The results were similar in a per-protocol analysis, where only the 46 participants who followed the instructions in the intervention group were included. Again, participants in the intervention group reported significantly lower mean amounts of perceived stress/overload overall, compared to
the control group (difference −0.8 (95% CI −1.5, -0.1), p=0.02), but stress/overload levels were statistically different between the two groups only Inhibitors,research,lifescience,medical at the baseline time point before resuscitation. Table 2 Association of intervention and overall stress and stress level at different time points Impact of intervention on performance CPR was started after a mean of 43 sec (95% CI 39–46), and mean hands-on time in the first 120 sec overall was 55 sec (95% CI 51–59). On average, 11 leadership statements (95% CI
10–11) were recorded. There was a significant positive correlation between leadership statements and hands-on time (0.20, p=0.02) and a significant negative correlation between leadership statements and time to start CPR (r= -0.24, p<0.01). This indicates that participants with more leadership Inhibitors,research,lifescience,medical statements started earlier and did more uninterrupted CPR. The intervention group had about 10% more hands-on time in the first 120 sec compared to the control group; this difference was, however, not statistically significant (57.8 sec (±3.28) Inhibitors,research,lifescience,medical vs 52.2 sec (±2.86), difference 5.5 (95% CI −3.1, 14.2), p=0.2). There were no differences Inhibitors,research,lifescience,medical between the two randomisation groups with regard to time to start CPR, particularly time to chest compression, ventilation and defibrillation (see Table 3). No differences between the groups also emerged for the number of leadership statements. The per-protocol analysis yielded similar results. Table 3 Association of intervention and resuscitation
performance We also investigated the effect of the intervention in different subgroups (Figure 3). Male participants appeared to benefit more from the intervention Inhibitors,research,lifescience,medical compared to females (beta HIF inhibitor Coefficient (95% CI) 9.05 (−2.69, 20.79) vs. 3.88 (−7.65, 15.41). Also, participants in the highest stress quartile appeared to benefit more from the intervention compared to participants in the lower quartiles (beta coefficient (95% CI) 13.08 (−6.12, much 32.28) vs 4.15 (−5.7, 14.01). The effect of the intervention did not reach statistical significance in any of these subgroups. Figure 3 Effect of intervention on hands-on time in different subgroups. Coefficient relates to results of linear regression analysis including interaction terms for each subgroup. CI denotes confidence interval. Numbers refer to seconds of hands-on time within … Discussion This study investigated the influence of a short task-focusing strategy on perceived stress levels and performance of rescuers in a simulated CPR scenario. We found an increase in stress/overload levels during the resuscitation period and an association of stress/overload with CPR performance.