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Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study

Published online by Cambridge University Press:  14 December 2016

Wenche Torunn Mathiesen*
Affiliation:
Department of Anesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway Norwegian Air Ambulance Foundation, Department of Research and Development, Drøbak, Norway
Conrad Arnfinn Bjørshol
Affiliation:
Department of Anesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway Department of Clinical Medicine, University of Bergen, Bergen, Norway
Sindre Høyland
Affiliation:
University of Stavanger, Stavanger, Norway Centre for Risk Management and Societal Safety (SEROS), Stavanger, Norway
Geir Sverre Braut
Affiliation:
Department of Research, Stavanger University Hospital, Stavanger, Norway Stord/Haugesund University College, Haugesund, Norway
Eldar Søreide
Affiliation:
Department of Anesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway Network for Medical Sciences, University of Stavanger, Stavanger, Norway
*
Correspondence: Wenche Torunn Mathiesen, ICN, MA Stavanger University Hospital Forskningens Hus, Armauer Hansensgate 2 P.O. Box: 8100, 4068 Stavanger, Norway E-mail: wenche.torunn.mathiesen@sus.no

Abstract

Background

Survival rates after out-of-hospital cardiac arrest (OHCA) vary considerably among regions. The chance of survival is increased significantly by lay rescuer cardiopulmonary resuscitation (CPR) before Emergency Medical Services (EMS) arrival. It is well known that for bystanders, reasons for not providing CPR when witnessing an OHCA incident may be fear and the feeling of being exposed to risk. The aim of this study was to gain a better understanding of why barriers to providing CPR are overcome.

Methods

Using a semi-structured interview guide, 10 lay rescuers were interviewed after participating in eight OHCA incidents. Qualitative content analysis was used. The lay rescuers were questioned about their CPR-knowledge, expectations, and reactions to the EMS and from others involved in the OHCA incident. They also were questioned about attitudes towards providing CPR in an OHCA incident in different contexts.

Results

The lay rescuers reported that they were prepared to provide CPR to anybody, anywhere. Comprehending the severity in the OHCA incident, both trained and untrained lay rescuers provided CPR. They considered CPR provision to be the expected behavior of any community citizen and the EMS to act professionally and urgently. However, when asked to imagine an OHCA in an unclear setting, they revealed hesitation about providing CPR because of risk to their own safety.

Conclusion

Mutual trust between community citizens and towards social institutions may be reasons for overcoming barriers in providing CPR by lay rescuers. A normative obligation to act, regardless of CPR training and, importantly, without facing any adverse legal reactions, also seems to be an important factor behind CPR provision.

MathiesenWT, BjørsholCA, HøylandS, BrautGS, SøreideE. Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study. Prehosp Disaster Med. 2017;32(1):27–32.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Berdowski, J, Berg, RA, Tijssen, JG, Koster, RW. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation. 2010;81(11):1479-1487.Google Scholar
2. Sasson, C, Rogers, MA, Dahl, J, Kellermann, AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63-81.CrossRefGoogle ScholarPubMed
3. Savastano, S, Vanni, V. Cardiopulmonary resuscitation in real life: the most frequent fears of lay rescuers. Resuscitation. 2011;82(5):568-571.Google Scholar
4. Sasson, C, Haukoos, JS, Bond, C, et al. Barriers and facilitators to learning and performing cardiopulmonary resuscitation in neighborhoods with low bystander cardiopulmonary resuscitation prevalence and high rates of cardiac arrest in Columbus, OH. Circ Cardiovasc Qual Outcomes. 2013;6(5):550-558.Google Scholar
5. Axelsson, A. Bystander cardiopulmonary resuscitation: would they do it again? J Cardiovasc Nurs. 2001;16(1):15-20.Google Scholar
6. Renn, O. Risk Governance: Coping with Uncertainty in a Complex World. London, United Kingdom: Earthscan; 2008.Google Scholar
7. Cone, DC, Middleton, PM. Are out-of-hospital cardiac arrest survival rates improving? Resuscitation. 2015;91:A7-A8.Google Scholar
8. Lindner, TW, Søreide, E, Nilsen, OB, Torunn, MW, Lossius, HM. Good outcome in every fourth resuscitation attempt is achievable--an Utstein template report from the Stavanger region. Resuscitation. 2011;82(12):1508-1513.CrossRefGoogle ScholarPubMed
9. Lindner, T, Langørgen, J, Sunde, K, et al. Factors predicting the use of therapeutic hypothermia and survival in unconscious out-of-hospital cardiac arrest patients admitted to the ICU. Critical Care. 2013;17(4):R147.Google Scholar
10. Jacobs, I, Nadkarni, V, Bahr, J, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa). Circulation. 2004;110(21):3385-3397.Google Scholar
11. Blaikie, N. Designing Social Research: The Logic of Anticipation. Cambridge, United Kingdom: Polity Press; 2009.Google Scholar
12. Ridenour, CSN, Isadore., Mixed Methods Research: Exploring the Interactive Continuum. Carbondale, Illinois USA: Southern Illinois University Press; 2011.Google Scholar
13. Axelsson, A, Herlitz, J, Fridlund, B. How bystanders perceive their cardiopulmonary resuscitation intervention; a qualitative study. Resuscitation. 2000;47(1):71-81.CrossRefGoogle ScholarPubMed
14. Graneheim, UH, Lundman, B. Qualitative content analysis in nursing research: concepts, procedures, and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-112.Google Scholar
15. Karlsson, G, Hedman, K, Fridlund, B. Views on patient safety by operations managers in somatic hospital care: a qualitative analysis. Open Journal of Nursing. 2011;1:33-42.Google Scholar
16. Atlas.ti Qualitative Data Analysis. 2002-2014. http://www.atlasti.com/nl_201003_v62.html. Accessed February 1, 2016.Google Scholar
17. Lee, MJ, Hwang, SO, Cha, KC, Cho, GC, Yang, HJ, Rho, TH. Influence of nationwide policy on citizens’ awareness and willingness to perform bystander cardiopulmonary resuscitation. Resuscitation. 2013;84(7):889-894.Google Scholar
18. Strömsöe, A, Andersson, B, Ekstrom, L, et al. Education in cardiopulmonary resuscitation in Sweden and its clinical consequences. Resuscitation. 2010;81(2):211-216.Google Scholar
19. Tanigawa, K, Iwami, T, Nishiyama, C, Nonogi, H, Kawamura, T. Are trained individuals more likely to perform bystander CPR? An observational study. Resuscitation. 2011;82(5):523-528.Google Scholar
20. Skirbekk, H. Tillit i Norge. Oslo, Norway: Res Publica; 2012.Google Scholar
21. Fugelli, P, Ingstad, B. Helse på norsk: god helse slik folk ser det. Gyldendal Norsk Forlag; 2009.Google Scholar
22. Roeser, S. The role of emotions in judging the moral acceptability of risks. Safety Science. 2006;44(8):689-700.Google Scholar
23. Helsloot, I, Ruitenberg, A. Citizen response to disasters: a survey of literature and some practical implications. J Contingencies Crisis Management. 2004;12(3):98-111.Google Scholar
24. Mathiesen, WT, Bjørshol, CA, Braut, GS, Søreide, E. Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study. BMJ Open. 2016;6(5).Google Scholar
25. Bohm, K, Vaillancourt, C, Charette, ML, Dunford, J, Castren, M. In patients with out-of-hospital cardiac arrest, does the provision of dispatch cardiopulmonary resuscitation instructions as opposed to no instructions improve outcome: a systematic review of the literature. Resuscitation. 2011;82(12):1490-1495.Google Scholar
26. Segaard, SB, Wollebæk, D. Sosial kapital i Norge. Oslo, Norway: Cappelen Damm Akademisk.Google Scholar
27. Sasson, C, Meischke, H, Abella, BS, et al. Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for healthcare providers, policymakers, public health departments, and community leaders. Circulation. 2013;127(12):1342-1350.CrossRefGoogle Scholar
28. Manger, T, Nordahl, T, Hansen, O. Motivasjon og mestring. Oslo, Norway: Gyldendal Akademisk; 2012.Google Scholar
29. Kahneman, D, Tversky, A. Prospect theory: an analysis of decision under risk. Econometrica: Journal of the Econometric Society. 1979;263-291.Google Scholar
30. Swor, R, Khan, I, Domeier, R, Honeycutt, L, Chu, K, Compton, S. CPR training and CPR performance: do CPR-trained bystanders perform CPR? Acad Emerg Med. 2006;13(6):596-601.Google Scholar
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