Sasson Comilla, Haukoos Jason S, Ben-Youssef Leila, Ramirez Lorenzo, Bull Sheana, Eigel Brian, Magid David J, Padilla Ricardo
American Heart Association, Dallas, TX; University of Colorado School of Medicine, Aurora, CO; Colorado School of Public Health, Aurora, CO.
University of Colorado School of Medicine, Aurora, CO; Colorado School of Public Health, Aurora, CO; Denver Health Medical Center, Denver, CO.
Ann Emerg Med. 2015 May;65(5):545-552.e2. doi: 10.1016/j.annemergmed.2014.10.028. Epub 2014 Dec 3.
Individuals in neighborhoods composed of minority and lower socioeconomic status populations are more likely to have an out-of-hospital cardiac arrest event, less likely to have bystander cardiopulmonary resuscitation (CPR) performed, and less likely to survive. Latino cardiac arrest victims are 30% less likely than whites to have bystander CPR performed. The goal of this study is to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO.
Six focus groups and 9 key informant interviews were conducted in Denver during the summer of 2012. Purposeful and snowball sampling, conducted by community liaisons, was used to recruit participants. Two reviewers analyzed the data to identify recurrent and unifying themes. A qualitative content analysis was used with a 5-stage iterative process to analyze each transcript.
Six key barriers to calling 911 were identified: fear of becoming involved because of distrust of law enforcement, financial, immigration status, lack of recognition of cardiac arrest event, language, and violence. Seven cultural barriers were identified that may preclude performance of bystander CPR: age, sex, immigration status, language, racism, strangers, and fear of touching someone. Participants suggested that increasing availability of tailored education in Spanish, increasing the number of bilingual 911 dispatchers, and policy-level changes, including CPR as a requirement for graduation and strengthening Good Samaritan laws, may serve as potential facilitators in increasing the provision of bystander CPR.
Distrust of law enforcement, language concerns, lack of recognition of cardiac arrest, and financial issues must be addressed when community-based CPR educational programs for Latinos are implemented.
居住在少数族裔和社会经济地位较低人群构成的社区中的个体,更有可能发生院外心脏骤停事件,接受旁观者心肺复苏(CPR)的可能性更小,存活的可能性也更小。拉丁裔心脏骤停受害者接受旁观者心肺复苏的可能性比白人低30%。本研究的目的是确定在科罗拉多州丹佛市的5个低收入拉丁裔社区中,拨打911、学习和实施心肺复苏的障碍和促进因素。
2012年夏天在丹佛进行了6次焦点小组讨论和9次关键 informant 访谈。由社区联络人进行的有目的抽样和滚雪球抽样被用于招募参与者。两名评审员分析数据以确定反复出现和统一的主题。采用定性内容分析法,通过5个阶段的迭代过程分析每份笔录。
确定了拨打911的6个关键障碍:由于对执法部门的不信任、经济、移民身份、对心脏骤停事件缺乏认识、语言和暴力而害怕卷入其中。确定了7个可能妨碍旁观者实施心肺复苏的文化障碍:年龄、性别、移民身份、语言、种族主义、陌生人以及害怕触摸他人。参与者建议,增加西班牙语定制教育的可及性、增加双语911调度员的数量以及政策层面的改变,包括将心肺复苏作为毕业要求并加强《好撒玛利亚人法》,可能成为增加旁观者心肺复苏实施率的潜在促进因素。
在为拉丁裔实施基于社区的心肺复苏教育项目时,必须解决对执法部门的不信任、语言问题、对心脏骤停缺乏认识以及经济问题。