The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation

Abstract

BackgroundThe influence of past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events toward willingness to “pay it forward” by helping the next cardiac arrest victim was explored.MethodsUsing a validated questionnaire, 6248 participants were asked to rate their willingness to perform bystander chest compression with mouth-to-mouth ventilation and chest compression-only CPR. Their past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events were also recorded.ResultsKruskal-Wallis test with post hoc Dunn’s pairwise comparisons showed that the following were significantly more willing to perform CPR with mouth-to-mouth ventilation: familial experience of “nonfatal cardiac events” (mean rank = 447) vs “out-of-hospital cardiac arrest with no CPR” (mean rank = 177), U = 35442.5, z = −2.055, p = 0.04; “in-hospital cardiac arrest and successful CPR” (mean rank = 2955.79) vs “none of these experiences” (mean rank = 2468.38), U = 111903, z = −2.60, p = 0.01; and “in-hospital cardiac arrest with successful CPR” (mean rank = 133.45) vs “out-of-hospital arrest with no CPR” (mean rank = 112.36), U = 4135.5, z = −2.06, p = 0.04. For compression-only CPR, Kruskal-Wallis test with multiple runs of Mann-Whitney U tests showed that “nonfatal cardiac events” group was statistically higher than the group with “none of these experiences” (mean rank = 3061.43 vs 2859.91), U = 1194658, z = −2.588, p = 0.01. The groups of “in-hospital cardiac arrest with successful CPR” and “in-hospital cardiac arrest with transient return of spontaneous circulation” were the most willing groups to perform compression-only CPR.ConclusionPrior familial experiences of receiving CPR and medical help, particularly among those with successful outcomes in a hospital setting, seem to increase the willingness to perform bystander CPR.

The psychological and behavioural factors associated with laypeople initiating CPR for out-of-hospital cardiac arrest: a systematic review

“…concerns for woman 21% 291 resp. concerns for child 51% Cheng-Yu et al 2016 [ 50 ] Adults (≥20) 401 144 (unwilling to perform on stranger) 11% Compton et al 2003 [ 55 ] School teachers 201 180 64% of untrained 41% of trained Coons & Guy 2009 [ 56 ] Adults (≥18) 755 435 (who endorsed reasons) 19.4% stranger 26.4% (family) Cu 2009 [ 50 ] Caregivers of children presenting to the Emergency Department (≥18 years) 348 125 (unwilling to perform CPR on adult) 38% Dami 2010 [ 51 ] Call to Dispatch Centre with OHCA 738 73 medically appropriate who refused 3% Dobbie 2018 [ 53 ] Adults (≥16 years) 1027 1027 22% Donohoe 2006 [ 54 ] Adults (≥16 years) NR Focus groups (NR) NR (Qualitative theme identified) Dwyer 2008 [ 56 ] Adults (≥18) 1208 379 (not confident) 10% Han 2018 [ 58 ] Family members (≥18 years) of patients at risk of cardiac arrest 203 88 7% Huang 2016 [ 60 ] School and University students (13–21 years) 1407 546 (unwilling to perform on stranger) 68% …”

“…concerns for woman 14% 291 resp. concerns for child 23% Chen et al 2017 [ 48 ] Adult laypersons (≥18 yrs) + 3 < 18 years 1841 1841 44% Cheng-Yu et al 2016 [ 50 ] Adults (≥20) 401 144 (unwilling to perform on stranger) 6% Cho et al 2010 [ 54 ] Lay people aged 11 years and over 890 539 (unwilling to perform CPR) 50% Cu 2009 [ 50 ] Caregivers of children presenting to the Emergency Department (≥18 years) 348 125 (unwilling to perform CPR on adult) 77% Dobbie 2018 [ 53 ] Adults (≥16 years) 1027 1027 19% Huang 2016 [ 60 ] School and University students (13–21 years) 1407 546 (unwilling to perform on stranger) 53% Iserbyt 2016 [ 63 ] Secondary school pupils 313 313 31% (girls) 23% (boys) Johnston 2003 [ 65 ] Adults (≥18 years) 4490 4490 2% Karuthan et al 2019 [ 78 ] College students 393 393 36% (HO stranger) 27% (HO family-member) Kanstad, Nilsen & Fredriksen 2011 [ 77 ] Secondary school students (16–19 years) 376 376 79% Maes et al 201...…”

“…concerns for child 5% (blame) 11. Environmental context Disagreeable characteristics General Axelsson et al 1996 [ 36 ] People who reported making a CPR attempt between 1990 and 1994 742 51 bystanders described hesitation NR Dobbie 2018 [ 53 ] Adults (≥16 years) 1027 1027 19% Hauff 2003 [ 59 ] Call to Dispatch Centre with OHCA 404 52 who did not accept CPR instructions 2% Lerner et al 2008 [ 83 ] Call to Dispatch Centre with OHCA 168 145 who did not follow CPR instructions 3% Shams et al 2016 [ 119 ] University students 948 948 30% Blood Johnston 2003 [ 65 ] Adults (≥18 years) 4490 4490 12% Lester, Donnelly & Weston 1997 [ 84 ] First year high school pupils 233 233 23% Lester, Donnelly & Assar 1997 [ 85 ] General public 241 241 5% Cu 2009 [ 50 ] Caregivers of children presenting to the Emergency Department (≥18 years) 348 125 (unwilling to perform CPR on adult) 10% Kandakai & King 1999 [ 76 ] College students 214 214 8...…”

“…Environmental context Having friends with heart diseases Kuramoto 2008 [ 80 ] 1132 Japan Adults (≥15 years) Willingness to attempt CPR 1.8 (1.1–3.0) Self-rated health status Ro et al 2016 [ 111 ] 62,425 Korea ≥19 years Provision of bystander CPR (CPR self-efficacy) Good self-rated health status 1.3 (1.2–1.4) 2. Skills Previous experience of CPR Chew et al 2019 [ 53 ] 6248 Malaysian Adults (min age NR) Willingness to perform CPR Previous experience of administering CPR Mean rank =2877.42, U = 1,205,596, p < 0.001 Hawkes et al 2019 [ 68 ] 2084 UK Adults (≥18 years) Likelihood of performing CPR Having witnessed OHCA previously 1.53 (1.17–2.10) Kuramoto 2008 [ 80 ] 1132 Japan Adults (≥15 years) Willingness to attempt CPR Actual experience with CPR 3.8 (1.7–8.) Sasaki et al 2015 [ 113 ] 4853 Japan adults (≥15 years) Confidence in performing CPR Previous experience performing CPR CC: 4.8 (1.8–12.9) MMV: 3.7 (2.1–6.6) AED: 2.7 (1.3–5.7) Schmid et al 2016 [ 116 ] 371 Costa Rica age unknown Willingness to perform CPR on a stranger Prior witness OHCA 2.5 (1.2–5.3) 6.…”

Predictive Dispatch of Volunteer First Responders: Algorithm Development and Validation

“…The main reasons for not performing CPR were panic, the perception of bystanders that they are not able to perform CPR correctly, and a fear of hurting the patient [ 38 ]. Familial experiences of receiving CPR were associated with an increase in responders’ willingness to perform CPR [ 39 ]. The UnityPhilly study, which established a network of volunteers to provide naloxone to those experiencing an opioid overdose, reported that 17% of the alerted volunteers accepted the alert, and 11.9% of the alerted volunteers arrived at the scene [ 34 ].…”