Article: The living experience of surviving out-of-hospital cardiac arrest and spiritual meaning making
Author(s): Maria Aristidou, Maria Karanikola et al.
Date published: 21 April 2023
Journal: Nursing Open.
Link to full article: The living experience of surviving out-of-hospital cardiac arrest and spiritual meaning making

This study examines the experiences of out-of-hospital cardiac arrest survivors within the specific cultural setting of Greek Cypriots (who are predominantly devout Christian Orthodox). The study was undertaken by nurses in an attempt to better provide holistic support to these survivors. It was not specifically focused on the near-death experience per se.

Participants were recruited from a register of cardiac arrest survivors at a metropolitan General Hospital in Cyprus.

7 males and 1 female were interviewed (using open-ended questions and lasting 60–90 minutes) three times by the principal investigator between September 2015 and April 2017.

All participants were Christian Orthodox and their out of hospital cardiac arrest (OHCA) had occurred 2–10 years before the time of interview.

Perhaps unsurprisingly, all participants attributed a strong spiritual meaning to their surviving the OHCA.

Of particular interest is their reporting of their embodied experience during the event.

Participants described their encounter with death and dying and shared elements of their experiences resembling near-death experiences. All participants shared the perception that time collapsed during their near-death experience: ‘at that moment, my entire life went through my brain like a movie’ (P1); their near-death experiences also included moving through a tunnel, flying towards the light, seeing other entities, and experiencing positive emotions. Most participants described a sense of being ‘bodiless’, to ‘have left their body behind’, or ‘very light’, and ‘buoyant’ (P4, P7, P8), and feeling a force pulling on their bodiless existence: P8 described: ‘all of a sudden, an invisible force, an immense force started pulling me upwards’. Representatively, P7 experienced ‘entering this tunnel’, P8 encountered ‘flying upwards to the sky’, while P4 ‘saw a light and moved towards it’. However, the crossing to the light was not uneventful as it was interrupted by other, special entities entitled to ‘check who would pass over’ (P4). This world also housed other presences, regarded by some of the participants as souls, which appeared either familiar or unfamiliar to them: ‘could see bright things; like a glittering shadow but couldn’t make out any faces… perhaps they were souls’ (P8). Likewise, P7 ‘felt people next to him, like someone’s shadow’, but could not make them out. Instead, P5 said: ‘I saw so many people dead. My father and mother were there’.

All participants expressed a profound transformative effect of surviving the OHCA:

In this new reality, participants felt a different and deep appreciation of common things once taken for granted; like waking up in the morning or seeing a baby laugh or play. Most importantly, surviving a cardiac arrest signified ‘an ending to this (previous) life’ (P3) and aroused the participants’ sense of mortality and a pursuit for the meaning of being in the world and of having a soul. One participant wondered that there are ‘billions of people on this earth… Where do these souls go? There must be something else…’ (P5). Likewise, most participants ‘believed that the soul has no ending. It does go somewhere else… It just can’t vanish into thin air…’ (P7). Death was also perceived differently. Participants shared that they were no longer afraid of dying, even that they ‘ready for death’ and that death is ‘beautiful’ (P6). P5 highlighted: ‘I used to be so scared of it; I’m no longer scared of death…’.

The authors note that although some cultural related symbolism and the interpretation of their survival as being a ‘divine gift’ were different to typical NDE reports, there were also many similarities, such as entering a transitional tunnel, encountering a bright light ect.

Previous studies have suggested that transcendental experiences are shaped by a dying patient’s cultural and personal constructs (Schwaninger et al., 2002). However, a constancy of NDE themes across historical periods and cultures raise questions on whether NDEs have specific neural correlates (Charland-Verville et al., 2014), and several neurobiological mechanisms have been proposed (Nelson, 2015). Regardless of solid neurobiological explanations, NDEs become part of survivors’ presence and meaning in the world. Therefore, it is important that health care professionals and loved ones recognise the experience of NDE, and support individuals in their journey of constructing meaning. It is noteworthy that participants with NDEs felt stigmatised (Moore & Greyson, 2017). Educating the public, health care professionals and the family on how to respond and relate to OHCA survivors with NDEs is important in supporting their journey of life transformation (Samoilo & Corcoran, 2020).