Barriers to bystander CPR in deprived communities: Findings from a qualitative study

Dobbie, Fiona; Uny, Isabelle; Eadie, Douglas; Duncan, Edward; Stead, Martine; Bauld, Linda; Angus, Kathryn; Hassled, Liz; MacInnes, Lisa; Clegg, Gareth

doi:10.1371/journal.pone.0233675

Cited by 25 publications

(18 citation statements)

References 29 publications

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“…Most participants identified the fear of harassment by police and the medico-legal system.as a barrier and cited lack of laws safeguarding lay rescuers in Pakistan. This finding is similar to studies from China and Scotland, where bystanders feared being caught up in a legal dispute as a barrier [ 17 , 28 ]. Public perception that CPR and other life saving skills should only be performed by medical professionals are further reinforced by policies discouraging bystander engagement.…”

Section: Discussionsupporting

confidence: 87%

Lifesaving skills training in schools – A qualitative study to explore students, teachers, and parent’s perceived opportunities and challenges

et al. 2023

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Objective The objective of this study is to explore the perception of teachers, parents and students’ regarding implementation of a school-based lifesaving skills program and help predict potential barriers and solutions. Methods This qualitative exploratory study was conducted in Karachi, Pakistan, from December 2020- to October 2021. We included students, teachers, and parents of secondary (grades VIII, IX, and X) and higher secondary level students (grades XI and XII) in Karachi, Pakistan's public and private schools and colleges. We selected one public, two semi-private, and two private schools. We recruited students, teachers, and parents through convenience sampling. We conducted fifteen focus group discussions (FGDs) with the students, six FGDs with the teachers, and eighteen in-depth interviews (IDIs) with parents. We transcribed the data from audio recordings and translated it into the English language. Finally, we manually analyzed the data using thematic analyses. Results This study found that bystanders' main barriers to performing lifesaving skills are lack of knowledge, fear of legal involvement, fear of hurting the patient by incorrect technique, lack of empathy among community stakeholders, and gender bias. However, the participants had a positive and supportive attitude toward implementing lifesaving skills training in schools. They suggested starting student training in the early teenage years, preferred medical staff as trainers, and suggested frequent small sessions in English/Urdu both or Urdu language and training via theory and practical hands-on drills. Furthermore, the training was proposed to be integrated into the school curriculum to make it sustainable. Finally, the government needs to support the program and make the legal environment more conducive for bystanders. Conclusion This study identified the significant barriers to performing lifesaving skills in an emergency in a low- and middle-income country (LMIC). The participants supported implementing a national lifesaving skills program in schools and colleges. However, the participants expressed that support is needed by the government for sustainability, integrating lifesaving skills into the school curriculum, providing legal support to the bystanders, and creating awareness among the general public.

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Section: Discussionsupporting

confidence: 87%

Lifesaving skills training in schools – A qualitative study to explore students, teachers, and parent’s perceived opportunities and challenges

et al. 2023

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“…There is no speci c law to safeguard and protect the bystanders and rescuers in Pakistan, such as the "Good Samaritan Law." This nding is similar to studies from China and Scotland, where bystanders feared being caught up in a legal dispute as a barrier 36,45 .…”

Section: Discussionsupporting

confidence: 86%

Lifesaving Skills Training in Schools – A Qualitative study to explore students, teachers, and parent's perceived opportunities and challenges

Shaukat¹,

Ali²,

Jaffer³

et al. 2022

Preprint

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ObjectiveThe objective of this study is to explore the perception of teachers, parents and students’ regarding implementation of a school-based lifesaving skills program and help predict potential barriers and solutions. MethodsThis qualitative exploratory study was conducted in Karachi, Pakistan, from December 2020- to October 2021. We included students, teachers, and parents of secondary (grades VIII, IX, and X) and higher secondary level students (grades XI and XII) in Karachi, Pakistan's public and private schools and colleges. We selected one public, two semi-private, and two private schools. We recruited students, teachers, and parents through convenience sampling. We conducted fifteen focus group discussions (FGDs) with the students, six FGDs with the teachers, and eighteen in-depth interviews (IDIs) with parents. We transcribed the data from audio recordings and translated it into the English language. Finally, we manually analyzed the data using thematic analyses.ResultsThis study found that bystanders' main barriers to performing lifesaving skills are lack of knowledge, fear of legal involvement, fear of hurting the patient by incorrect technique, lack of empathy among community stakeholders, and gender bias. The participants had a positive and supportive attitude toward implementing lifesaving skills training in schools. They suggested starting student training in the early teenage years, preferred medical staff as trainers, and suggested frequent small sessions in English/Urdu both or Urdu language and training via theory and practical hands-on drills. Furthermore, it was proposed that the training be integrated into the school curriculum to make it sustainable. Finally, the government needs to support the program and make the legal environment more conducive for the bystanders.ConclusionThis study identified the significant barriers to performing lifesaving skills in an emergency in a low- and middle-income country (lmic). The participants showed support for implementing a national lifesaving skills program in schools and colleges. However, the participants expressed that support is needed by the government for sustainability, integrating the lifesaving skills into the school curriculum, providing legal support to the bystanders, and creating awareness among the general public.

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“…The findings of this review informed the analysis of a qualitative research study on bystander CPR with deprived communities in Scotland which identified similar individual and environmental barriers to be targeted through tailored interventions. 50…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to delivering bystander cardiopulmonary resuscitation in deprived communities: a systematic review

Uny

Angus

Duncan

et al. 2022

Perspect Public Health

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Background: There is a higher incidence of cardiac arrest in economically deprived areas; however, data show that bystander cardiopulmonary resuscitation (CPR) in those areas is lower. This results in lower survival rates, placing those communities at a double disadvantage. This systematic review explored the barriers and facilitators to engaging with bystander CPR in deprived communities. Methods: Studies were eligible for inclusion if they addressed any barrier or facilitator to performing bystander CPR or being trained in CPR or training others. Studies had to either be set in a deprived area or examine a deprived population. Selected studies were published between January 2000 and December 2017 and reported on primary research. No language limitations were applied. Searches were conducted in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, PubMed, and Web of Science Core Collection. Unpublished ‘grey’ literature was also searched as well as the reference lists of any relevant studies. Results: The systematic review highlighted several main factors acting as barriers or facilitators to engaging with bystander CPR in deprived communities: (1) the willingness to learn or perform CPR, (2) the confidence to perform CPR, and (3) self-reported likelihood of performing CPR. The review also revealed additional barriers to engaging with CPR which are specific to – or more acute for – individuals from socioeconomically deprived backgrounds or areas. Discussion: We found little evidence suggesting that the willingness to perform or learn bystander CPR is lower in deprived communities compared to the general population. However, the confidence to perform CPR in deprived communities was affected by some measures of socioeconomic status. The results also crucially highlighted other barriers more acute in deprived communities: the risk to personal safety in administering CPR; the fear of legal consequences; and the lack of community cohesion and other cultural barriers.

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Barriers to bystander CPR in deprived communities: Findings from a qualitative study

Cited by 25 publications

References 29 publications

Lifesaving skills training in schools – A qualitative study to explore students, teachers, and parent’s perceived opportunities and challenges

Lifesaving skills training in schools – A qualitative study to explore students, teachers, and parent’s perceived opportunities and challenges

Lifesaving Skills Training in Schools – A Qualitative study to explore students, teachers, and parent's perceived opportunities and challenges

Barriers and facilitators to delivering bystander cardiopulmonary resuscitation in deprived communities: a systematic review

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