Research Article: A 5-year change of knowledge and willingness by sampled respondents to perform bystander cardiopulmonary resuscitation in a metropolitan city

Date Published: February 7, 2019

Publisher: Public Library of Science

Author(s): Sungbae Moon, Hyun Wook Ryoo, Jae Yun Ahn, Jung Bae Park, Dong Eun Lee, Jung Ho Kim, Sang-chan Jin, Kyung Woo Lee, Chiara Lazzeri.


Nationwide and regional interventions can help improve bystander cardiopulmonary resuscitation (CPR) awareness, knowledge, and the willingness. Periodic community investigation will help monitor the effect. This study aimed to compare the experience of CPR education, CPR knowledge, and CPR willingness, during a 5-year interval.

This is a pre and post study. Two surveys were done in February 2012 and December 2016. National and regional intervention including legislation promoting public involvement, standardizing CPR education programs, training CPR instructors, and installing supporting organizations were done at the period. In both surveys, respondents were selected via quota sampling in Daegu Metropolitan City and answered the survey through face-to-face interview. Respondents’ general demographic characteristics, CPR educational experience, CPR knowledge and CPR willingness were questioned.

Total of 2141 respondents (1000 in 2012, 1141 in 2016) were selected. The percentage of respondents who received CPR education itself and recent education were higher after intervention compared to before intervention (36.2% vs. 55.1%, 16.9% vs. 30.1%, respectively). Correct knowledge of performing CPR seems to be improved overall (1.6% vs. 11.7%, odd ratio 14.28, 95% confidence interval 5.68–35.94). However, less respondents were willing to perform CPR on strangers (54.5% vs 35.0%).

Nationwide and regional interventions to promote bystander CPR and CPR education were associated with increased CPR education experience and improved correct CPR knowledge in performing bystander CPR. Willingness to perform bystander CPR on family did not increase significantly and CPR willingness to strangers was decreased. Additional legal and technological measures should be implemented to promote bystander CPR.

Partial Text

Sudden cardiac death remains one of the leading causes of death in developed countries[1] and is considered as a major burden to the population[2–3]. In the early 21st century, there were approximately 600–700 non-traumatic out-of-hospital cardiac arrest (OHCA) cases annually in the Daegu Metropolitan City area; this number increased from 887 in 2012 to 1009 in 2016[4].

Total of 2141 respondents answered both surveys. The most common age group was 40–49 years in both the first and second surveys (23.3% and 21.0%, respectively). The percentage of respondents with a family history of cardiac disease was higher after intervention. Most people received college education (42.6% and 51.1%, respectively) and earned between 2 million to 3 million South Korean won (approximately 1900 to 2700 US dollars, 23.8% and 22.8%, respectively). The reason for a significant difference in age, educational status, and monthly income between groups was the change in the Daegu population census. More detailed results of the general demographic characteristics of respondents are described in Table 1.

Based on this study, we observed 2 substantial findings. Firstly, the percentage of the general population who received CPR education and knowing correct CPR knowledge increased during the 5-year study interval, meaning that interventions regarding public CPR education may have contributed to this result. The respondents also had improved identification of correct compression hand position, rate, and depth in performing bystander CPR. This result is meaningful because high-quality CPR is crucial during any resuscitation[20]. Furthermore, there was an increase in the willingness to perform bystander CPR on family members, but a decrease in the willingness to perform CPR on strangers, during the same period.




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