preferences is the major factor in increasing risks for
chronic, cardiovascular and other conditions associated to obesity. This notion to adjust
their diet can be clarified through their statements:
“Nung una kong atake kasi kumbaga nag-ano lang ingat lang ako sa kinakain
pero nakakain pa din ako ng mga bawal mahirap pa kasi talagang pigilan. Gulay
minsan tapos minsan karne para balanse pa din.”[PCAP1 line45-50]
(I observed proper diet but sometimes I would also cheat on my diet because
oftentimes it is hard to control. So I decided to balance it out by alternating meat
and veggies)
“Oo malaki ang nagbago kasi lalo pag first time wala akong ideya sa
nararamdaman ko. Kaya naman tuloy pa din ako sa mga gawain ko at mga
pagkain ng bawal siguro bawas sa iba pero minsan kasi di mo rin mapipigilan.”
[PCAP3 line37-42]
(I really had a lot of changes on my first time especially. I only had limited
knowledge about it. Sometimes I would also eat food that are not allowed for me because
I get tempted.)
Through these statements, it was emphasized by the informants that after their
first attack they are able to change their dietary habits though not fully compliant they
have recognized the importance of adjusting their food habits to compensate with their
condition, because for them this is the easiest task to do first aming than the other
treatment and also easy to provide. The American Heart Association (2018) proposed
few dietary adjustments that should be applied in order to avoid heart attacks and
improve the health of the heart. They suggested that avoiding salt, trans fat, saturated fats
and added sugars can reduce the risks being included in the 326,000 people who undergo
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cardiac arrests in a year. In ccordance to this, healthcare providers such as nurses must
teach the patient and relatives the proper diet. Advice the relatives to collaborate with the
patient eating changes habit so this could help the patient and prevent the patient to have
another occurrence of their attacks.
Decrease in Vices
The next theme cluster is Decrease in Vices which emphasizes the experience of
post resuscitated patients who drink alcohol and smoke tobacco. Despite having their
vices these patients have recognized how these habits of them increases their risk in
worsening their current condition. To further clarify the experiences these are some of the
statements that were provided by the informants:
“Sino bang walang bisyo malakas akong uminom noon pati sigarilyo. Unang
beses na atakihin ako nagbabawas ako kasi delikado na ang kalusugan ko.
Naninigarilyo pa din naman hindi naman tulad dati kasi dati umuubos ako ng
isang kaha maghapon.”[PCAP5 line 24-29]
(Everybody has vices. I drink and smoke regularly back then. On my first attack, I
tried to decrease the amount of my consumption and I would also drink
occasionally. Unlike before I could finish a pack of cigarette a day)
“Nung first time ko dahil nga di ko pa gaanong pinapansin yung nangyayare

saken sige pa din ako sa mga dati kong bisyo yosi at alak pero dahil may takot
nagbawas pa din ako kahit papaano.” [PCAP2 line 30-35]
(I still had my vices back when I only had my first attack because I really don’t
pay much attention to my condition. Though there is still the uneasiness every
time I drink and smoke, I tried to lessen them. )

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Along with diet it is also important to make a few adjustments in the lifestyle
especially removing unhealthy habits such as alcohol drinking and tobacco use because
this can add to the risks of developing cardiovascular diseases (Mukamal, 2006). In
addition to this, The American Heart Association (2014) has advised people not to drink
alcohol if have not started drinking yet because alcohol drinking can lead to increase in
blood pressure and could branch out into different heart diseases. According to the
informants this changes are not that easy to accept that’s why little by little they are
trying their best to remove the unhealthy habits. In the like manner, nurses must provide
health teachings that could elaborate their understanding further to lifestyle adjustments
and advice alternatives in order to aid cessation of bad habits.
Table 2. Theme clusters and Formulated meanings under the emergent theme
“Recurrence of Attacks”
Theme clusters Formulated meanings

Accepting circumstances of health  compliance to treatment regimen
condition
Healthy lifestyle plus Diet  avoid foods that are restricted from
diet
 smoking cessation
 avoiding alcoholic beverages
 proper body workout
Strength deterioration  feeling of powerlessness and
exhaustion with small activities
Shift in societal roles  demoted functional responsibilities
in the society
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Fear of impending loss  recurrence and survival of

forthcoming attacks
 separation from significant others
Spiritual stability  strengthened faith in recovery
 positive insight on the value of life
Family support  toughened support system coming
from family
Shown in the table on the last page is the second emergent theme titled
Recurrence of Attacks. Under this emergent theme are six theme clusters. These theme
clusters highlights the experiences of post resuscitated patients after having the
recurrence of their attacks and how it affected them. The experiences they shared were
thematically arranged according to the formulated meanings of their statements. The first
theme cluster is Accepting Circumstances of health Condition. In this theme cluster, it
had been highlighted that with the recurrence of their attacks informants have accepted
their condition and the circumstances that comes with it. Another theme cluster on the
second emergent theme is Healthy lifestyle plus diet. The second theme cluster explains
the dedication of the informants in improving their quality of life by readjusting their
lives in line with the challenges of their disease. The third theme cluster is Strength
deterioration. This is when the informants emphasized their feelings of weakness and
fatigue during or after their activities in which links us to the next theme cluster which is
Shift in Societal Roles that focuses on the informant’s difficulty in adjusting their roles
from being able to being unable to do their responsibilities. Due to their inability to
perform tasks because of their deteriorating strengths it had been challenging for them to
get back to their past roles in their family and community. Another struggle for
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hypenated patients is the fear over their anticipated loss that leads to another theme
cluster which is the Fear of Impending Loss under the emergent theme Recurrence of
attacks. Despite the fear of the informants they have learned to value and gain positive
view in life along with strengthened faith toward their recovery which points to another
theme cluster which is Spiritual Stability.
Accepting Circumstances of Health Condition
The first theme cluster in the second emergent theme is Accepting Circumstances
of Health Condition. This theme cluster emphasizes the experiences of post resuscitated
patients wherein they have concluded and come to realization in accepting their
condition. Along with their acceptance, they were able to cooperate better in the
treatment process of their health condition and the patients were more willing to
participate to recover optimum level of health that they could attain. To clarify this, the
informants provided significant statements through their interview:
“Minsan sa isang buwan ang check-up ko dahil iskedyul ng doctor yun eh. Lahi
namin sa nanay. Edi kumbaga sa ano eh tinanggap eh yun na ang dumapo sa
pamilya yung ganoong sakit kaya ganoon.” [PCAP1 line 122-127]
(I have my regular monthly check-ups. I had a family history of this condition. I
eventually learned to accept my situation because I know it runs in the family.)
“Pero ayos naman masaya at kinakaya. Kung maaari ay ayoko pero kung ano
man ang dumating ay ayos lang. panget o maganda basta handa na ko kung alin
man doon. Mas sumusunod na ko sa utos ni doc. Buong pamilya kumakain ng
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masustansya. Wag matigas ang ulo. Sumusunod at iniiwasan ang bawal para
mabuhay pa ng mahaba haba.” [PCAP3 line63-71]
(It’s fine, still happy and fighting. If I were to choose, I would definitely choose to
be healthy but still, whatever happens, happens. Come what may. I have been
more obedient to my doctor. Being stubborn won’t help me. Adherence to
treatment can prolong my life.) My family also eats my diet.
The above statement shows how the informants have accepted and adjusted with
their condition along with it is how they perceive there changes positively. In the 5 stages
of grief the last stage of grieving is the acceptance. This is when a person is now able to
acknowledge their loss whether this might be a person or object. (Kubler-Ross, 1969 as
cited by Gregory) In line with this theory, post resuscitated patients may have developed
and undergone these stages. Their loss may not be necessarily someone or an object. The
loss can be from their past selves or old habits that couldn’t be done anymore due to their
health condition. As posed by the statements above it is evident that they have accepted
such situation.
Healthy lifestyle plus Diet
Another theme cluster is Healthy Lifestyle plus Diet. This theme cluster
highlights the changes the informants have made with regards to their lifestyles and diet.
In 89% of people who adheres in proper diet 81% of them have observed the
improvements on their symptoms (PhysiciansCommittee, n.d). Most commonly doctors
would recommend fish and chicken diet but over time patients who follow this kind of
diet gets worse (Shaw, 2014). In line with this, informants recognized these risks,
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therefore chose to take action by changing their diet plans. It will be clarified further with
the following statements:
“Kumakain din ako ng gulay kaya lang di pwede na iisa. Bawal pang igisa. Tapos
sa isda naman bawal yung malansa. Tapos kelangan sa isda eh puro ihaw o kaya
pinangat. Pero yung mga ano baboy manok bawal talaga. Netong naging grabe
na ko dati kasi ay! Wala akong pakialam kahit na bawal . mamamatay kung
mamamatay. Eh ngayong nakita kong nahihirapan na ang mga anak ko di na ko
nag-ano. Nakita ko naman lahat ng anak ko di ako pinabayaan kahit ilang beses
akong naatake.”[PCAP4 line97-106]
(I eat vegetables in varieties but is not allowed to be sautéed. For fish steamed or
boiled are the only preparations. Meat products such as pork and chicken must be
avoided. On my first time I didn’t care as to what I eat and I eat what I want. But
when it had recurred I have seen how my children have suffered with me which
made me change my mind)
“Kakain ka ng masustansya at iwasan ang mga baboy. Kasi dati puro ako
matataba pero ngayon hindi na. madalas na ko sa gulay. Noon kasi sisig lechon
pero ngayon nakakatakot na. nahihilig na talaga ako sa gulay kasi natatakot na
kong maulit na naman pa yung nangyare”[PCAP5 line 104-109]
I only eat (Low fat and more nutritious foods. I always eat fatty foods back then
but now I have settled to veggies and grilled pork were my favorite but now with
the fear of my condition I stuck with vegetables because I fear that I might suffer
another attack.)
The lack of commitment to a healthy lifestyle is a major contributor for the
increasing risks of developing heart problems in the United States (American Heart
Association, 2015). A program called Cardiac Rehabilitation is designed to improve the

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current condition of the heart and there are three major elements that would reduce all
modifiable risks: Exercise, healthy lifestyle and stress reduction (American Heart
Association, 2016). Therefore, adherence to proper diet would highly affect the quality of
health the informants will possess. Healthcare providers such as nurses could intervene in
this type of situations by providing proper knowledge on what type of diet should be
followed as well as the importance of reinforcing it.
Aside from changes in diet plans informants also emphasized that along with diet
they have discontinued and eradicated completely their unhealthy habits such as tobacco
smoking. To a better understanding here are some of the significant statements made by
the informants:
“Pero ngayon hindi na. eh kahit labag sa loob ko kelangan kong sumunod lalo na
kung gusto mong mabuhay pa ng mas matagal. Kelangan iwasan ang dapat
iwasan hindi naman habang buhay eh magagawa mo yung mga ganoong bagay.
Iyong paninigarilyo ko tinigil ko na talaga. Minsan darating talaga yon.”
[PCAP5 line 29-34]
(Though it is hard for me and I don’t like it. I have to follow what is best for my
health especially when you want to live longer. Avoid what is harmful to health
because you cannot always do those things anymore. I have stopped smoking.
Things like these would come to our lives.)
“Gaya nga ng sabi ko mga habits ko kung noon eh ako ay madalas manigarilyo
ngayon wala na talaga. Mahirap magkasakit ng ganto kelangan mag-ingat ka na
habang malakas ka pa.” [PCAP2 line 59-63]
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(I had bad habits back then like frequent smoking but now I have stopped. It’s
hard to deal with this condition that’s why you have to stay healthy while you’re
still able to.)
Tobacco smoking has been the leading cause for cardiovascular diseases even
light and low-tar cigarettes can increase the risks. Smoking cessation can substantially
decrease risks of attacks within a few weeks (University of Iowa, 2016). With regards to
experiences of the informants, change in their lifestyle habits and removing tobacco
smoking to it can substantially decrease their risk of having another attack therefore
decreasing the chances of being resuscitated again in which also leads to decreasing the
anxiety felt by the informants as to the recurrence of their attacks and resuscitations. This
practice should be advised and elaborated by the nurses through health teaching imposing
their roles as health promoters.
Aside from changing diet and smoking cessation informants have also
emphasized that they have totally eradicated alcohol from their diet because it was
advised to them that alcoholic beverages can also harm the health of their heart. To
further explain informants have provided the following significant statements through
interview:
“Ngayon takot na ko na uminom kasi may sakit ka na nga eh tapos di ka pa

magbabago edi lumala lang lalo. Mapapaikli lang ang buhay mo.” [PCAP2 line
39-42]
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(I’m scared of drinking after my attacks. You have to change when you are sick
because if you are stubborn it will only worsen your condition. It will just kill
you. )
“Ganun talaga kung gustong humaba pa ang buhay, alisin ang kinakaugalian
mong gawin o kainin lalo mga bisyo na yosi at alak dapat wala na
talaga.”[PCAP5 line36-38]
(If you want to preserve and prolong your life you have to change your ways
especially diet and lifestyles. It should be eradicated totally.)
In the like manner, alcohol consumption also contributes to increasing the risks of
developing heart diseases because alcohol can increase the levels of blood pressure which
may most likely lead to heart problems. Aside from this, according to Sandee LaMotte in
CNN Philippines (2018) there is no amount of alcohol consumption which is good for the
health and it is better not to drink at all. Therefore, total eradication of alcohol from their
diets can significantly improve their health conditions and it is a responsibility of nurses
to point this out to patients having problems to alcohol consumptions.
With regards to healthy lifestyle informants have stated that in combination with
their proper diet and eradication of bad health habits they have also added exercise in
their daily routine to accompany them in keeping their heart functioning and active. In
order to clarify this notion the following statements will state their experiences:
“Di ako madalas nakahiga sabi nga ng doctor eh exercise! Sa umaga na parang
ah nagjojogging pero hindi naman jogging na patakbo yun bang unti unti na
lalakad ka. Yun iaano mo ang katawan mo para bang step by step yung paglakad
mo eh dahan dahan hanggang sa pabilis ng pabilis” [PCAP1 line 88-95]
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(My doctor told me to exercise. I jog at the morning but with precaution because I
don’t want to force myself. It should be done progressively.)
“Oo buhat nung inatake ako di na ko gaanong nagtatrabaho pero lumalabas

naman ako pag nag-eehersisyo. Mga tamang lakad lang onting takbo para sa
pagdaloy ng dugo” [PCAP5 line 101-104]
(After my attacks, I don’t usually do much but I go out and try jog and exercise. I
walk and run to aid proper and more efficient blood circulation.)
It also shows that along with proper diet, and healthy habits it is also important to
allot time for proper exercise. For people with heart conditions it is important that
exercise should be kept in moderation and gradually increase level of exercise because
extensive exercises can stress out the heart (Chest Heart and Stroke Scotland, 2018). It
was advised by the American Heart Association (2015) through their Cardiac
Rehabilitation Program that one of the major elements affecting cardiac health is proper
exercise. There has been a study focusing on how muscle strengthening activities could
help reduce risk to acquiring CVD. Moreover, Physical activities are good predictators of
the health status of an individual (Artero et al, 2013). Ability of informants to perform
activities could be good markers as to describing a patient’s overall health condition,
therefore with moderation in exercises and activities could aid the informants to achieve
their old activities again if pursued with commitment along with other adjustments with
lifestyles and habits.

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Strength Deterioration
Apart from the adjustments made by the informants, symptoms of the damage to
their health are still evident in their day to day activities. One of these symptoms is the
slow yet observable deterioration of their sense of strength. As gathered by the
researchers some significant statements of the informants explain these experiences:
“Mas masakit yung pangalawa kong atake. Kasi yung pangalawa mas malala.
Yung una kasi unexpected eh biglaan talaga yung pangalawa naman alam mo na
kasi pag naramdaman mo na kaya may halo ng takot. Parang habang tumatagal
lalo kasing lumalala”[PCAP5 line 67-72]
(My second attack was more painful and worse. My first was unexpected but
when I felt the symptoms on my second attack I felt fear because it feels like with
every attack my condition gets worse)
“Nung pangatlong atake ko, mataas ang kolesterol ko. Eh ayun nga para akong
nawawalan ng pag-asa. Parang napanghihinaan na ko hindi parang dati na ang
lakas ko.” [PCAP4 line 45-48]
(I had high cholesterol levels on my third attack. I felt hopeless. I feel so weak
unlike the times when I was still able to do things.)
“Para bang mas mahirap ngayon. Yung pinanghihinaan ka ng loob, na

nanghihina din ang katawan mo.” [PCAP1 line 81-84]
(It is harder this time. It is when you feel useless because your body can’t function
properly.)
Moreover, through the statements from the informants it highlighted that there is
feeling of fatigue on patients even with small activities alone. After surviving cardiac
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arrests it was found out that most patients experience significant impairments in their
level of functioning. Up to 50% of patients who suffered cardiac arrests have complained
of chronic fatigue (Wachelder, 2009) According to a psychologist in 1959 as cited by
McLeod, in the stages of psychosocial development, the generativity vs stagnation can be
a way to explain this aspect of experience by the patients. In this stage of psychosocial
development people on this level is to either attain generativity or stagnation. If the
person doesn’t feel like he/she is able to attain productivity, it is likely that the person
will end up stagnant and lose his/her resolve to perform tasks. If the person feels like
he/she is able to function and still be productive despite other factors, he is able to cope
and therefore falls on the generativity side (McLeod, 2018). Thus, post resuscitated
patients may feel stagnated due to being unable to perform tasks because of the
deterioration in physiological strength but however they could also achieve generativity if
the informants are able to cope with activities and would be able to view alternatives in
performing activities without exerting much effort or achieving it in a simpler technique.
This is also one of the responsibilities of nurses as helping the informants to find
techniques that could aid carrying out of activities or use of assistive devices that can
enhance their movements.
Shift in Societal Roles
Aside from the physiological effects of the experiences of post- resuscitated
patients, it has also been emphasized by the informants that the changes they have
encountered have also wounded them emotionally. Most specifically, the changes in their
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roles as a human being as to their functions in the society, friends and family. Statements
have been provided by the informants to further clarify the notion:
“ Dati nakakatulong sa pamilya pero ngayon pabigat na lang. tumutulong na

lang sa bahay. Si ate na ang nagbabantay sa akin. Dati ako pa bumibisita sa mga
kaibigan ko pero ngayon sila na. nakakainggit pero ganun talaga.”[PCAP3 line
51-57]
(I am not able to help with my family anymore. My daughter stays with me. I
used to come over to my friends but it is the other way around now)
“Nahihiya at naawa ako sa mga anak ko kasi dapat ako pa din ang tumutulong
sakanila. Eh ngayon sila pa nag-aalaga saken. May mga anak na sila naano ako
kasi dadagdag pa ko sa alagain at gastos”[PCAP4 line 68-71]
(I am ashamed to face my family because I can’t provide for them anymore. Now,
I feel like I am being a burden to my family.)
It was evident with the statements of the patients shows how significantly affected
they were emotionally, after their experiences. In a research study in Netherlands by
Wachelder et al (2009), approximately 38% of people who have survived suffer from
anxiety and depression. As seen and observed by the informants, anxiety and depression
is likely taking place in their lives with regards to their inability to do the duties they used
to perform. In line with this, healthcare providers should intervene with this situation as
to preventing them to be threat to themselves and aid verbalization of feelings to help
identify problems as well as resolving them with adaptive coping techniques.
Aside from the physiological effects of the experiences of post- resuscitated
patients, it has also been emphasized by the informants that the changes they have
encountered have also wounded them emotionally. Most specifically, the changes in their
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roles as a human being as to their functions in the society, friends and family. Statements
have been provided by the informants to further clarify the notion:
“ Dati nakakatulong sa pamilya pero ngayon pabigat na lang. tumutulong na

lang sa bahay. Si ate na ang nagbabantay sa akin. Dati ako pa bumibisita sa mga
kaibigan ko pero ngayon sila na. nakakainggit pero ganun talaga.”[PCAP3 line
51-57]
(I am not able to help with my family anymore. My daughter stays with me. I
used to come over to my friends but it is the other way around now)
“Nahihiya at naawa ako sa mga anak ko kasi dapat ako pa din ang tumutulong
sakanila. Eh ngayon sila pa nag-aalaga saken. May mga anak na sila naano ako
kasi dadagdag pa ko sa alagain at gastos”[PCAP4 line 68-71]
(I am ashamed to face my family because I can’t provide for them anymore. Now,
I feel like I am being a burden to my family.)
It was evident with the statements of the patients shows how significantly affected
they were emotionally, after their experiences. In a research study in Netherlands by
Wachelder et al (2009), approximately 38% of people who have survived suffer from
anxiety and depression. As seen and observed by the informants, anxiety and depression
is likely taking place in their lives with regards to their inability to do the duties they used
to perform. In line with this, healthcare providers should intervene with this situation as
to preventing them to be threat to themselves and aid verbalization of feelings to help
identify problems as well as resolving them with adaptive coping techniques.
Fear of Impending Loss
Another element in the experiences of post-resuscitated patients is their
anxiousness toward anticipated loss. It had been highlighted by the informants that after
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being resuscitated multiple times, it made them frightened of what are the other possible
outcomes of their resuscitation and how it would affect them as well as their significant
others. Being terrified of another arrest and resuscitation made them feel uneasy. To
further elaborate significant statements are taken from the informants’ interviews:
“Gaya ng may takot ako pagkainaatake na ko sa puso. Wala eh kailangan

talagang magbago at hindi pupwedeng hindi ka magbago. Kasi minsan konting
pagod may kaba ka na anjan na naman at di mo maalis isipin na baka yun na ang
huli mo kaya mas nakakatakot”[PCAP2 line 23-30]
(I always feel fear whenever I have my attacks. I need to change because it is a
must. Sometimes, when I feel tired I also feel uneasy because I might get another
attack. It also might be my last.)
“Siguro yung gawain ko noon kasi normal, ngayon madami ng bawal. Kaunting
kibot takot. May kaba. Baka anytime atakihin” [PCAP3 line 48-51]
(Back then I have normal routines but now there are so many restrictions. With
just simple activities and I feel like there is going to be another attack)
“At yung kaba kapag may nararamdaman kang paninikip ng dibdib parang
hayan na naman jusko baka eto na to. Kasi pag inatake ka naman di mo masasabi
kung anong mangyayare” [PCAP5 line 95-98]
(There is fear every time I feel my chest tighten. I got this notion that tells me that
here it comes again. )
The statements of the informants highlight their worries of another recurrence of
their attacks and moreover what would be its result. According to American Heart
Association (2018), it is normal to be afraid for not having full control over one’s own
life but through positive self-talk and proper understanding to own condition it could
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lessen its symptoms. In chronic patients it was found that these types of patients have
more often and intense thoughts about their deaths (Khawar, 2013). In line with this, the
Terror Management Theory in 1986 by Greenberg, Solomon and Pyszczynski as cited by
Heflick is a theory that proposed fear of death can trigger more positive behaviour to
people suffering from it. Therefore encouraging them to preserve life and may increase
self-esteem (Heflick, 2012). So as to the experiences of the informants, their feelings of
worry towards their unexpected death happens commonly to patients with chronic
conditions like them but this fear or threat they feel to their lives can be utilized properly
in order to view life positively and to be able to preserve and value life better. This
concept must be realized by patients with the help of healthcare providers such as nurses.
Nurses should lead their patients toward this goal of life preservation through therapeutic
communication and establishing a therapeutic relationship.
In addition0, informants who have considered that their condition may lead to
their own death have also prepared and felt dreaded that soon they may leave their family
behind. Patients have emphasized their feelings of worry about what would happen to
their family if the attacks would recur and result to death. In order to elaborate the
informants’ experiences significant statements are taken from their interview:
“Masakit at malungkot. Natatakot akong maiwan ang pamilya ko. Ayoko silang
iwan. Kelangan pa nila ako at gusto ko pa silang mapanood, makita at
makasama” [PCAP3 line 13-17]
(Painful and sad. I don’t want to leave my family. They still need me. And I want
to watch them grow.)

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“Kailangan mo na talagang magbago at hindi pwedeng hindi magbago kasi

mahirap. Mahirap mawala kasi yung mga anak mo mga bata pa masyado.
Walang katuwang yung asawa ko sa pagpapalaki. Kaya hangga’t maaari gusto
ko pang mabuhay” [PCAP2 line 52-59]
(You have to change. It is hard to leave because my children are still young. My
husband can’t take care of them on his own. That’s why I still want to live longer)
Informants have emphasized their concerns regarding the aftermath of their death
concerning their families. The most distressing event a family could suffer is a death
crisis which is inevitable and could disrupt a family system. (Afolabi, 2014) Death of a
family member can highly affect family status functionally because of the sudden
presence of a space or void on where someone once was (Rosalia, 2016), this can also be
a factor that could contribute in developing a dysfunctional family that could lead to
different problems such as increase in incidence of illness in the family, behavioural
problems and marital conflicts (Giuffra, n.d). Informants verbalized their thoughts with
regards to what will happen if death would finally separate them to their families which
may result to dysfunctional families. As nurses, along with the patient, family should also
be prepared with the outcomes of the patient’s disease. Through health teaching letting
the family decide and be included with the treatment activities of the patient would be
able to enlighten and prepare the family as to what are the possible situations their family
member may be in.
Spiritual Stability
In contrary to the dreadful situation of the informants, they were also able to cope
and thought of the good side. Informants were able to recognize that despite their losses,
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recovery and attaining functional level of health is not farfetched. With proper discipline
in the treatment regimens and adherence to medical advices it is likely to achieve
productivity. To clarify this notion patients have given statements through their
interviews:
“Wag matigas ang ulo. Sumusunod at iniiwasan ang bawal para mabuhay pa ng
mahaba haba. Siguro laban lang! sayang ang buhay kung ano ang pinagkaloob
tanggapin na lang para mabawasan ang sakit. Magpagaling at sumunod sa
doctor” [PCAP3 line 69-75]
(Don’t be stubborn and follow the restrictions to continue living. Fighting! It is a
shame to waste life and you have to accept to reduce the pain. Take care and
follow the doctor)
“mag-iingat sa lahat ng kinakain, sa lahat ng mga sa ano na eh pagka gabi eh di

natin malalaman kapag ka sumakit eh dinapuan ka ng sakit di mo alam kug saan
ka aano kaya mag-ingat na lang.” [PCAP1 line 130-135]
(Be careful on what to eat. At night, we don’t know it might recur. Just be careful
because we can never tell when and where it might happen again)
By analysing the statements, it was evident that the informants have developed a
positive approach towards their condition. As they have perceived treatment regimens to
be helpful to relieving symptoms it also has provided them sense of control over their
condition. Moreover, this can also enable people to work for their recovery and provide
sense of improved well-being (Unantenne, 2013). Spiritual strengthening improves the
quality of life the patient would live. Aside from that, patients are also likely to be more
independent and able to handle stress more effectively (Lawler&Younger, 2002).
Adaptive coping mechanisms of the informants have been highlighted in these

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statements. Stability of the informants through this coping mechanism could substantially
affect their behaviour towards their condition making them more reliable and
independent to self-care in which is one of the goals of treatment as nurses.
Furthermore, in part of achieving highest level of health condition for post
resuscitated patients. It was also stated by the informants that they have learned to cherish
their life and make the most out of it. Due to the fear of dying it led the patients to value
and recognizes the worth of their life and health. Explaining these experiences from the
informants significant statements are taken through interviews:
“Nakikita ko na ngayon na isa akong pinagpalang tao. Kasi binigyan niya ko ng

tyansa na ipagpatuloy ang buhay ko. Kasi kala ko talaga mamamatay na ko nung
inatake ko.” [PCAP5 line 88-91]
(I can see that I am a blessed person. The Lord gave me another chance to
continue my life. I thought I was going to die that day.)
“Maswerte ako na nandito pa ako para makasama ang pamilya ko.

Nagpapasalamat ako na may pagkakataon pa ko.” [PCAP3 line 24-27]
(I am lucky that I am still able to spend time with my family again. I am grateful
that I still had the chance.)
Most patients having near death experience have emerged with more positive
perception regarding living a fulfilled and significant life despite their distressing
struggles and tremendous emotions (Hartley, 2016) Statistically, 80% of people who
suffered a near death experience have claimed that this made a significant difference in
their lives in various aspects. In addition these patients have developed a notion to focus
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on what he/she has now rather than stressing out over the past experiences. (Atwater,
2017). As verbalized by the informants through their experiences, their attacks and
resuscitations have made them see the worth of their lives with regards to their unfulfilled
functions and as to their point of views of their achievements. This positive outlook could
serve as motivation to adhere in treatment regimens which is highly needed by nurses
with regards to the interventions that requires cooperation of patient and this positive
attitude should be achieved with the support of therapeutic communication used by the
nurses.
Family support
Through observation and statements of the informants, the support from the
family has been evidently shown especially after multiple resuscitations because it had
been perceived that cardiac arrests can manifest multiple times and it is likely to reoccur.
Significant statements taken during the interview with the patients will provide better
understanding upon this notion:
“Nakasuporta lang sila. Kaya noon di ko naramdaman na may sakit ako

at napapabayaan ako. Nakita ko yung pag-aalaga nila. Pag may sakit ako halos
lahat sila nakabantay na sa aken. Di nila ko iniiwan. Doon lumalakas ang loob
ko.” [PCAP4 line 61-65]
(They have supported me. That’s what helped me not to feel sad over myself and
they never made feel left out. I have seen them exert their efforts. When I feel
sick, all of them are there to take care of me. They never leave me. That’s what
made me stronger)
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“Syempre unang una sa lahat sermon ang natikman ko sa asawa ko yung

pag-aalala ganun. Pero naiintindihan ko naman kasi ganun naman lahat. Yung
mga anak ko nag-aalala din sila nga yung nasa tabi ko nung nasa ospital ako.
Nagpapasalamat ako sakanila. Walong anak ko nanjan talaga sila” [PCAP5 line
76-81]
(I really had admonish from my wife but I understand because I know she
is only worried about me. My children were also worried and stayed with me at
the hospital. I am thankful for them. All eight of them were really there.)
Consistent and strong support system is one of the most significant essentials for
fast and efficient recovery of most patients suffering from different illnesses (Landau,
2011) in a study by Rosland and Piette (2015), family members should help their patients
to recover by setting goals of treatment, practice communication to motivate patients
therefore promoting adherence to treatment and as well as involving themselves in the
course of treatment. Inclusion of family members in treatment process could alleviate
feelings of anxiety of patients by having the sense of familiarity. With regards to the
experiences of the informants, the support provided by their family members had made
them feel at ease. Nurses assess the overall health of patients and included with these is
how the family members of the patient cope because ineffective coping of the family can
lead to disruption to the functions of the family in which should be seen as a possible
problem that threatens the health of individuals. Thus, this a responsibility of a nurse to
be recognized and prevented. Counselling of family members is also an intervention that
could be performed by nurses with regards to performing their roles as counsellors.

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In line with the statement of the problems of this study, through extensive analysis of the
experiences of the informants the questions have been provided with answers.
1. What are the difficulties of post cardiac arrest patients after multiple
resuscitations?
Through the experiences of post cardiac arrest patients that have been shared, the
researchers are able to determine the difficulties of patients with regards to their
complaints and worries that have been expressed through the interviews. One of the main
problems faced by the informants is their inability to return to their old habits as well as
activities because strenuous activities should be avoided as advised by their doctors.
Their feeling of body weakness and short span of endurance have made them more
worried about their condition. Due to their incapacity for activities, this has also made
them feel useless and unproductive some have progressed to depression however most
are able to get by and see their condition positively. Aside from the depression there is
also fear towards own death. The two sides of post resuscitation results can be very
bothersome especially to patients because it is their lives at stake. Anxiety of the
informants has wounded them deeply because it had made them too conscious of time left
for them and what are the things that they will miss. These difficulties are main concerns
of the informants but with these difficulties, adaptive coping techniques emerged.
2. How do they cope with this traumatic event?
As mentioned by the experiences of the informants, coping was never easy and it had
been their main struggle but through analysis, coping techniques presented and adapted
by the patients have made their way of living easier. As discussed above, one of the
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difficulties is decrease in activity, one of the coping techniques demonstrated by the
informants is that they have adjusted their lifestyle in order to improve their health status
therefore making more able to perform activities. Along with lifestyle changes, they have
been more committed and adhered to treatment plans in attempt to strengthen them and
improve their capacity to tolerate activities. Also, aside from problems with activities,
anxiety was suffered by the informants due to their impending deaths. Near death
experience have affected them and have built up fear within them. With this fear,
informants have developed an adaptive coping technique to view their experience as a
second chance as well as to value their time and live a fulfilling life. This positive
outlook had led them to be more independent, reliable and cooperative to treatment
process also promoted adherence to medical advises and medication. Also, with the aid of
the optimism developed by the informants they are able to cope with their depression and
reduce its symptoms that could complicate health condition.

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Chapter 4
Summary, Conclusions and Recommendations
Upon doing the study, all the data gathered by the researchers by way of using a
semi-structured interview. Important statements made by the informants were arranged
and analysed fully. The researchers also formulated the meanings from the statements
according to their level of understanding. Furthermore, researchers also manage to
precisely arrange the gathered data and the formulated meanings into theme clusters
which are all under the emergent themes through extensive examinations. Nonetheless,
the statements made by the informants aided the researchers to come up with an analysis
as well as evaluate the experiences they had from their multiple resuscitations. From the
changes and adjustments they made down to their way of coping and accepting their
situations.
In addition to this, the extracted data from the informants’ verbal replies to the
questions provided are used by the researchers as basis for an in-depth discussion. In
order to broaden the understanding with regards to the experiences of the multiple
resuscitated patients. With the process of analysis and screening made by the researchers,
some information given by the patients were found irrelevant to the focus of the study
hence they were set aside.
Experiences by the informants were arranged thematically by the researchers from
emergent themes, to the theme clusters down to their formulated meanings:
First onset of attack
Under this emergent theme are the experiences of the informants on the first onset
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of their attack and resuscitation. The following theme clusters are grouped according to
the aspects of health where the informants are affected. Alongside, are also how the
patient’s overthrew the difficulties and premises they have encountered along their way.
Also, emphasized in this theme, is how the informant’s view their selves after what
happened.
Denial to present condition
In this theme cluster, it had been elaborated that the informants experienced
inability to accept their condition mostly due to its sudden onset. It was also highlighted
how difficult it is for the patients to accept their condition. Moreover, stated in this theme
cluster are the manifestations of denial as the informant’s coping technique in facing the
clinical reality of being ill.
Requires assistance to activities
This theme explains another experience of the informants wherein they have
difficulties in performing activities on their own. Complex and effort-exerting activities
are hard to be achieved by these patients due to the weakness of the body that they are
suffering. Along with this, is that informants tend to alter or reduce their activities and
more often it is necessary for them to always have someone available to assist them in
activities.
Incompliance to medical advises and regimens
As part of their denial phase, patients tend to disagree with treatments.
Participation of patients to treatments is important to prevent recurrence of attacks and
resuscitation. Adherences to diet plans and lifestyle readjustments are the major elements
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of post care in patients who have undergone multiple resuscitations. Hence, in
compliance could be risky and may not promote increase to the level of health the
informants must achieve.
Adjustment in food choices
As part of the changes the patients should undergo is the modification in their diet
which is another experience that made the patient find their conditions to be difficult and
challenging. Diet regimens have been one of the main complaints of patients and also the
most difficult to follow. Informants have emphasized that oftentimes they are not able to
follow the diet requirement advised by the doctors and they tend to cheat more frequent
not realizing its consequences.
Decrease in vices
With cooperation of the informants, one of their difficulties is also removing vices
from their everyday routine. Though the adjustments like these are already done by the
patients, adherence and total eradication of these vices are not yet achieved and
recognized by these patients. Discipline in achieving a healthier lifestyle have been
challenging to these type of patients due to not recognizing the severity of their condition
Recurrence of attacks
In this emergent theme, it was highlighted the experiences of the informants who
have experienced resuscitation from cardiac arrests. This shows the difficulties and their
coping techniques in facing their problems regarding their condition.
Accepting circumstances of health
Due to its recurrence it made the individuals gain understanding and acceptance to
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their condition. Along with this, their feelings of being unable to control their condition
left them with no other choice other than accepting it.
Healthy lifestyle plus diet
Another theme cluster that explains what changes these patients have made with
regards to enhancing their health and preventing another attack. With these experiences it
also provided ways on how to keep and take care of their health as to reducing their risks
on having attacks and undergoing resuscitation again.
Strength deterioration
Problems to functioning have been highlighted by the informants on this theme
cluster. It was found out that with every recurrence of resuscitation, they felt weak and it
seems like their strength is diminishing.
Shift in societal roles
Demotion in the roles of the patients, in the family, community and society, have
made the informants feel worthless. Especially to the patients who have been providers of
the family, they have expressed disappointments on being unable to work and function as
they used to.
Fear of impending loss
Fear has been evident to these patients as they verbalized their fear of losing.
Losing their family, as with regards to their future death which explains their fear of
being separated to their family. Losing their own life, in line with their condition it is
undeniable that this may be the cause of their own death which is what they fear.
Times
Spiritual stability
Despite all the losses they fear, these patients have verbalized some realizations
that their conditions have taught them and one of them is to value their lives because it is
a chance given to them to spend more time with the people around them and also having
faith in recovering from this challenge given to them
Family support
Support system from their loved ones has been more evident after being
resuscitated multiple times according to the informants. They have also viewed as this as
their motivation in fighting off their condition and striving to live longer along with
recovering from the damages.
Conclusions
The conclusions that have been the product of this research are as follows:
1. The experiences of the patients who underwent resuscitation multiple times are
arranged and classified into variety of themes. This study has focused mostly on
their struggles they had to face after acquiring their condition.
2. Along with the differences, the informants have struggled through, coping
behaviours were also tackled and explained as to how they have managed to
overcome these differences.
3. This study also shows the domino effect on how the patients have been affected
with regards to the different aspects of health. It elaborates the relationship
between each change they have to overcome and how does these alterations have
influenced their lives.

Times
4. In addition, with regards to the different aspects of health this study shows that
the adjustments of post resuscitation patients not just includes physiological
adjustments hence, it also wounded them spiritually and emotionally.
5. This study also shows the variety of coping mechanisms used by the informants
and how it affected their condition regardless to the direction of its development
either positive or negative.
6. Introduced also by this study is the comparison of the experiences of patients who
have undergone resuscitation once and patients who had it several times.
Differences between the two set of experiences were elaborated to pin point the
main metamorphoses and how these changes affected the individuals
7. Moreover, it is observed that to these people the element of time is very essential
for they view that they only had little to spend. Therefore, valuing their lives more
and having a more positive outlook in life.
Recommendations
With all the gathered data, the researchers would like to suggest the following
recommendations for the lived experiences of post-cardiac arrest patients who have been
resuscitated multiple times.
For the post-cardiac arrest patients who have been resuscitated multiple times
This research would facilitate them to exhibit the understanding towards their own
experiences and let them see what phase they are going to deal with which would let
them be aware of their own condition. Afterward, the research proposes to understand life
Times
experiences of the post-cardiac arrest patients who have been resuscitated multiple times
in which this premise enact itself as living testaments that would draw the other post-
cardiac arrest patients to recognize and accept their own condition.
For the post-cardiac arrest patient who have been resuscitated once
This research would enable them to display the understanding with regards to the
experiences of the post-cardiac patients that have been resuscitated multiple times for
them to accept and recognized their condition early. Subsequently, the research intends to
help them to have insight on the things that the patients that who have been resuscitated
multiple times neglected to do hence; it would help them prevent worsening. Through
health teachings, the data gathered by this study could be disseminated to aid patients
understand their condition and take treatmen regimens seriously. Aside from health
teachings, coping techniques that have emerged in this study could be suggested to the
patients to address current symptoms.
For the future researchers
Primarily one of the common recommendations that the study would contribute for
the future researchers would able to extract portion of information on the study.
Moreover, the impact and difficulties of patients who have been revive not once but
multiple times from cardiac patients would be the keyword for the researchers to find the
needed information that the premise would be able to give. Furthermore, the researchers
could also consider suggesting, improving and revising the factors that are involved on
the research. This study could be furthermore elaborated and discussed using different
Times
methods of data analysis as well as increasing numbers of informants to cover more
varieties of individual. In addition, different research designs and instruments should also
be tested to get another angle of approach that could help analysis be more broad and
extensive.
For the family of the patients who have been revive multiple times from cardiac
arrest
Lastly, the support system involves the family to dive into awareness to the
difficulties and circumstances of post resuscitated patients especially multiple times
through this research. With the given research, physiological and psychological aspects
that are mentioned would enable the family to widen and maximize their understanding
regarding on how they can help them to cope with their condition. Moreover, adaptation
of other coping techniques could be provided by this study to multiple post-cardiac arrest
patients.
For the nurses and other health care providers
The research study can serve as references not only for future studies but also in
formulating care for these types of patients. Coping techniques included in this study
could be suggested to patients and this study would also serve as guide as to what were
possible difficulties patients would encounter. Having knowledge with the future
problems of these patients, nurses and health care providers may perform preventive
measures and prepare the patient to what it may have affected him/her.
Transcrip
Times Pag Lin Significant Formulated Theme Emergent
t No. e e Meaning Meaning Cluster Theme
No. No.
PCAP4 89 12- “ Nung una di - unable to Denial to First Onset

15 ko talaga maisip accept illness present of Attack
na mangyayare condition
and
saken yung
ganito para adjustments
bang tinatanggi
ng isipan ko - forcefully
yung sitwasyon. tries to return
Masakit kasi with normal
isipin na routines
biglaan eh.”
PCAP5 92 17- “Nagising ako - unable to Denial to First Onset

19 sinabi saken ng accept illness present of Attack
asawa ko yung condition
and
tungkol sa
kondisyon ko di adjustments
ako nakasalita.
Ayoko eh. Ang - forcefully
naisip ko agad tries to return
…bakit? Bakit with normal
ako?” routines
PCAP3 86- 9- ” Yung unang - unable to Denial to First Onset

87 13 beses ko kahit accept illness present of Attack
papaano condition
and
sumubok ako ng
mga trabaho sa adjustments
bahay pero yung
katawan ko ba - forcefully
eh parang tries to return
umaayaw kasi with normal
ramdam ko routines
kaagad ang
pagod.”
Times
PCAP1 82- 84- “Bale inatake - unable to Denial to First Onset

83 88 ako ng unang accept illness present of Attack
beses talagang condition
and
nagtrabaho pa
din ako sa adjustments
bahay.
Naglalaba, - forcefully
nagluluto, tries to return
naglilinis pero with normal
noon eh routines
ramdam ko na
ang
panghihina.”
PCAP3 88 57- “Sa mga gawain necessitate Requires First Onset

62 nga kaunti na support from assistance of Attack
lang mga with
significant
gawain sa activities
bahay di gaano others
yung mga
simple kaya ko
pa naman kasi
madalas akong
nagpapatulong
kay ate kasi siya
yung bantay ko
palagi”
PCAP4 90 55- “Kahit maglaba necessitate Requires First Onset

57 pupunta pa yung support from assistance of Attack
anak ko siya pa with
significant
ang maglalaba. activities
Pati pagluluto others
di na ko
makapagluto ng
maano”
PCAP1 83 100 “Kumbaga - does not take Incompliance First Onset

- naiinom lang medications of Attack
Times
107 ako ng gamot regularly to Medical

kapag may
nararamdaman -uninterested Advises
ako. Di ko with treatment
naman talaga
regimens and
nasusunod yang
mga recovery
maintenance na procedure
yan. Mahirap
kasi di naman
ako nasanay sa
mga gamot na
yan tsaka di ba
ika nga ng iba
masama yung
marami kang
naiinom na
gamot.”[
PCAP4 90- 84- “Kasi nung una - does not take Incompliance First Onset
91 89 kong binigyan medications of Attack
ng maintenance to Medical
regularly
ininom ko lang
Advises
siya ng tatlong
-uninterested
taon tapos
inistop ko nung with treatment
inistop ko dun regimens and
na siya
recovery
umatake. Tapos
uminom ako ulit procedure
so nung mga
nakaginhawa
ako umistop na
naman ako.
Nung umokay
na ko inistop ko
na yun.”
Times
PCAP4 89 35- Una kong atake - does not take Incompliance First Onset
39 sabi ng doctor medications of Attack
pwede daw to Medical
regularly
akong
Advises
magpaopera
-uninterested
pero baka daw
di ko kayanin. with treatment
Naisip ko regimens and
naman na
recovery
madadaan pa
naman to sa procedure
pag-iingat at
siguro sa gamot
kung sakali kaya
di din ako
pumayag.
Nagpauwe na ko
sa mga anak ko
nun
PCAP1 84 140 “Pero nung sa - does not take Incompliance First Onset
- unang beses ko medications of Attack
145 di ako to Medical
regularly
nakakapagpa-
Advises
check up ng
-uninterested
madalas kung
kelan lang with treatment
sipagin ganon. regimens and
Kasi ang ano ko
recovery
naman
kampante ako procedure
dahil di naman
ako
nakakaramdam
ng kung ano
ano.”
PCAP1 82 45- “Nung una kong attempts in Adjustments First Onset

atake kasi
Times
50 kumbaga nag- eating a well- in Food of Attack

ano lang ingat balanced diet Choices
lang ako sa
kinakain pero
nakakain pa din
ako ng mga
bawal mahirap
pa kasi talagang
pigilan. Gulay
minsan tapos
minsan karne
para balanse pa
din.”[
PCAP3 87 37- “Oo malaki ang attempts in Adjustments First Onset

42 nagbago kasi eating a well- in Food of Attack
lalo pag first
balanced diet Choices
time wala akong
ideya sa
nararamdaman
ko. Kaya naman
tuloy pa din ako
sa mga gawain
ko at mga
pagkain ng
bawal siguro
bawas sa iba
pero minsan
kasi di mo rin
mapipigilan.”
PCAP5 92 24- “Sino bang reduction in Decrease in First Onset

29 walang bisyo consumption of Attack
malakas akong Vices
of vices
uminom noon
pati sigarilyo.
Unang beses na
atakihin ako
nagbabawas
Times
ako kasi
delikado na ang
kalusugan ko.
Naninigarilyo
pa din naman
hindi naman
tulad dati kasi
dati umuubos
ako ng isang
kaha
maghapon.”
PCAP2 85 30- “Nung first time reduction in Decrease in First Onset

35 ko dahil nga di consumption of Attack
ko pa gaanong Vices
of vices
pinapansin yung
nangyayare
saken sige pa
din ako sa mga
dati kong bisyo
yosi at alak pero
dahil may takot
nagbawas pa
din ako kahit
papaano.”
PCAP1 85 122 “Minsan sa compliance to Accepting Recurrenc

- isang buwan treatment e of
127 ang check-up ko circumstance Attacks
regimen
dahil iskedyul
s of health
ng doctor yun
eh. Lahi namin condition
sa nanay. Edi
kumbaga sa ano
eh tinanggap eh
yun na ang
dumapo sa
pamilya yung
ganoong sakit
Times
kaya ganoon.”
PCAP3 88 63- “Pero ayos compliance to Accepting Recurrenc

71 naman masaya treatment e of
at kinakaya. circumstance Attacks
regimen
Kung maaari ay
s of health
ayoko pero kung
ano man ang condition
dumating ay
ayos lang.
panget o
maganda basta
handa na ko
kung alin man
doon. Mas
sumusunod na
ko sa utos ni
doc. Buong
pamilya
kumakain ng
masustansya.
Wag matigas
ang ulo.
Sumusunod at
iniiwasan ang
bawal para
mabuhay pa ng
mahaba haba.”
PCAP4 91 97- “Kumakain din - avoid foods Healthy Recurrenc

106 ako ng gulay that are e of
kaya lang di lifestyle plus Attacks
restricted from
pwede na iisa.
Diet
Bawal pang diet
igisa. Tapos sa
isda naman -smoking
bawal yung cessation
malansa. Tapos
kelangan sa isda - avoiding
Times
eh puro ihaw o alcoholic

kaya pinangat. beverages
Pero yung mga
ano baboy - proper body
manok bawal
workout
talaga. Netong
naging grabe na
ko dati kasi ay!
Wala akong
pakialam kahit
na bawal .
mamamatay
kung
mamamatay. Eh
ngayong nakita
kong
nahihirapan na
ang mga anak
ko di na ko
nag-ano. Nakita
ko naman lahat
ng anak ko di
ako pinabayaan
kahit ilang beses
akong naatake.”
PCAP5 94 104 “Kakain ka ng - avoid foods Healthy Recurrenc

- masustansya at that are e of
109 iwasan ang mga lifestyle plus Attacks
restricted from
baboy. Kasi dati
Diet
puro ako diet
matataba pero
ngayon hindi -smoking
na. madalas na cessation
ko sa gulay.
Noon kasi sisig - avoiding
lechon pero
alcoholic
ngayon
nakakatakot na.
Times
nahihilig na beverages
talaga ako sa
gulay kasi - proper body
natatakot na workout
kong maulit na
naman pa yung
nangyare”
PCAP5 92 29- “Pero ngayon - avoid foods Healthy Recurrenc

34 hindi na. eh that are e of
kahit labag sa lifestyle plus Attacks
restricted from
loob ko
Diet
kelangan kong diet
sumunod lalo na
kung gusto -smoking
mong mabuhay cessation
pa ng mas
matagal. - avoiding
Kelangan
alcoholic
iwasan ang
dapat iwasan beverages
hindi naman
habang buhay - proper body
eh magagawa workout
mo yung mga
ganoong bagay.
Iyong
paninigarilyo ko
tinigil ko na
talaga. Minsan
darating talaga
yon.”
PCAP2 86 59- “Gaya nga ng - avoid foods Healthy Recurrenc

63 sabi ko mga that are e of
habits ko kung lifestyle plus Attacks
restricted from
noon eh ako ay
Diet
madalas diet
manigarilyo
Times
ngayon wala na -smoking

talaga. Mahirap cessation
magkasakit ng
ganto kelangan - avoiding
mag-ingat ka na
alcoholic
habang malakas
ka pa.” beverages
- proper body
workout
PCAP2 86 39- “Ngayon takot - avoid foods Healthy Recurrenc

42 na ko na that are e of
uminom kasi lifestyle plus Attacks
restricted from
may sakit ka na
Diet
nga eh tapos di diet
ka pa
magbabago edi -smoking
lumala lang cessation
lalo. Mapapaikli
lang ang buhay - avoiding
mo.”
alcoholic
beverages
- proper body
workout
PCAP5 92 36- “Ganun talaga - avoid foods Healthy Recurrenc

38 kung gustong that are e of
humaba pa ang lifestyle plus Attacks
restricted from
buhay, alisin
Diet
ang diet
kinakaugalian
mong gawin o -smoking
kainin lalo mga cessation
bisyo na yosi at
alak dapat wala - avoiding
Times
na talaga.” alcoholic
beverages
- proper body
workout
PCAP1 83 88- “Di ako - avoid foods Healthy Recurrenc

95 madalas that are e of
nakahiga sabi lifestyle plus Attacks
restricted from
nga ng doctor
Diet
eh exercise! Sa diet
umaga na
parang ah -smoking
nagjojogging cessation
pero hindi
naman jogging - avoiding
na patakbo yun
alcoholic
bang unti unti
na lalakad ka. beverages
Yun iaano mo
ang katawan mo - proper body
para bang step workout
by step yung
paglakad mo eh
dahan dahan
hanggang sa
pabilis ng
pabilis”
PCAP5 94 101 “Oo buhat nung - avoid foods Healthy Recurrenc

- inatake ako di that are e of
104 na ko gaanong lifestyle plus Attacks
restricted from
nagtatrabaho
Diet
pero lumalabas diet
naman ako pag
nag-eehersisyo. -smoking
Mga tamang cessation
lakad lang
Times
onting takbo - avoiding

para sa alcoholic
pagdaloy ng
beverages
dugo”
- proper body
workout
PCAP5 93 67- “Mas masakit feeling of Strength Recurrenc

72 yung pangalawa powerlessness e of
kong atake. Kasi deterioration Attacks
and
yung pangalawa
mas malala. exhaustion
Yung una kasi with small
unexpected eh
activities
biglaan talaga
yung pangalawa
naman alam mo
na kasi pag
naramdaman
mo na kaya may
halo ng takot.
Parang habang
tumatagal lalo
kasing
lumalala”
PCAP4 90 45- “Nung feeling of Strength Recurrenc

48 pangatlong powerlessness e of
atake ko, deterioration Attacks
and
mataas ang
kolesterol ko. exhaustion
Eh ayun nga with small
para akong
activities
nawawalan ng
pag-asa. Parang
napanghihinaan
na ko hindi
parang dati na
Times
ang lakas ko.”
PCAP1 82 81- “Para bang mas feeling of Strength Recurrenc

84 mahirap powerlessness e of
ngayon. Yung deterioration Attacks
and
pinanghihinaan
ka ng loob, na exhaustion
nanghihina din with small
ang katawan
activities
mo.”
PCAP3 87 51- “ Dati demoted Shift in Recurrenc

57 nakakatulong sa functional e of
pamilya pero Societal Attacks
responsibilitie
ngayon pabigat
Roles
na lang. s in the society
tumutulong na
lang sa bahay.
Si ate na ang
nagbabantay sa
akin. Dati ako
pa bumibisita sa
mga kaibigan ko
pero ngayon sila
na. nakakainggit
pero ganun
talaga.”
PCAP4 90 68- “Nahihiya at demoted Shift in Recurrenc

71 naawa ako sa functional e of
mga anak ko Societal Attacks
responsibilitie
kasi dapat ako
Roles
pa din ang s in the society
tumutulong
sakanila. Eh
ngayon sila pa
nag-aalaga
saken. May mga
anak na sila
Times
naano ako kasi

dadagdag pa ko
sa alagain at
gastos”
PCAP2 85 23- “Gaya ng may - recurrence Fear of Recurrenc

30 takot ako and survival e of
pagkainaatake Impending Attacks
of
na ko sa puso.
Loss
Wala eh forthcoming
kailangan attacks
talagang
magbago at - separation
hindi
from
pupwedeng
hindi ka significant
magbago. Kasi others
minsan konting
pagod may kaba
ka na anjan na
naman at di mo
maalis isipin na
baka yun na ang
huli mo kaya
mas
nakakatakot”
PCAP3 87 48- “Siguro yung - recurrence Fear of Recurrenc

51 gawain ko noon and survival e of
kasi normal, Impending Attacks
of
ngayon madami
Loss
ng bawal. forthcoming
Kaunting kibot attacks
takot. May kaba.
Baka anytime - separation
atakihin”
from
significant
Times
others
PCAP5 94 95- “At yung kaba - recurrence Fear of Recurrenc

98 kapag may and survival e of
nararamdaman Impending Attacks
of
kang paninikip
Loss
ng dibdib forthcoming
parang hayan attacks
na naman jusko
baka eto na to. - separation
Kasi pag
from
inatake ka
naman di mo significant
masasabi kung others
anong
mangyayare”
PCAP3 87 13- “Masakit at - recurrence Fear of Recurrenc

17 malungkot. and survival e of
Natatakot akong Impending Attacks
of
maiwan ang
Loss
pamilya ko. forthcoming
Ayoko silang attacks
iwan. Kelangan
pa nila ako at - separation
gusto ko pa
from
silang
mapanood, significant
makita at others
makasama”
PCAP2 86 52- “Kailangan mo - recurrence Fear of Recurrenc

59 na talagang and survival e of
magbago at Impending Attacks
of
hindi pwedeng
Loss
hindi magbago forthcoming
kasi mahirap. attacks
Mahirap
mawala kasi - separation
Times
yung mga anak from

mo mga bata pa significant
masyado.
others
Walang
katuwang yung
asawa ko sa
pagpapalaki.
Kaya hangga’t
maaari gusto ko
pang mabuhay”
PCAP3 88 69- “Wag matigas - strengthened Spiritual Recurrenc

75 ang ulo. faith in e of
Sumusunod at Stability Attacks
recovery
iniiwasan ang
bawal para
-positive
mabuhay pa ng
mahaba haba. insight on the
Siguro laban value of life
lang! sayang
ang buhay kung
ano ang
pinagkaloob
tanggapin na
lang para
mabawasan ang
sakit.
Magpagaling at
sumunod sa
doctor”
PCAP1 84 130 “mag-iingat sa - strengthened Spiritual Recurrenc

- lahat ng faith in e of
135 kinakain, sa Stability Attacks
recovery
lahat ng mga sa
ano na eh pagka
-positive
gabi eh di natin
malalaman insight on the
kapag ka
Times
sumakit eh value of life

dinapuan ka ng
sakit di mo alam
kug saan ka
aano kaya mag-
ingat na lang.”
PCAP5 94 88- “Nakikita ko na - strengthened Spiritual Recurrenc

91 ngayon na isa faith in e of
akong Stability Attacks
recovery
pinagpalang
tao. Kasi
-positive
binigyan niya ko
ng tyansa na insight on the
ipagpatuloy ang value of life
buhay ko. Kasi
kala ko talaga
mamamatay na
ko nung inatake
ko.”
PCAP3 87 24- “Maswerte ako - strengthened Spiritual Recurrenc

27 na nandito pa faith in e of
ako para Stability Attacks
recovery
makasama ang
pamilya ko.
-positive
Nagpapasalama
t ako na may insight on the
pagkakataon pa value of life
ko.”
PCAP4 90 61- “Nakasuporta toughened Family Recurrenc

65 lang sila. Kaya support e of
noon di ko support Attacks
system
naramdaman na
may sakit ako at coming from
napapabayaan family
ako. Nakita ko
yung pag-
Times
aalaga nila. Pag

may sakit ako
halos lahat sila
nakabantay na
sa aken. Di nila
ko iniiwan.
Doon lumalakas
ang loob ko.”
PCAP5 93 76- “Syempre toughened Family Recurrenc

81 unang una sa support e of
lahat sermon support Attacks
system
ang natikman ko
sa asawa ko coming from
yung pag-aalala family
ganun. Pero
naiintindihan ko
naman kasi
ganun naman
lahat. Yung mga
anak ko nag-
aalala din sila
nga yung nasa
tabi ko nung
nasa ospital
ako.
Nagpapasalama
t ako sakanila.
Walong anak ko
nanjan talaga
sila”
Times
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Times
APPENDICES

(Formerly Dr. Yanga’s Francisco Balagtas Colleges)
182 Mc Arthur Highway, Wakas, Bocaue, Bulacan
(044) 692-5291 loc. 115
COLLEGE OF HEALTH SCIENCES
LETTER OF INTENT
Dear Ma’am/Sir,
Good day!
We, Fourth year Nursing students in College of Health and Sciences of Dr. Yanga’s Colleges
Inc., are conducting a research entitled “Life Restarted: Lived Experiences of Postcardiac Arrest
Patients Who Have Been Resuscitated Multiple Times”, in partial fulfilment of our requirements
in Nursing Research 2.
In line with this, we are humbly seeking your permission to allow us to conduct a study in your
institution. The research is directed only on the experiences of postcardiac arrest patients that we
believe can be for great help for the said study. Their interview will be audio recorded. This
would not affect the credibility of the institution. We can assure that the information given as well
as the informant’s identity will be kept confidential.
Your cooperation is very much needed and appreciated for the success of this study. We are
hoping for your utmost consideration regarding this matter.
Thank you and God bless!
Respectfully yours,
The researchers
Noted by:
Regie P. De Jesus, RN, MAN

Professor, Nursing Research
Approved by:
Teodora M. Delos Reyes, RN, DNS
Dean, College of Health Sciences

Times

(Formerly Dr. Yanga’s Francisco Balagtas Colleges)
182 Mc Arthur Highway, Wakas, Bocaue, Bulacan
(044) 692-5291 loc. 115
COLLEGE OF HEALTH SCIENCES
Consent of Participant
I have read the information presented in the information letter about a study being conducted by
the Fourth year Nursing students in the Colleges of Health and Sciences of Dr. Yanga’s Colleges,
Inc. I have had the opportunity to ask any information about the study, to received satisfactory
answer to my questions, and any details that I wanted. I am aware that I may withdraw from the
study without loss of participation credit at any time by advising the researchers of this
decision.
With full knowledge of all foregoing, I agree, of my own free will, to participate in that study.
Print Name
Signature of Participant
Times
The following are the guide questions asked to the informants by the researchers using
semi-structured interview:
1. How do you feel after being resuscitated?
2. Are there any changes made every after resuscitation? What are these and
how are you coping with it?
3. How do you see yourself with regards to your current condition?
4. Are there any differences between every resuscitation? What are these and
what are your perceptions about it?
5. What are the aspects of your life that have been affected by this
phenomenon?
6. With all of your experiences about the phenomenon, how did it affect your
well-being?
7. Are you willing to undergo the same process again? Why?
8. What are the preventive measures that you are doing in taking care of your
health?
9. With regards to your condition, how does your family deal with it?
10. What can you say to the people that are having the same condition?
Times
Transcript Line
number number Statements
PCAP 1 1 Eh blangko ang isip ko noong mga
2 panahon na ako ay nirerevive pero sa
3 umpisa eh ang nangyare eh hapon
4 bandang ala una nagising
5 akonararamdaman ko na masakit ang
6 dibdib ko, pinagpapawisan ako. Butil butil
7 ang pawis nang magpunta ako ng CR
8 dumumi ako tapos butil butil ang pawis ko
9 at masakit pa din ang dibdib ko. Edi nung
anon a yun eh ginising ko yung kasama ko
10
sa bahay at humingi ako ng tubig na
11
malamig at akoy uhaw. Nung bumangon
12
yung kasama ko hinipo ako at ako raw ay
13
basang basa ng pawis pinainom ako ng
14 tubig at pinahiga ako at binihisa tapos
15 nagising ako nasa hospital na ako at wala
16 na kong maalala. Yun yung una kong
17 atake yung pangalawa eh halos ganoon
18 din basang basa ako ng pawis at dibdib pa
19 din ang umaano sa aken anjan na may x-
20 ray ako. Taon bago umano yung
21 pangalawa kong atake meron yatang
22 pitong taon o walong taon. Mayroon
23 akong ECG noon x-ray tapos eh
24 pinagbabawal akong uminom ng malamig
na tubig eh hindi ko din mapigilin na para
25
bang ang lalamunan ko ay tuyong tuyo.
26
Atsaka inanno ako na para bang ang
27
dibdib ko’y masakit na masakit. Nawalan
28
ako ng malay noon blangko ang isip ko
29 wala akongf maalala noon. Kumbaga sa
30 ano eh akala ko eh ako’y mamamatay na
31 sa ganoong sitwasyon. Pagkagisisng ko’y
32 nasa hospital na ako. Mayroon akong
33 takot, kaba na baka maulit ulit yung
34 nangyare na yun na kumbaga eh baka pag
35 nangyare na yun doon na ko matuluyan
Times
36 kung halimbawa eh sa pangatlong beses

37 na mangyare iyon. Mayroong pagbabago
38 din kaya nga lang eh konting ingat at
39 maraming… maraming bawal sa pagkain,
40 pagtatrabaho, sa bahay at may mga gamot
pa ang ginagawa eh inaano ng doctor na
41
wag magsobrang pagod at ano kumbaga
42
disiplina na lang. Nung una kong atake
43
kasi kumbaga nag-ano lang ingat lang ako
44
sa kinakain pero nakakain pa din ako ng
45 mga bawal mahirap pa kasi talagang
46 pigilan. Gulay minsan tapos minsan karne
47 para balanse pa din. Ako naman yung akin
48 naman hindi naman highblood kundi no
49 blood ang umaano sa may ugat na
50 bumabara sa puso kaya nangyare yun
51 yung bumabara na ugat. Edi ako ay
52 nagdasal na kumbaga eh sana ay wag ng
53 mangyare ulit yung nangyare na yan. At
54 kumbaga eh mahirap isipin. Di naman ako
55 nahihirapan sa bawal na pagkain dahil
kumbaga eh kung gusto mo talaga na
56
gumaling makakagawa ka ng kung ano
57
ang bawal eh pwede mong iwasan. Di ko
58
na matandaan dahil blangko talaga ang
59
isip ko eh. Parehas lang ang mga nangyare
60 nung una at pangalawa. Parehas na
61 masakit ang dibdib, di ka makahinga,
62 kung ano yung ginawa sa aken nung
63 unang atake sa pangalawang atake eh
64 ganoon dn. Na may ECG pinainom inom
65 ng mga gamot gamot. Pakiramdam ko eh
66 mas maano mas matindi etong pangalawa.
67 Nung una kasi nakalakad pa ko at mejo
68 maano pa ang isip ko eh dine sa
69 pangalawa eh na parang walang malay
70 ako na nablangko ang isip ko pagsubok
talaga na hindi naman namin gustong
71
mangyare yang sakit kaya dasal na lang.
72
ganun pa din kaya lang yung lakas ko dati
73
na sa ngayon ano nagbago na para bang
74
Times
75 mas mahina ako ngayon kesa dun sa wala

76 kang ano di pa ko.. nung di pa ko
77 inaatake. Para bang mas mahirap ngayon.
78 Yung pinanghihinaan ka ng loob, na
79 nanghihina din ang katawan mo. Bale
inatake ako ng unang beses talagang
80
nagtrabaho pa din ako sa bahay.
81
Naglalaba, nagluluto, naglilinis pero noon
82
eh ramdam ko na ang panghihina. Di ako
83
madalas nakahiga sabi nga ng doctor eh
84 exercise! Sa umaga na parang ah
85 nagjojogging pero hindi naman jogging na
86 patakbo yun bang unti unti na lalakad ka.
87 Yun iaano mo ang katawan mo para bang
88 step by step yung paglakad mo eh dahan
89 dahan hanggang sa pabilis ng pabilis. Puro
90 ang iniisip ko eh bawal sa akin yan bawal
91 sa aken yun.. ganun.. para bang bawal sa
92 aken ang lahat. Kung minsan di mo rin
93 matitiskung minsan din nakakakain ang
94 nung mga bawal sa aken katwiran eh may
gamot naman. Kumbaga naiinom lang ako
95
ng gamot kapag may nararamdaman ako.
96
Di ko naman talaga nasusunod yang mga
97
maintenance na yan. Mahirap kasi di
98
naman ako nasanay sa mga gamot na yan
99 tska di ba ika nga ng iba masama yung
100 marami kang naiinom na gamot. Eh
101 siguro kung yun talaga ang ano eh bakit
102 hindi at kung ano eh ayoko sana pero
103 kung talagang dadating ulit ang ganoong
104 pangyayare hindi ka na makakahindi at
105 talagang dadating at dadating eh hindi mo
106 inaasahan. Hindi ka na makakahindi. At
107 nangyare na eh. Hindi naman sa handa
108 ako kumbaga eh kung kailan dumating eh
109 tanggapin at ano wala namang magagawa
eh. Yung lahat ngf bawal at lahat ng ano
110
eh na pag-eexercise at pag-iinom ng
111
gamot. Maintenance na. madami akong
112
gamot na sa dugo na kumbaga eh para di
113
Times
114 na eh lumapot ng ano na yung sa dugo

115 atsaka sa marami sa cholesterol. Minsan
116 sa isang buwan ang check-up ko dahil
117 iskedyul ng doctor yun eh. Lahi namin sa
118 nanay. Edi kumbaga sa ano eh tinanggap
eh yun na ang dumapo sa pamilya yung
119
ganoong sakit kaya ganoon. Oo naman
120
nag-aalala sila kadamayko sila sa oras ng
121
ah… pagka eh yung sumpong ng atake na
122
yan eh ano kasama ko sila sa ospital. Eh
123 ang masasabi ko lang eh.. mag-iingat sa
124 lahat ng kinakain, sa lahat ng mga sa ano
125 na eh pagka gabi eh di natin malalaman
126 kapag ka sumakit eh dinapuan ka ng sakit
127 di mo alam kug saan ka aano kaya mag-
128 ingat na lang. Wala akong bisyo hindi
129 ako naiinom ng alak o kahit na
130 manigarilyo. Wala naglalaba, napapagod
130 lang. ano pahinga muna at pagka talagang
131 pakiramdam ko eh alang pagbabago
132 atsaka ako nagpupunta sa check-up. Pero
nung sa unang beses ko di ako
133
nakakapagpa-check up ng madalas kung
134
kelan lang sipagin ganon. Kasi ang ano ko
135
naman kampante ako dahil di naman ako
136
nakakaramdam ng kung ano ano. Wala eh
137 kumbaga eh wala pa silang malay noon
138 pero kumbaga eh nag-aalala dn. Asawa
139 ko, bayaw ko at ambulansya. Nagpatawag
140 kami ng ambulansya. Oras na napagod eh
141 na para bang nanghihina na eh kumbaga
142 eh maano ang kabog ng dibdib ko nito na
143 lang ako nagpapacheck-up. Nung
144 sumpungin ng malala ang dibdib ko at
145 hirap na hirap akong huminga at ano pa
146 noon. 100% na kumbaga eh andiyan siya
147 at nasa tabi ko. Nag-aalala siya noon.
Pagka sobrang pagod eh may kirot pa din.
148
Nag-iinom na lang ako ng gamot. Sa
149
sobrang pagod eh nakakaramdam din ako
150
ng paninikip ng dibdib. Nanahi at pagka
150
Times
151 ano eh nagtatanim tanim ng halaman.

152 Hanggang sa bukid at yun bang mga
153 paunti unting halaman na pang-ulam.
154 Gulay- gulay.
155
156
157
158
159
160
161
162
163
Transcript Line
number number Statements
PCAP 2 1 Ako naman eh walang maramdaman at
2 tulog ako nun eh. Sumakit ang dibdib ko
3 tapos yung pawis ko tumutulo na. sabi ng
4 asawa ko eh dalhin na ko sa ospital.
5 Nung papunta na kami sa ospital eh
6 nawalan na ko ng malay. Nung mawalan
7 ako ng malay eh nasa ospital na ko
8 pagkagising ko. Sabi eh yung ano ko
9 tawag dun yung sa puso. Nung ano
10 nireresuscitate. Eh ang isip ko ay wala
11 parang madilim lang. blangko lang ang
isip ko. Wala akong naaalala sa mga
12
nangyayare. Sabi lang ng asawa ko
13
pagkagising ko eh atake nga daw. Di ko
14
alam yung mga nangyare saken nun.
15
Basta ang alam ko eh nawalan ako ng
16 malay. Eh pagkatapos kong makasurvive
17 netong pangalawa kong atake naging
18 mas maingat na ko sa mga pagkain ko.
19 Kadalasan puro gulay at isda. Di ko nga
20 maaya mga kaibigan ko. Di na ko
21 umiinom kasi nagagalit kasi nagagalit
22 ang misis ko. Iyong alak bawal. Gaya ng
Times
23 may takot ako pagkainaatake na ko sa

24 puso. Wala eh kailangan talagang
25 magbago at hindi pupwedeng hindi ka
26 magbago. Kasi minsan konting pagod
27 may kaba ka na anjan na naman at di mo
maalis isipin na baka yun na ang huli mo
28
kaya mas nakakatakot. Nung first time
29
ko dahil nga di ko pa gaanong pinapansin
30
yung nangyayare saken sige pa din ako
31
sa mga dati kong bisyo yosi at alak pero
32 dahil may takot nagbawas pa din ako
33 kahit papaano. Napapainom pa rin ako
34 nung una kasi alam mo na sa mga
35 kaibigan pero minsan naman
36 naiintindihan nila kung bakit pass ako
37 kung minsan. Ngayon takot na ko na
38 uminom kasi may sakit ka na nga eh
39 tapos di ka pa magbabago edi lumala
40 lang lalo. Mapapaikli lang ang buhay
41 mo. Nung una di ko masyadong iniisip
42 mga bilin ng doctor pasaway pa din
ganon. Di ako masyadong naiinom ng
43
gamot kasi ayoko ng maraming mga
44
tableta na iniinom.Bigla nagigising na
45
lang ako na may mga nakakabit sa akin.
46
Noong una di pa namin alam na atake
47 pala sa puso. Akala ko eh napagod lang
48 ako. Nung pangalawa eh alam na namin.
49 Pumunta kagad kami noon sa ospital.
50 Kailangan mo na talagang magbago at
51 hindi pwedeng hindi magbago kasi
52 mahirap. Mahirap mawala kasi yung mga
53 anak mo mga bata pa masyado. Walang
54 katuwang yung asawa ko sa pagpapalaki.
55 Kaya hangga’t maaari gusto ko pang
56 mabuhay. Gaya nga ng sabi ko mga
57 habits ko kung noon eh ako ay madalas
manigarilyo ngayon wala na talaga.
58
Mahirap magkasakit ng ganto kelangan
59
mag-ingat ka na habang malakas ka pa.
60
61
Times
62
63
Transcript Line
number number Statement
PCAP 3 1 Naalala ko nawalan na ko ng malay nun
2 pero bago yun habang nasa bahay pa ko
3 papasok sa trabaho nakaramdam ako ng
4 sakit sa balikat ko. Iyon tapos mabigat sa
5 dibdib na parng makirot ayun pagtapos
6 nun wala na kong maalala. Wala na kong..
7 maalala talaga. Wala na kong maalala
8 kung paano pero sabi saken ni jenny may
9 ginamit daw saken noon. Yung unang
beses ko kahit papaano sumubok ako ng
10
mga trabaho sa bahay pero yung katawan
11
ko ba eh parang umaayaw kasi ramdam ko
12
kaagad ang pagod. Masakit at malungkot.
13 Natatakot akong maiwan ang pamilya ko.
14 Ayoko silang iwan. Kelangan pa nila ako
15 at gusto ko pa silang mapanood, makita at
16 makasama.. Sa pitong taon , matapos nung
17 unang atake ngayon maayos na kahit ano
18 ng mangyare. Oo madami sa pamilya, sa
19 trabaho, pati na rin sa aking sarili. Mas
20 lalo kong gustong makasama ang pamilya
21 ko kahit na ano at makapagtrabaho at
22 makasama lang sila. Maswerte ako na
23 nandito pa ako para makasama ang
24 pamilya ko. Nagpapasalamat ako na may
pagkakataon pa ko. Marami ng bawal sa
25
aking gaya ng sa pagkain, pag gawa ng
26
mga bagay na dati kong ginagawa di ko na
27
magawa ngayon. Adjust! Kelangan eh.
28
Para sa pamilya. Naawa ako sa sarili ko
29 kasi kung dati malakas ako ngayon
30 mahina basta iba na. masakit makita na
31 kung dati nakakatrabaho ka ngayon asawa
32 at anak mo na lang. naging taong bahay na
33 lang ako. Pero ngayon kelangan sumunod.
34 Oo malaki ang nagbago kasi lalo pag first
35 time wala akong ideya sa nararamdaman
36 ko. Kaya naman tuloy pa din ako sa mga
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37 gawain ko at mga pagkain ng bawal

38 siguro bawas sa iba minsan kasi di mo rin
39 mapipigilan. Madaming emosyon at takot
40 talaga para sa pamilya, takot sa kalagayan,
maraming bawal at pag-iingat. Pero
41
ngayon parang hindi na kahit kailan ayos
42
lang. hinarap ko painot inot pero sa pitong
43
taon na ayos na sige lang. Siguro yung
44 gawain ko noon kasi normal, ngayon
45 madami ng bawal. Kaunting kibot takot.
46 May kaba. Baka anytime atakihin. Dati
47 nakakatulong sa pamilya pero ngayon
48 pabigat na lang. tumutulong na lang sa
49 bahay. Si ate na ang nagbabantay sa akin.
50 Dati ako pa bumibisita sa mga kaibigan ko
51 pero ngayon sila na. nakakainggit pero
52 ganun talaga. Sa loob kasi to. Sa mga
53 gawain nga kaunti na lang mga gawain sa
54 bahay di gaano yung mga simple kaya ko
55 pa naman kasi madalas akong
nagpapatulong kay ate kasi siya yung
56
bantay ko palagi medyo naawa na rin ako
57
sa sarili ko eh. Pero ayos naman masaya at
58
kinakaya. Kung maaari ay ayoko pero
59
kung ano man ang dumating ay ayos lang.
60 panget o maganda basta handa na ko kung
61 alin man doon. Mas sumusunod na ko sa
62 utos ni doc. Buong pamilya kumakain ng
63 masustansya. Wag matigas ang ulo.
64 Sumusunod at iniiwasan ang bawal para
65 mabuhay pa ng mahaba haba. Siguro
66 laban lang! sayang ang buhay kung ano
67 ang pinagkaloob tanggapin na lang para
68 mabawasan ang sakit. Magpagaling at
69 sumunod sa doctor.
70
71
72
73
74
75
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Transcript Line
PCAP 4 1 Ang naalala ko nun masakit ang dibdib ko, masakit siya
2 hanggang likod hanggang hindi na ko makahinga hirap
3 na hirap na ko. Yun yung una ah. Tapos nun nawalan na
4 ko ng malay. Pagtapos nung nawalan nga ako ng malay
5 ilang araw akong tulog. Sabi ng doctor sa loob daw ng
6 24hours at di pa ko ako nagising wala na.. ang alam ko
7 lang may naikabit silang aparato sa aken. Sabi ng anak ko
8 kinabitan nga daw ako tapos kumbaga naiiyak na daw
9 sila. Pinapatabi sila ng doctor nun wala na. nung iano raw
10 ako nabuhay daw ako kaya lang yun nga tulog. Meron
11 nung una may nagbago kasi nakaka… lahat ng mga ano
nagagawa ko. Nung una di ko talaga maisip na
12
mangyayare saken yung ganito para bang tinatanggi ng
13
isipan ko yung sitwasyon. Masakit kasi isipin na biglaan
14
eh. Ayun tapos etong sumunod na atake ko. Ano.. mga..
15 nawalan ako ng malay mga… apat na oras. Sabi ng anak
16 ko nung pangalawa. Ang ano lang nun ginagawa ng mga
17 anak ko di nila ko pinakikilos wala, sila na lahat ang
18 kumikilos, lahat ng gumagawa. Dahil bawal na sa akin
19 eh. Di na ko pede nung mga bagay na dating ginagawa di
20 ko na magawa. Dahil madaling mapagod yung puso ko.
21 Pangatlo na netong July 17. Parang nanghina na ko.. sabi
22 ng doctor di na daw pwedeng maoperahan kasi baka daw
23 bumigay na. kasi daw yung puso ko di na dinadaluyan ng
24 kuryente kaya hirap na siyang mag-ano. Oo meron kasi
25 yung una ko nung nagkamalay ako nung medyo nagising
26 ako nabalik ko pa yung dating lakas ng katawan ko eh
yung mga dapat kong ginagawa ako nagagawa ko pa.
27
etong huli, wala na. konting lakad lang hinihingal na ko
28
mabilis na kong mapagod. Eh ano kasi kung di lang dahil
29
sa mga anak ko baka bumigay na din ako saka yung apo
30
ko. Syempre dalawa na yung doctor na pinuntahan namin
31 iisa lang ang sinabi. Kasi yung unang pinuntahan namin
32 kumbaga di na daw tatagal akodoon na ko bumigay eh.
33 Una kong atake sabi ng doctor pwede daw akong
34 magpaopera pero baka daw di ko kayanin. Naisip ko
35 naman na madadaan pa naman to sa pag-iingat at siguro
36 sa gamot kung sakali kaya di din ako pumayag.
37 Nagpauwe ako na ko sa mga anak ko nun. Napanghinaan
38 na ko ng loob kaya lang yung mga kaibigan ko na
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39 nagsasabi sa akin lakasan ko raw yung loob ko kasi para

40 nga sa mga anak ko. Ang ginagawa ng mga anak ko
41 tinetherapy niya ko kasi yung una kong atake mataas daw
42 ang dugo ko. Sumunod na atake ko, puso na. Nung
pangatlong atake ko, mataas ang kolesterol ko. Eh ayun
43
nga para akong nawawalan ng pag-asa. Parang
44
napanghihinaan na ko hindi parang dati na ang lakas ko.
45
Eh sa akin kung mangyayare man ulit yun eh para di na
46 mahirapan ang mga anak ko eh iano na.. kasi naaawa din
47 ako sa mga anak ko. Yung gastos, imbes na mapunta sa
48 mga anak niya napupunta pa saken. Kung ano yung
49 sinasabi na bawal sinusunod ko na lang kasi ang daming
50 bawal sa akin eh. Sa una kong atake sa pagkain, trabaho
51 at mapagod at yung kumilos na ano. Kahit maglaba
52 pupunta pa yung anak ko siya pa ang maglalaba. Pati
53 pagluluto di na ko makapagluto ng maano. Kasi di na nila
54 pinakikita sa akin yung ano na napanghihinaan sila eh.
55 Syempre kung nakikita ko nga naman na napanghihinaan
56 sila lalo lang din akoang manghihina. Kaya kumbaga
57 parang dati pa rin na walang nangyare at nakasuporta
lang sila. Kaya noon di ko naramdaman na may sakit ako
58
at napapabayaan ako. Nakita ko yung pag-aalaga nila.
59
Pag may sakit ako halos lahat sila nakabantay na sa aken.
60
Di nila ko iniiwan. Doon lumalakas ang loob ko. Yun
61
kasi ang ano sakanila ng doctor na wag nila ipakita na
62 pinanghihinaan sila kasi pag nakita daw na
63 pinanghihinaan sila lalong hihina yung ano ko. Nahihiya
64 at naawa ako sa mga anak ko kasi dapat ako pa din ang
65 tumutulong sakanila. Eh ngayon sila pa nag-aalaga saken.
66 May mga anak na sila naano ako kasi dadagdag pa ko sa
67 alagain at gastos. Bawal akong magalit at mastress.
68 Madaming bawal.. bawal ding maging masaya ng sobra
69 kasi yung puso ko nga di na siya maano. Kasi yung puso
70 ko namamaga na nga at yung mga ugat barado na.
71 madami akong gamot puro gamot ko yan lahat. Eto sa
72 kirot lahat to iniinom ko may pang umaga may pang gabi
eto din para sa high blood. Eto pa sa diabetes. Pero
73
matatag ako sobra. Sabi ko nga pag nakikita ko yung mga
74
anak ko eh. Ako lang aanuhin ko sakanila kung sa umpisa
75
pa lang nararamdaman na nila na sumasakitra ng dibdib
76
nila magpatingin na sila. Pag sila’y binigyan ng doctor ng
77
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78 gamot tapos maintenance na nila imaintenence nila kasi

79 di nila alam puso na ang naapektuhan kasi nung una kong
80 binigyan ng maintenance ininom ko lang siya ng tatlong
81 taon tapos inistop ko nung inistop ko dun na siya
umatake. Tapos uminom ako ulit so nung mga
82
nakaginhawa ako umistop na naman ako. Nung umokay
83
na ko inistop ko na yun. Bale two years na kong
84
nakastop. Pagistop ko na yon dun grumabe yung ano ko.
85 Kaya nga sabi ng doctor kung pinagpatuloy ko daw yung
86 gamot ko at hindi sana ako umistop eh sana naayos pa.
87 ngayon aral na sa aken yon. Kaya nga sabi ng anak ko”
88 ma ang gamot inumin mo.” Walang problema kami ang
89 bibili. Pati mga anak ako yung mga gamot ko sila na ang
90 umaano. Kasi marami ng bawal sa akin Quaker na nga
91 lang pinakakain sa akin. Kumakain din ako ng gulay kaya
92 lang di pwede na iisa. Bawal pang igisa. Tapos sa isda
93 naman bawal yung malansa. Tapos kelangan sa isda eh
94 puro ihaw o kaya pinangat. Pero yung mga ano baboy
95 manok bawal talaga. Netong naging grabe na ko dati kasi
96 ay! Wala akong pakialam kahit na bawal . mamamatay
kung mamamatay. Eh nyng nakita kong nahihirapan na
97
ang mga anak ko di na ko nag-ano. Nakita ko naman
98
lahat ng anak ko di ako pinabayaan kahit ilang beses
99
akong naatake. Lahat sila halos eh kulang na lang eh wag
100
ng umuwi.
101
102
103
104
105
106
107
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Transcript Line
PCAP 5 1 Sa pagkakaalala ko mga dalwang beses na. nung una
2 medyo bata bata pa ko yung pangalawa ilang buwan lang
3 ang nakakalipa. Yung una trenta pa lang ako nun
4 ngayong pangalawa 44 na ko. May lahi kami ng may
5 sakit sa puso kasi di lang ako ang ganito sa pamilya
6 namin. Yung lolo’t lola ko yung ang kinamatay nila kay
7 nung inatake ako kala ko mamamatay na ko. Masakit ang
pakiramdam ko na parang may nakadagan sa katawan ko.
8
Pero parang di ko din naramdaman kasi nakakita ako ng
9
liwanag kala ko mamamatay na ko. Habang nakahiga ako
10
parang nasisilaw ako tas wala akong maramdaman sa
11 paligid ko. Natutulog lang ako ng tanghali nun. Biglang
12 sumakit yung dibdib ko tas tinawag ko yung asawa ko tas
13 nawalan na ko ng malay. Di ko na maalala yung nangyare
14 basta paggising ko nasa ospital na ko. Dinala na nila ako
15 sa hospital. Actually, di ko maalala yung ginawa sa aken.
16 Nagising ako sinabi saken ng asawa ko yung tungkol sa
17 kondisyon ko di ako nakasalita. Ayoko eh. Ang naisip ko
18 agad “bakit? Bakit ako?”. Tumagal na din ng may
19 konting takot at kaba pero kahit ganun pasasalamat sa
20 taas kasi kung oras mo oras mo na ika nga ng iba. Ayun
21 lang wala namang pagsisise kasi buhay mo yan eh
22 ginusto mo yan. Syempre babawasan ang mga bisyo ko at
yung mga pagkain na hindi dapat kainin. Sino bang
23
walang bisyo malakas akong uminom noon pati sigarilyo.
24
Unang beses na atakihin ako nagbabawas ako kasi
25
delikado na ang kalusugan ko. Naninigarilyo pa din
26
naman hindi naman tulad dati kasi dati umuubos ako ng
27 isang kaha maghapon. Pero ngayon hindi na. eh kahit
28 labag sa loob ko kelangan kong sumunod lalo na kung
29 gusto mong mabuhay pa ng mas matagal. Kelangan
30 iwasan ang dapat iwasan hindi naman habang buhay eh
31 magagawa mo yung mga ganoong bagay. Iyong
32 paninigarilyo ko tinigil ko na talaga. Minsan darating
33 talaga yon. Tulad ko medyo bata bata pa ko nung inatake
34 ako medyo minalas lang ako pero ganun talaga kung
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35 gustong humaba pa ang buhay, alisin ang kinakaugalian

36 mong gawin o kainin lalo mga bisyo na yosi at alak dapat
37 wala na talaga. Dose anyos pa lang ako noong nakatikim
38 ako ng alak. Hindi ko pa inisip na magkakasakit ako
syempre bata ka pa, kumikita ka ng pera at may oras ka
39
sympre magpapakasaya ka lalo pa’t binata ka. Sampung
40
taon naman ako nung nanigarilyo ako kasi alam mo na
41
ang barkada maimpluwensya talagang makakatikim ka
42 ng ganoong mga bagay kahit bata ka pa. katropa ng mga
43 kapatid ko ang kasama ko noon mga high school mas
44 matanda lang ako ng isang taon sakanila magkakasama
45 kami sa bilyaran. Syempre nung una gugulpihin ka
46 talaga. Pero once na may trabaho ka na at kumikita ka na
47 ng pera wala ng magagwa yan. Eh kaso di naman habang
48 buhay eh bata ka kaya kelangan mo ding tigilan ang mga
49 nakasanayan na. dapat maging mature ka kasi di ka na
50 tugma sa mga ganoong gawain at bisyo. Medyo out of
51 shape na ko ika nga diba di na tulad ng dati. Sa ngayon
52 wala ng pananakit ng dibdib kasi umiinom na ko ng mga
53 herbal herbal na yan tsaka yung mga gamot ko. Mataas
kasi talaga ang dugo ko mga 160/110. Kaya marami
54
akong gamot na iniinom. Kulang kulang limang taon na
55
kong nagtetake ng maintenance. Mga mayo yung huli
56
kong atake kasi eh. Isang lingo ako sa ospital nung unang
57
atake ko pero netong pangalawa ko halos dalawang
58 buwan akong nandoon kakalabas ko lang din. Kasi yun
59 ay hirap na hirap na ang katawan ko. Nakabitan pa nga
60 akong ng tubo nun sa ICU. Akala ko nun mamamatay na
61 ko kaya todo dasal na ko. Oo bakit naman hindi sino
62 bang gustong mabuhay. Sayang ang buhay. Regalo yon
63 kaya wag sasayangin. Mas masakit yung pangalawa kong
64 atake. Kasi yung pangalawa mas malala. Yung una kasi
65 unexpected eh biglaan talaga yung pangalawa naman
66 alam mo na kasi pag naramdaman mo na kaya may halo
67 ng takot. Parang habang tumatagal lalo kasing lumalala
68 habang may bisyo at may ginagawa ko mas luumalala
talaga. Nung una ko di pa ko kasi tumitigil sa bisyo pero
69
nagbabawas di na tulad nung dati. Di na siya kasing dalas
70
noong dati. Eh nasa diyos na yan kung aatakihin ulit ako.
71
Syempre unang una sa lahat sermon ang natikman ko sa
72
asawa ko yung pag-aalala ganun. Pero naiintindihan ko
73
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74 naman kasi ganun naman lahat. Yung mga anak ko nag-

75 aalala din sila nga yung nasa tabi ko nung nasa ospital
76 ako. Nagpapasalamat ako sakanila. Walong anak ko
77 nanjan talaga sila. Nag-aaral pa yung iba pero yung
panganay ko hnggang sa pangatlo nagtatrabaho na. sila
78
na yung nagbibigay ng sustento sa amin. Syempre bukod
79
sa bawas ng mga bawal eh nagtry din akong mag-
80
ehersisyo kahit papaano. Tumatakbo ako sa umaga. Para
81 yung dugo ko gumanda ang daloy at di na magbara. Di ba
82 nga kapag nagbabara eh yun yong inaatake. Kontrolin
83 talaga dapat lahat. Nakikita ko na ngayon na isa akong
84 pinagpalang tao. Kasi binigyan niya ko ng tyansa na
85 ipagpatuloy ang buhay ko. Kasi kala ko talaga
86 mamamatay na ko nung inatake ko. Di na ko katulad ng
87 dati nanghina na ang katawan ko. Tas ngayon nga
88 nawalan na ko ng negosyo buhat ng inatake ako kasi
89 nahihirapan na kong gumalaw. Basta mas mahirap di na
90 tulad nung dati na healthy ka pa. At yung kaba kapag
91 may nararamdaman kang paninikip ng dibdib parang
92 hayan na naman jusko baka eto na to. Kasi pag inatake ka
93 naman di mo masasabi kung anong mangyayare. Oo
94 naman sila yung nanjan sila nung inatake ako di nila ko
iniwanan. Kahit medyo lumpo lumpo na ko nandyan pa
95
din sila. Oo buhat nung inatake ako di na ko gaanong
96
nagtatrabaho pero lumalabas naman ako pag nag-
97
eehersisyo. Mga tamang lakad lang onting takbo para sa
98
pagdaloy ng dugo. Kakain ka ng masustansya at iwasan
99 ang mga baboy. Kasi dati puro ako matataba pero ngayon
100 hindi na. madalas na ko sa gulay. Noon kasi sisig lechon
101 pero ngayon nakakatakot na. nahihilig na talaga ako sa
102 gulay kasi natatakot na kong maulit na naman pa yung
103 nangyare. Ako ang padre de pamilya eh ako ang
104 pundasyon mahirap para sakanila kapag nawala ako.
105 Yung pagmamahal at pagsuporta nung panahong
106 pakiramdam ko eh lumpo at baldado ako lagi silang
107 nandyan. Advise saken ng doctor ko noon na manatili sa
108 higaan. Pinapayo ko lang ngayon pa lang bawasan niyo
109 na habang maaga pa kasi habang tumatagal lalo palala
110 yan. Di naman talaga maiiwasan yan eh kaso kelangan
talagang bawasan. Kung dadating man yun edi yun na
111
hanggang dun na yun. Wala na. kasi ano eh.. once is
112
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113 enough twice is too much.. nabasa ko lang hahahaha.

114 Tatanggapin. Nasa diyos na lahat yun.
115
116
117
118
119
120
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Ma. Ayla B. Ballesteros

11 Pelican Street St. Francis Subd., Meycauayan, Bulacan
Contact No. (0936) 669 7610
Email Ad. ma.aylaballesteros@gmail.com
Educational Attainment:
 Tertiary: Dr. Yanga’s Colleges

Bocaue, Bulacan
S.Y: 2015-2019
 Secondary: [2014-2015] Jarmmeth Academy

Muzon, San Jose del Monte, Bulacan
 Primary: [2009-2010] Jarmmeth Academy

Muzon, San Jose del Monte, Bulacan
Personal Information:
 Date of Birth: September 20, 1998
 Place of Birth: Sta. Maria, Bulacan
 Height: 5’4’’
 Weight: 122 lbs
 Civil Status: Single
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Lailani Kim C. Doria

#2472 Purok 3 Bambang, Bulakan, Bulacan
09476077073
ldoria062098@gmail.com
EDUCATIONAL ATTAINMENT
Tertiary: Dr. Yanga’s Colleges

Bocaue, Bulacan
S.Y: 2015-2019
Secondary: Doña Candelaria Meneses Duque High School

Bambang, Bulakan, Bulacan
SY: 2010-2014
Primary:Bambang Elementary School

Bambang, Bulakan, Bulacan
SY: 2004-2010
PERSONAL INFORMATION
Age: 20 years old
Gender: Female
Height: 5'2 ft
Weight: 47 kg
Religion: Catholic
Birthdate: June 20, 1998
Birthplace: Bagumbayan Bulakan,Bulacan
Citizenship: Filipino
Religion: Catholic
Civil Status: Single
Mother: Carmela C. Doria
Father: Wilfredo C. Doria
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Crisan Joy Sevillano Lardero

466 gitna st. Balubad Bulakan, Bulacan
Contact Numbers: 0905705064/ Email Address: crisanlardero09@gmail.com
Personal Information
Birthdate: August 09, 1999
Birthplace: Guimba Nueva Ecija
Status: Single
Gender: Female
Religion: Born Again Christian
Nationality: Filipino
Educational Background
Tertiary Dr. Yanga’s Colleges Inc.
2015 - 2019 Degree of Bachelor of Science in Nursing
Secondary
2011 – 2015 Dona Trinidad Mendoza Institute
Elementary
2005 – 2011 Dr. Manuel S. Tansinsin Memorial School

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DR. YANGA’S COLLEGES, INC.

A Thesis Study Presented to the Faculty Members of

In Partial Fulfilment of the Requirements

Ballesteros, Ma. Ayla B.

Bernabe, Cheska Marie P.

Doria, Lailani Kim C.

Lardero, Crisan Joy S.

to the people who have helped in the success of this study.

uncertainty. Also, who continued to be understanding regardless of the circumstances of

advises and suggestions for the betterment of the paper.

THE INFORMANTS for being cooperative and persevered to be part of the

order to be more comprehensive for the readers.

and wisdom in order to achieve the goal of the researchers.

List of Tables………………………………………………………………………… vii

List of Figures……………………………………………………………………….. viii

Chapter I: THE PROBLEM AND ITS BACKGROUND

Statement of the Problem………………………………………………………..11

Scope and Limitation……………………………………………………………11

Significance of the study……………………………………………………..…12

Review of Related Literature and Studies…………………………...………….13

CHAPTER II: RESEARCH METHODS

Data Gathering Procedure……………………………………………………….21

CHAPTER III: RESULT AND DISCUSSION

Finding and Discussion……………………………………………………..2

Table 1 First Onset of Attack……………………………………………….29

Table 2 Reccurence of Attack………………………...…………………….39

CHAPTER IV: Summary, Conclusions and Recommendations

Appendix A: Letter of intent

Appendix B: Letter of consent

Appendix C: Consent Form

Appendix D: Signed Consent Form

Appendix E: Editing Certificate

Appendix H: Curriculum Vitae

The Problem and its Background

(ACLC medical training, 2018)

patients (Jegtvig, 2014).

by 10% every minute (Philippine Heart Association, 2018). Resuscitation is defined as

Cardio Pulmonary Resuscitation is a life-saving procedure that consists of chest

psychological imbalances to the individual. According to the study of Magdalena et al.

times from cardiac arrests.

Kubler Ross stages of Grief

According to Elisabeth Kubler-Ross as cited in Holland (2014), a Swiss

and they often have difficulty in accepting their situation.

Grief can be explained in a variety of experiences and situations. Mostly it is

caused by relationships, substance abuse or grieving over an impending death. The 5

have passed two or three of the stages (Gregory, 2018).

Grief theory of Erich Lindemann

As cited by Whats’s Your Grief (2017), Erich Lindemann a psychiatrist and

emancipation, re-adjustment and formation of new bonds. In emancipation, since people

with the conflict of his/her situation (Whats’s Your Grief, 2017).

lifestyle or the change that has occurred.

Psychosocial theory by Erik Erikson

As cited by McLeod (2018), Erik Erikson is an ego psychologist who developed

and can be developed or modified by experiences (McLeod, 2018).

Failure to develop a psychosocial development of patient can highly affect the

family member. In contrast, if a patient is well-motivated and able to cope positively

The Adaptation Model of Nursing by Sister Callista Roy

the four adaptive modes: physiological-physical, self-concept group identity, role

function and interdependence. In physiological-physical mode, its goal is to address the

and receiving of love.

According to Roy, adaptation is a “process and outcome whereby thinking and

human and environmental integration”. As nurses being the facilitator of adaptation is

able to manipulate stimuli concerning their adaptation. Improving adaptation during