From the Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland (S-N, M-T, R-G), ERC Research NET (S-N, R-G), Department for Assessment and Evaluation, Institute for Medical Education Bern, University of Bern, Bern (S-H), Department of Anaesthesiology and Intensive Care Medicine, Spital Limattal, Schlieren, Switzerland (N-K) and School of Medicine, Sigmund Freud University Vienna, Vienna, Austria (R-G).
Eur J Anaesthesiol. 2021 Oct 1;38(10):1096-1104. doi: 10.1097/EJA.0000000000001335.
Fast delivery of high-quality cardiopulmonary resuscitation is crucial in improving patient outcome after out of hospital cardiac arrest. First responders (trained laypersons) are dispatched to shorten time to basic life support and can be organised in groups or individually.
A comparison of factors enabling or impairing first responders' engagement in groups and as individuals are unknown. Therefore, we investigated these factors.
Qualitative comparison.
We set up six focus groups from March to June 2017 in the Canton of Bern, Switzerland. Thirteen group and 13 individual first responders participated.
Interviews were audio-recorded, transcribed, coded and analysed following a thematic analytic approach. Two researchers coded the transcripts separately, identified, discussed and adjusted categories, themes and subthemes.
Factors supporting first responders' engagement are: additional training, support from peers and society, satisfaction of personal desires (all important for all first responders), interdisciplinary collaboration (important for group first responders).Factors impairing first responders' engagement are: individual first responders lack training opportunities and collaboration, individual first responders lack support from peers and society, all first responders report lack of medical knowledge/skills and technical problems, confidentiality issues, legal insecurity and ethical concerns bother all first responders, intimidation by 'professional first responders' and professional burden. First responders organised in groups benefit from more training, enhanced peer support and collaboration with other groups. Individual first responders lack training opportunities and collaboration with emergency medical services.
Team spirit and peer-support engages group first responders, whereas individual first responders are impaired by lack of social support. Involvement with society triggers both first responder types to become and stay first responders. As first responders in groups have substantial additional benefits, enhancing such groups might strengthen current first responder systems.
在改善院外心脏骤停患者预后方面，快速提供高质量心肺复苏至关重要。第一响应者（经过培训的非专业人员）被派往现场以缩短基础生命支持的时间，他们可以以小组或个人的形式组织。
第一响应者以小组或个人形式参与的促成因素和阻碍因素尚不清楚，因此我们对此进行了研究。
定性比较。
我们在瑞士伯尔尼州于 2017 年 3 月至 6 月设立了 6 个焦点小组。13 名小组和 13 名个人第一响应者参加了研究。
对访谈进行录音、转录、编码，并采用主题分析方法进行分析。两位研究人员分别对转录本进行编码，识别、讨论和调整类别、主题和子主题。
支持第一响应者参与的因素有：额外培训、同行和社会的支持、个人愿望的满足（对所有第一响应者都很重要）、跨学科合作（对小组第一响应者很重要）。阻碍第一响应者参与的因素有：个人第一响应者缺乏培训机会和协作、个人第一响应者缺乏同行和社会支持、所有第一响应者都报告缺乏医学知识/技能和技术问题、保密性问题、法律不安全和道德问题困扰所有第一响应者、受到“专业第一响应者”的恐吓和职业负担。以小组形式组织的第一响应者受益于更多的培训、增强的同行支持以及与其他小组的合作。个人第一响应者缺乏与紧急医疗服务的培训机会和协作。
团队精神和同行支持使小组第一响应者参与其中，而社会支持的缺乏则使个人第一响应者受到阻碍。与社会的互动促使两种第一响应者都成为并保持第一响应者。由于小组第一响应者有实质性的额外收益，因此增强这种小组形式可能会加强当前的第一响应者系统。
