Effects of a Web-based Support Programme for Cardiac Arrest Survivors

Cardiac arrest is a serious public health issue, affecting around 13,000 people annually in Sweden. Survivors often face long-term physical, cognitive, and emotional challenges, including anxiety, depression, fatigue, sleep disturbances, and post-traumatic stress. These difficulties can significantly impact daily life, and many survivors struggle to return to work or previous routines.

Although guidelines recommend follow-up within 1-3 months after hospital discharge, support is often fragmented and varies across regions. Survivors frequently report limited access to reliable information and emotional support. Research has shown that structured education and rehabilitation are essential for both survivors and their families, yet current care models rarely address these needs in a comprehensive way.

To help fill this gap, a web-based support programme was co-created in 2024-2025 by researchers, healthcare professionals, cardiac arrest survivors, and patient organizations. The programme includes educational modules, patient and family stories, videos, practical exercises, and tools for self-management and personal recovery planning. It also features a moderated chat forum for peer support. A feasibility study showed that the programme was easy to use and perceived as relevant and helpful.

The study begins with a pilot phase (n=10) to test study procedures, followed by a randomized controlled trial (RCT) with 120 participants across six Swedish regions. Participants are recruited during routine follow-up visit one month after discharge. All participants receive standard care. Those randomized to the intervention group gain access to the digital support programme for 12 weeks. The control group receives standard care and gains access to the programme after study completion.

Consent and data collection are handled digitally. Participants are asked to complete online surveys at baseline, 3 months, and 6 months. These surveys cover wellbeing, quality of life, sleep, fatigue, emotional health, and cognitive function. The study also collects usage data from the programme to understand how participants engage with the content. No physical tests or extra clinic visits are required.

The study aims to generate new knowledge about how digital tools can support recovery after cardiac arrest, improve wellbeing, and reduce healthcare burden by offering accessible, person-centered rehabilitation.

No informado en este registro.

Behavioral: Digital Support Programme

Participants in this arm receive standard follow-up care according to national guidelines. They do not have access to the digital support programme during the study period. However, they are placed on a waitlist and are offered access to the programme after study completion.

The intervention consists of a web-based support programme designed for individuals recovering from cardiac arrest. Participants in the intervention group receive access to the programme for 12 weeks. The programme includes educational modules, patient and family stories, videos, practical exercises (e.g., breathing techniques, fatigue management), tools for personal recovery planning, and a moderated chat forum for peer support. Participants can access the content at their own pace and according to their individual needs. The programme is delivered entirely online and does not require any physical visits or clinical procedures.

Plazo: From baseline to 3 months after enrollment.

The Questionnaire on Well-Being is a tool designed to capture subjective well-being. It consists of 18 questions, each rated from 0 to 4, which are added together to give a total score between 0 and 72. Higher scores reflect greater perceived well-being, while scores below 50 have been linked to significant psychological distress.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Quality of Life (EuroQol Five-Dimension Five-Level questionnaire, EQ-5D-5L).

Score range: 0 to 1 (index value). Higher scores indicate better quality of life.

Change from baseline in Quality of Life (EuroQol Visual Analogue Scale). Score range: 0 to 100. Higher scores indicate better self-rated health.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Life Satisfaction (Life Satisfaction Questionnaire, LiSat-11) at 3 and 6 months.

Score range: 11 to 66. Higher scores indicate greater life satisfaction. Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Anxiety (Generalised Anxiety Disorder 7-item scale, GAD-7) at 3 and 6 months.

Score range: 0 to 21. Higher scores indicate more severe anxiety symptoms.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Depression (Patient Health Questionnaire 9-item scale, PHQ-9) at 3 and 6 months. Score range: 0 to 27. Higher scores indicate more severe depressive symptoms.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Post-Traumatic Stress (Impact of Event Scale - Revised, IES-R) at 3 and 6 months. Score range: 0 to 88. Higher scores indicate more severe post-traumatic stress symptoms.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Fatigue (Modified Fatigue Impact Scale, MFIS-21) at 3 and 6 months. Score range: 0 to 84. Higher scores indicate greater impact of fatigue.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 and 6 months after enrollment.

Change from baseline in Sleep (Minimal Insomnia Symptom Scale, MISS) at 3 and 6 months. Score range: 0 to 12. Higher scores indicate more severe insomnia symptoms.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Plazo: From baseline to 3 months after enrollment.

Change from baseline in Cognitive Function (single-item question on perceived cognitive difficulties) at 3 and 6 months. Score range: 1 to 5. Higher scores indicate greater perceived cognitive impairment.

Outcomes will be analyzed both as change from baseline to each time point (3 and 6 months), and as within-subject change between the 3- and 6-months assessments to evaluate sustained or delayed effects of the intervention.

Effects of a Web-based Support Programme for Cardiac Arrest Survivors: A Randomized Controlled Trial With Process Evaluation (The CARDIS Study)