Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea

doi:10.5847/wjem.j.1920-8642.2018.04.001

Abstract

Abstract:

BACKGROUND: To promote potentially life-saving bystander cardiopulmonary resuscitation (CPR), the proportion of CPR-trained general public and their attitude toward CPR should be assessed, which is yet to be done in the former Soviet Union countries. As a case study, the survey is aimed to investigate the prevalence of CPR training, CPR knowledge, attitude and willingness to attend training and attempt CPR in the general population of the Crimea.
METHODS: A personal interview survey was done from November 2017 to January 2018 with quota sampling reflecting age, gender and territorial distribution of the Crimean population.
RESULTS: Out of 384 persons surveyed, 53% were trained in CPR. Of trained, 24% passed training within the last year, 44% attended a single course. Among the non-trained, 51% never thought about the need to attend training. Knowledge of CPR is generally poor. About 52% wish to learn CPR, 79% and 91% are willing to attempt CPR on a stranger or a loved one, respectively. Lack of knowledge is the strongest barrier to attempt CPR. People aged ≥60, those with educational level lower than high school, widowed and retired are mostly untrained and unwilling to learn CPR. Females and unemployed are mostly untrained, but willing to be educated.
CONCLUSION: There is a need for increasing CPR training and retraining, and improving awareness and motivation to learn CPR in the Crimean population, targeting the least trained groups. The results could be used as a reference point for future studies in the former USSR countries, utilising the same methodology.

Key words: Cardiopulmonary resuscitation, Cardiac arrest, First aid, Training, Survey

Alexei Birkun, Yekaterina Kosova. Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea[J]. World Journal of Emergency Medicine, 2018, 9(4): 237-248.

Figures/Tables 8

Table 1

Respondents’ characteristics and univariate association with previous CPR training

Characteristics	Total, n (%)	Previous training, n(%)	No previous training, n(%)	Pearson’s Chi-square/ Likelihood ratio	P-value	Phi/ Cramér’s V
Sex				4.708	0.030	0.111
Male	174 (45.3)	103 (59.2)	71 (40.8)
Female	210 (54.7)	101 (48.1)	109 (51.9)
Age, years				19.522	0.003	0.225
18-24	32 (8.3)	22 (68.8)	10 (31.3)
25-29	34 (8.9)	19 (55.9)	15 (44.1)
30-39	78 (20.3)	38 (48.7)	40 (51.3)
40-49	61 (15.9)	39 (63.9)	22 (36.1)
50-59	67 (17.4)	40 (59.7)	27 (40.3)
60-69	61 (15.9)	31 (50.8)	30 (49.2)
≥ 70	51 (13.3)	15 (29.4)	36 (70.6)
Place of residence				2.049	0.152	-0.073
Urban	228 (59.4)	128 (56.1)	100 (43.9)
Rural	156 (40.6)	76 (48.7)	80 (51.3)
Marital status				13.777	0.008	0.189
Not married	81 (21.1)	53 (65.4)	28 (34.6)
Married	229 (59.6)	121 (52.8)	108 (47.2)
Divorced	34 (8.9)	17 (50.0)	17 (50.0)
Widowed	39 (10.2)	12 (30.8)	27 (69.2)
No answer	1 (0.3)	1 (100.0)	0 (0.0)
Education level				20.902	0.001	0.228
Primary school	1 (0.3)	0 (0.0)	1 (100.0)
Secondary school	12 (3.1)	3 (25.0)	9 (75.0)
High school	55 (14.3)	25 (45.5)	30 (54.5)
College or technical school	157 (40.9)	72 (45.9)	85 (54.1)
University	153 (39.8)	99 (64.7)	54 (35.3)
Academic degree	6 (1.6)	5 (83.3)	1 (16.7)
Occupation				32.948	<0.001	0.286
Employed	173 (45.1)	110 (63.6)	63 (36.4)
Self-employed	60 (15.6)	32 (53.3)	28 (46.7)
Student	24 (6.3)	18 (75.0)	6 (25.0)
Retired	104 (27.1)	36 (34.6)	68 (65.4)
Unemployed	20 (5.2)	8 (40.0)	12 (60.0)
Army conscript	2 (0.5)	0 (0.0)	2 (100.0)
Other	1 (0.3)	0 (0.0)	1 (100.0)
Medical education				20.591	<0.001	-0.232
Yes	22 (5.7)	22 (100.0)	0 (0.0)
No	362 (94.3)	182 (50.3)	180 (49.7)
Average monthly income				19.471	0.003	0.219
<10,000 RUR	86 (22.4)	40 (46.5)	46 (53.5)
≥10,000 - <20,000 RUR	122 (31.8)	53 (43.4)	69 (56.6)
≥20,000 - <30,000 RUR	76 (19.8)	51 (67.1)	25 (32.9)
≥30,000 - <40,000 RUR	37 (9.6)	20 (54.1)	17 (45.9)
≥40,000 - <60,000 RUR	9 (2.3)	8 (88.9)	1 (11.1)
≥60,000 RUR	5 (1.3)	4 (80.0)	1 (20.0)
No answer	49 (12.8)	28 (57.1)	21 (42.9)
Self-perceived CPR knowledge				94.384	<0.001	0.496
Absent	68 (17.7)	11 (16.2)	57 (83.8)
Poor	175 (45.6)	77 (44.0)	98 (56.0)
Moderate	114 (29.7)	90 (78.9)	24 (21.1)
Good	21 (5.5)	21 (100.0)	0 (0.0)
Very good	6 (1.6)	5 (83.3)	1 (16.7)

Table 1

Figure 1.

Table 2

Respondents’ characteristics associated with CPR knowledge in univariate analysis

Characteristics	Total, n (%)	Correct hand position, n(%)	Incorrect hand position/ no answer, n(%)	Pearson’s Chi-square/ Likelihood ratio/ Fisher’s exact test	P-value	Phi/ Cramér’s V
Previous CPR training				22.364	<0.001	0.241
Yes	204 (53.1)	116 (56.9)	88 (43.1)
No	180 (46.9)	59 (32.8)	121 (67.2)
Self-perceived CPR knowledge				22.796	<0.001	0.244
Absent	68 (17.7)	16 (23.5)	52 (76.5)
Poor	175 (45.6)	82 (46.9)	93 (53.1)
Moderate	114 (29.7)	62 (54.4)	52 (45.6)
Good	21 (5.5)	14 (66.7)	7 (33.3)
Very good	6 (1.6)	1 (16.7)	5 (83.3)
Age, years				15.752	0.015	0.203
18-24	32 (8.3)	17 (53.1)	15 (46.9)
25-29	34 (8.9)	16 (47.1)	18 (52.9)
30-39	78 (20.3)	46 (59.0)	32 (41.0)
40-49	61 (15.9)	31 (50.8)	30 (49.2)
50-59	67 (17.4)	28 (41.8)	39 (58.2)
60-69	61 (15.9)	23 (37.7)	38 (62.3)
≥70	51 (13.3)	14 (27.5)	37 (72.5)
Medical education				4.809	0.028	-0.112
Yes	22 (5.7)	15 (68.2)	7 (31.8)
No	362 (94.3)	160 (44.2)	202 (55.8)
Average monthly income				1.420	0.965	0.061
<10,000 RUR	86 (22.4)	36 (41.9)	50 (58.1)
≥10,000 - <20,000 RUR	122 (31.8)	56 (45.9)	66 (54.1)
≥20,000 - <30,000 RUR	76 (19.8)	35 (46.1)	41 (53.9)
≥30,000 - <40,000 RUR	37 (9.6)	19 (51.4)	18 (48.6)
≥40,000 - <60,000 RUR	9 (2.3)	5 (55.6)	4 (44.4)
≥60,000 RUR	5 (1.3)	2 (40.0)	3 (60.0)
No answer	49 (12.8)	22 (44.9)	27 (55.1)
Characteristics	Total, n (%)	Correct compression rate, n (%)	Incorrect compression rate/ no answer, n(%)	Pearson’s Chi-square/ Likelihood ratio/ Fisher’s exact test	P-value	Phi/ Cramér’s V
Previous CPR training				—	0.002	0.155
Yes	204 (53.1)	13 (6.4)	191 (93.6)
No	180 (46.9)	1 (0.6)	179 (99.4)
Self-perceived CPR knowledge				23.690	<0.001	0.331
Absent	68 (17.7)	0 (0.0)	68 (100.0)
Poor	175 (45.6)	3 (1.7)	172 (98.3)
Moderate	114 (29.7)	5 (4.4)	109 (95.6)
Good	21 (5.5)	6 (28.6)	15 (71.4)
Very good	6 (1.6)	0 (0.0)	6 (100.0)
Age, years				1.491	0.960	0.061
18-24	32 (8.3)	1 (3.1)	31 (96.9)
25-29	34 (8.9)	1 (2.9)	33 (97.1)
30-39	78 (20.3)	2 (2.6)	76 (97.4)
40-49	61 (15.9)	3 (4.9)	58 (95.1)
50-59	67 (17.4)	3 (4.5)	64 (95.5)
60-69	61 (15.9)	3 (4.9)	58 (95.1)
≥ 70	51 (13.3)	1 (2.0)	50 (98.0)
Medical education				—	0.039	-0.131
Yes	22 (5.7)	3 (13.6)	19 (86.4)
No	362 (94.3)	11 (3.0)	351 (97.0)
Average monthly income				14.874	0.021	0.216
<10,000 RUR	86 (22.4)	1 (1.2)	85 (98.8)
≥10,000 - <20,000 RUR	122 (31.8)	1 (0.8)	121 (99.2)
≥20,000 - <30,000 RUR	76 (19.8)	2 (2.6)	74 (97.4)
≥30,000 - <40,000 RUR	37 (9.6)	4 (10.8)	33 (89.2)
≥40,000 - <60,000 RUR	9 (2.3)	1 (11.1)	8 (88.9)
≥60,000 RUR	5 (1.3)	1 (20.0)	4 (80.0)
No answer	49 (12.8)	4 (8.2)	45 (91.8)

Table 2

Table 3

Figure 2.

Figure 3.

Table 4

Respondents’ characteristics associated with willingness to perform CPR in univariate analysis

Characteristics	Total, n(%)	Willing to attempt CPR on a stranger, n (%)	Not willing to attempt CPR on a stranger, n (%)	Pearson’s Chi-square/ Likelihood ratio/ Fisher’s exact test	P-value	Phi/ Cramér’s V
Previous CPR training				6.990	0.008	0.135
Yes	204 (53.1)	172 (84.3)	32 (15.7)
No	180 (46.9)	132 (73.3)	48 (26.7)
Willingness to attend CPR training				9.162	0.010	0.154
Yes	201 (52.3)	170 (84.6)	31 (15.4)
No	118 (30.7)	83 (70.3)	35 (29.7)
Unsure	65 (16.9)	51 (78.5)	14 (21.5)
Self-perceived CPR knowledge				46.030	<0.001	0.356
Absent	68 (17.7)	34 (50.0)	34 (50.0)
Poor	175 (45.6)	141 (80.6)	34 (19.4)
Moderate	114 (29.7)	103 (90.4)	11 (9.6)
Good	21 (5.5)	20 (95.2)	1 (4.8)
Very good	6 (1.6)	6 (100.0)	0 (0.0)
Knowledge of hand position for compressions				6.963	0.008	0.135
Yes	175 (45.6)	149 (85.1)	26 (14.9)
No	209 (54.4)	155 (74.2)	54 (25.8)
Serious health problems in friends/relatives				11.375	0.003	0.172
Yes	130 (33.9)	114 (87.7)	16 (12.3)
No	224 (58.3)	171 (76.3)	53 (23.7)
Unsure	30 (7.8)	19 (63.3)	11 (36.7)
Age, years				13.361	0.038	0.187
18-24	32 (8.3)	30 (93.8)	2 (6.3)
25-29	34 (8.9)	30 (88.2)	4 (11.8)
30-39	78 (20.3)	63 (80.8)	15 (19.2)
40-49	61 (15.9)	51 (83.6)	10 (16.4)
50-59	67 (17.4)	45 (67.2)	22 (32.8)
60-69	61 (15.9)	47 (77.0)	14 (23.0)
≥70	51 (13.3)	38 (74.5)	13 (25.5)
Characteristics	Total, n(%)	Willing to attempt CPR on a relative/ friend, n (%)	Not willing to attempt CPR on a relative/ friend, n (%)	Pearson’s Chi-square/ Likelihood ratio/ Fisher’s exact test	P-value	Phi/ Cramér’s V
Previous CPR training				6.249	0.012	0.128
Yes	204 (53.1)	192 (94.1)	12 (5.9)
No	180 (46.9)	156 (86.7)	24 (13.3)
Willingness to attend CPR training				0.997	0.608	0.051
Yes	201 (52.3)	185 (92.0)	16 (8.0)
No	118 (30.7)	105 (89.0)	13 (11.0)
Unsure	65 (16.9)	58 (89.2)	7 (10.8)
Self-perceived CPR knowledge				35.780	<0.001	0.305
Absent	68 (17.7)	49 (72.1)	19 (27.9)
Poor	175 (45.6)	162 (92.6)	13 (7.4)
Moderate	114 (29.7)	110 (96.5)	4 (3.5)
Good	21 (5.5)	21 (100.0)	0 (0.0)
Very good	6 (1.6)	6 (100.0)	0 (0.0)
Knowledge of hand position for compressions				13.382	<0.001	0.187
Yes	175 (45.6)	169 (96.6)	6 (3.4)
No	209 (54.4)	179 (85.6)	30 (14.4)
Serious health problems in friends/relatives				1.407	0.495	0.061
Yes	130 (33.9)	121 (93.1)	9 (6.9)
No	224 (58.3)	200 (89.3)	24 (10.7)
Unsure	30 (7.8)	27 (90.0)	3 (10.0)
Age, years				7.012	0.320	0.134
18-24	32 (8.3)	31 (96.9)	1 (3.1)
25-29	34 (8.9)	32 (94.1)	2 (5.9)
30-39	78 (20.3)	70 (89.7)	8 (10.3)
40-49	61 (15.9)	57 (93.4)	4 (6.6)
50-59	67 (17.4)	58 (86.6)	9 (13.4)
60-69	61 (15.9)	57 (93.4)	4 (6.6)
≥70	51 (13.3)	43 (84.3)	8 (15.7)

Table 4

Table 5

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Potential barriers to perform CPR	CPR on a stranger, n (%)	CPR on a relative/friend, n(%)
Personal physical limitations	71 (7.5)	28 (7.3)
Reluctance to be in the focus of attention	33 (3.5)	6 (1.6)
Fear to cause harm to a victim	240 (25.2)	137 (35.8)
Fear of legal implication	98 (10.3)	18 (4.7)
Lack of CPR knowledge and skills	257 (27.0)	169 (44.1)
Fear of catch an infection on a contact with a victim	92 (9.7)	8 (2.1)
Unpleasant external appearance of a victim	122 (12.8)	5 (1.3)
Personal problems requiring urgent solution	23 (2.4)	3 (0.8)
Opposite sex of a victim	8 (0.8)	2 (0.5)
Other	8 (0.8)	7 (1.8)
Total	952 (100.0)	383 (100.0)