1
|
Dong X, Kong SYJ, Xu H, Ho AFW, Blewer AL, Birkenes TS, Myklebust H, Zheng X, Li M, Zheng ZJ, Zhang Z, Zhang L. "Needed but lacked": Exploring demand- and supply-side determinants of access to cardiopulmonary resuscitation training for the lay public in China. Front Public Health 2023; 11:1164744. [PMID: 37124786 PMCID: PMC10130457 DOI: 10.3389/fpubh.2023.1164744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 05/02/2023] Open
Abstract
Background Despite years of public cardiopulmonary resuscitation (CPR) training efforts, the training rate and survival following out-of-hospital cardiac arrest (OHCA) have increased modestly in China. Access is imperative to increase the public CPR training rate, which is determined by both demand- (e.g., the lay public) and supply-side (e.g., CPR trainers) factors. We aimed to explore the demand and supply determinants of access to CPR training for the lay public in China. Methods Qualitative semi-structured interviews were conducted with 77 laypeople (demand side) and eight key stakeholders from CPR training institutions (supply side) in Shanghai, China. The interview guide was informed by Levesque et al. healthcare access framework. Data were transcribed, quantified, described, and analyzed through thematic content analysis. Results On the demand side, the laypeople's ability to perceive their need and willingness for CPR training was strong. However, they failed to access CPR training mainly due to the lack of information on where to get trained. Overestimation of skills, optimism bias, and misconceptions impeded laypeople from attending training. On the supply side, trainers were able to meet the needs of the trainees with existing resources, but they relied on participants who actively sought out and registered for training and lacked an understanding of the needs of the public for marketing and encouraging participation in the training. Conclusion Insufficient information and lack of initiative on the demand side, lack of motivation, and understanding of public needs on the supply side all contributed to the persistently low CPR training rate in China. Suppliers should integrate resources, take the initiative to increase the CPR training rate, innovate training modes, expand correct publicity, and establish whole-process management of training programs.
Collapse
Affiliation(s)
- Xuejie Dong
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | | | - Hanbing Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Andrew Fu Wah Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
- Pre-Hospital and Emergency Research Centre, Duke-National University of Singapore Medical School, Singapore, Singapore
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore
| | - Audrey L. Blewer
- Department of Family Medicine and Community Health, School of Medicine, Duke University, Durham, NC, United States
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States
| | | | | | | | - Minghua Li
- Shanghai Medical Emergency Center, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Zhifeng Zhang
- Shanghai Medical Emergency Center, Shanghai, China
- Zhifeng Zhang
| | - Lin Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Lin Zhang
| |
Collapse
|
2
|
Citolino Filho CM, Nogueira LDS, Gomes VM, Polastri TF, Timerman S. Effectiveness of cardiopulmonary resuscitation training in the teaching of family members of cardiac patients. Rev Esc Enferm USP 2022; 56:e20210459. [PMID: 35781324 DOI: 10.1590/1980-220x-reeusp-2021-0459en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/26/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a cardiopulmonary resuscitation training in the skill acquisition of family members of heart disease patients. METHOD A quasi-experimental study, conducted in a hospital in São Paulo, Brazil. The study participants were one or more relatives of patients with heart disease that were hospitalized at the institution. In the first phase, the participant's skills and theoretical knowledge on cardiopulmonary resuscitation were evaluated before and immediately after the training. The second phase took place one month after the training, in which the same evaluations were applied. The McNemar's and Stuart-Maxwell tests were adopted (5% significance level). RESULTS The theoretical knowledge of family members before and after training increased and a great retention of this knowledge after 30 days of training was observed. Immediately after training, the family members showed significant improvement of skills in the 15 analyzed actions and, after one month of training, they maintained most of the acquired practices on cardiopulmonary resuscitation, except for chest compressions frequency and the time between turning on the defibrillator and delivering the shock. CONCLUSION Cardiopulmonary resuscitation training was effective in the acquisition of theoretical and practical knowledge of the family members.
Collapse
Affiliation(s)
| | | | | | | | - Sergio Timerman
- Universidade de São Paulo, Faculdade de Medicina, Instituto do Coração, São Paulo, SP, Brazil
| |
Collapse
|
3
|
Citolino Filho CM, Nogueira LDS, Gomes VM, Polastri TF, Timerman S. Efetividade de treinamento sobre ressuscitação cardiopulmonar na aprendizagem de familiares de pacientes cardiopatas. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0459pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Avaliar a efetividade de um treinamento sobre ressuscitação cardiopulmonar na aprendizagem de familiares de pacientes cardiopatas. Método: Estudo quase experimental, realizado em hospital de São Paulo, Brasil. Participaram da pesquisa um ou mais familiares de pacientes cardiopatas internados na instituição. Na primeira fase foram avaliados o conhecimento teórico e as habilidades dos participantes sobre a ressuscitação cardiopulmonar antes e imediatamente após o treinamento. A segunda fase aconteceu um mês após o treinamento, com a aplicação das mesmas avaliações. Os testes McNemar e Stuart-Maxwell foram adotados (nível de significância de 5%). Resultados: Houve aumento do conhecimento teórico dos familiares antes e após o treinamento e elevada retenção desse conhecimento após 30 dias da capacitação. Os familiares apresentaram, após o treinamento, melhora significativa das habilidades nas 15 ações analisadas e, após um mês da capacitação, mantiveram a maioria das práticas assimiladas sobre ressuscitação cardiopulmonar, com exceção da frequência das compressões torácicas e do tempo entre ligar o desfibrilador e aplicar o choque. Conclusão: O treinamento sobre ressuscitação cardiopulmonar foi efetivo na aprendizagem teórica e prática dos familiares.
Collapse
|
4
|
Oh GJ, Lee K, Kim K, Lee YH. Indicators Related to Cardiopulmonary Resuscitation According to Occupation Among Family Members of Coronary Heart Disease Patients. Chonnam Med J 2020; 56:196-202. [PMID: 33014759 PMCID: PMC7520363 DOI: 10.4068/cmj.2020.56.3.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/01/2022] Open
Abstract
This study aimed to evaluate differences in cardiopulmonary resuscitation (CPR)-related indicators among families of community-dwelling coronary heart disease (CHD) patients according to their occupation. A total of 6,867 family members living with CHD patients were selected for analysis from the 2016 Korea Community Health Survey. Respondents' occupations were classified into managers and professionals (MP), clerks (CL), service and sales workers (SSW), agricultural/forestry/fishery workers (AFFW), mechanical and manual laborers (MML), and homemakers and unemployed (HU). The adjusted odds ratio (aOR) for awareness of CPR in the MP (3.82), SSW (1.73), and MML (1.29) groups were higher than that in HU (reference), while the CL (1.42) and AFFW (1.04) groups showed no significant difference compared to HU. The aORs for experience with CPR education and manikin-assisted CPR training were higher among the MP (4.00 and 3.94), CL (2.61 and 2.26), SSW (2.02 and 1.91), and MML (1.99 and 1.69) groups than in HU, and only AFFW (1.22 and 1.18) showed no difference from HU. Finally, the aOR for self-efficacy in CPR performance was significantly higher among the MP (3.17), CL (1.64), SSW (1.87), and MML (1.44) groups than in HU. However, there was no significant difference between AFFW (1.22) and HU in self-efficacy in CPR performance. To improve the survival rate of CHD patients through successful CPR at the pre-hospital stage during cardiac arrest, it is important to increase the ability of family members of CHD patients to perform CPR, especially among those in AFFW and HU occupations.
Collapse
Affiliation(s)
- Gyung-Jae Oh
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Kyungsuk Lee
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea
| | - Kyungsu Kim
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| |
Collapse
|
5
|
Yue P, Zhu Z, Wang Y, Xu Y, Li J, Lamb KV, Xu Y, Wu Y. Determining the motivations of family members to undertake cardiopulmonary resuscitation training through grounded theory. J Adv Nurs 2018; 75:834-849. [PMID: 30536860 DOI: 10.1111/jan.13923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 10/09/2018] [Accepted: 11/16/2018] [Indexed: 11/27/2022]
Abstract
AIMS To explore the motivation of family members of patients at high risk for sudden cardiac death for undertaking cardiopulmonary resuscitation (CPR) training. BACKGROUND Home cardiac arrests are associated with poor outcomes because few family members learn CPR. Little is known about factors that motivate family members to participate in CPR training. DESIGN We used grounded theory to establish a theoretical framework to explore the motivational factors for learning CPR among family members. METHODS Twelve participant observations and 42 semi-structured interviews with family members of different behaviours towards CPR training were conducted from December 2013 - November 2016. Data were analysed using constant-comparisons, situational analysis, and encoding. FINDINGS A motivation-behaviour theoretical framework for learning CPR was constructed. We identified meeting inner needs as the core category to demonstrate motivation. Security motivation and responsibility motivation emerged as main categories, which demonstrate that seeking a sense of security and shouldering family responsibility were important considerations for family members to learn CPR. These two motivations produced high-engagement behaviours of family members to learn CPR. CONCLUSIONS The motivations we identified-deriving from a sense of security and family responsibility-are the main reasons family members would learn CPR and, therefore, should be understood by medical professionals. Understanding these motivations may help in the formulation of customized CPR training that further meets the needs of family members. For example, motivational interventions that are integrated with a family-based CPR course can be designed to improve the participation of family members and the sustainability of the course.
Collapse
Affiliation(s)
- Peng Yue
- School of Nursing, Capital Medical University, Beijing, China
| | - Zhiyong Zhu
- College of Educational Administration, Beijing Normal University, Beijing, China
| | - Yongli Wang
- Fuxing Hospital, Yuetan Community Health Service Center, Capital Medical University, Beijing, China
| | - Yimin Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Jia Li
- School of Nursing, Capital Medical University, Beijing, China
| | - Karen V Lamb
- College of Nursing, Rush University, Chicago, Illinois
| | - Yahong Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Ying Wu
- School of Nursing, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Granfeldt A, Wissenberg M, Hansen SM, Lippert FK, Torp-Pedersen C, Christensen EF, Christiansen CF. Location of cardiac arrest and impact of pre-arrest chronic disease and medication use on survival. Resuscitation 2017; 114:113-120. [PMID: 28279694 DOI: 10.1016/j.resuscitation.2017.02.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/14/2017] [Accepted: 02/28/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Cardiac arrest in a private location is associated with a higher mortality when compared to public location. Past studies have not accounted for pre-arrest factors such as chronic disease and medication. AIM To investigate whether the association between cardiac arrest in a private location and a higher mortality can be explained by differences in chronic diseases and medication. METHODS We identified 27,771 out-of-hospital cardiac arrest patients ≥18 years old from the Danish Cardiac Arrest Registry (2001-2012). Using National Registries, we identified pre-arrest chronic disease and medication. To investigate the importance of cardiac arrest related factors and chronic disease and medication use we performed adjusted Cox regression analyses during day 0-7 and day 8-365 following cardiac arrest to calculate hazard ratios (HR) for death. RESULTS Day 0-7: Un-adjusted HR for death day 0-7 was 1.21 (95%CI:1.18-1.25) in private compared to public location. When including cardiac arrest related factors HR for death was 1.09 (95%CI:1.06-1.12). Adding chronic disease and medication to the analysis changed HR for death to 1.08 (95%CI:1.05-1.12). 8-365 day: The un-adjusted HR for death day 8-365 was 1.70 (95% CI: 1.43-2.02) in private compared to public location. When including cardiac arrest related factors the HR decreased to 1.39 (95% CI: 1.14-1.68). Adding chronic disease and medication to the analysis changed HR for death to 1.27 (95% CI:1.04-1.54). CONCLUSION The higher mortality following cardiac arrest in a private location is partly explained by a higher prevalence of chronic disease and medication use in patients surviving until day 8.
Collapse
Affiliation(s)
- Asger Granfeldt
- Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
| | - Mads Wissenberg
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Denmark; Emergency Medical Services Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Steen Møller Hansen
- Department of Clinical Epidemiology, Aalborg University Hospital, Aalborg, Denmark
| | - Freddy K Lippert
- Emergency Medical Services Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | | | - Erika Frischknecht Christensen
- Prehospital Emergency Services, North Denmark Region, Aalborg, Denmark; Center for Prehospital and Emergency Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Emergency Clinic, Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
| | | |
Collapse
|
7
|
Wanner GK, Osborne A, Greene CH. Brief compression-only cardiopulmonary resuscitation training video and simulation with homemade mannequin improves CPR skills. BMC Emerg Med 2016; 16:45. [PMID: 27894249 PMCID: PMC5127099 DOI: 10.1186/s12873-016-0110-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt). Methods Participants viewed the training video and practiced with the homemade mannequin. This was a parallel-design study with pre and post training evaluations of CPR skills (compression rate, depth, hand position, release), and hands-off time (time without compressions). CPR skills were evaluated using a sensor-equipped mannequin and two blinded CPR experts observed testing of participants. Results Twenty-four participants were included: 12 never-trained and 12 currently certified in CPR. Comparing pre and post training, the never-trained group had improvements in average compression rate per minute (64.3 to 103.9, p = 0.006), compressions with correct hand position in 1 min (8.3 to 54.3, p = 0.002), and correct compression release in 1 min (21.2 to 76.3, p < 0.001). The CPR-certified group had adequate pre and post-test compression rates (>100/min), but an improved number of compressions with correct release (53.5 to 94.7, p < 0.001). Both groups had significantly reduced hands-off time after training. Achieving adequate compression depths (>50 mm) remained problematic in both groups. Comparisons made between groups indicated significant improvements in compression depth, hand position, and hands-off time in never-trained compared to CPR-certified participants. Inter-rater agreement values were also calculated between the CPR experts and sensor-equipped mannequin. Conclusions A brief internet-based video coupled with skill practice on a homemade mannequin improved compression-only CPR skills, especially in the previously untrained participants. This training method allows for widespread compression-only CPR training with a tactile learning component, without fees or advance preparation.
Collapse
Affiliation(s)
- Gregory K Wanner
- Clinical Faculty, Department of Emergency Medicine, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE, 19718, USA. .,Philadelphia College of Osteopathic Medicine, Philadelphia, PA, 19131, USA.
| | - Arayel Osborne
- Clinical Faculty, Department of Emergency Medicine, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE, 19718, USA
| | - Charlotte H Greene
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA, 19131, USA
| |
Collapse
|