Yang Mingzhu, Song Junyang, Jin Yuanyuan, Peng Youqing
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
School of Nursing, Tongji University School of Medicine, Shanghai, 200092, China.
BMC Public Health. 2024 Dec 18;24(1):3420. doi: 10.1186/s12889-024-20888-w.
Out-of-hospital cardiac arrest (OHCA) is a major public health burden worldwide. Promoting bystander cardiopulmonary resuscitation (B-CPR) is a key element in improving the survival rate of OHCA. The security guard is a specific population in China that plays a significant role as bystanders in public settings. However, less is known about their experiences regarding B-CPR intention and performance. This study aimed to explore the experiences and perspectives of Chinese security guards regarding B-CPR and identify barriers to its performance.
Fifteen in-depth interviews were conducted with security guards in various public settings, including hospitals, residential living areas, office buildings, and public transportation stations. All interviews were audio recorded. Two researchers independently analyzed the transcripts through deductive and inductive content analysis. Informed by the "Intention-focused" model of B-CPR performance, deductive content analysis was initially performed to identify categories that align with the theoretical framework and thereby validate the theory. Subsequently, inductive content analysis was applied to code newly discovered content, therefore enriching the theory.
An "intention & performance-focused" model of B-CPR was developed. It was revealed that security personnel were more inclined to perform CPR without hesitation when the victim was a trusted individual. However, when faced with unfamiliar individuals, they tended to shrink back due to various barriers. Specifically, four layers of barriers to CPR performance were identified, encompassing security personnel factors, victim-related factors, organizational factors, and societal factors. Participants also shared their perspectives on the desired CPR training, including trainers, training contents, training formats, and training incentives.
Security guards should receive comprehensive CPR training to maximize their occupational value. In addition to strengthening CPR-related training, which includes theoretical knowledge and hands-on practice, psychological coping skills for managing overwhelming emotions and understanding relevant laws are also essential training elements that cannot be overlooked. When developing relevant intervention strategies, policies, and regulations, it's critical to consider the country's context and the cooperation of the organization where the security guard is employed. The model developed in this study can provide a reference for designing interventions and policy to improve the B-CPR intention and performance for other specific groups.
院外心脏骤停（OHCA）是全球主要的公共卫生负担。推广旁观者心肺复苏术（B-CPR）是提高OHCA存活率的关键要素。保安在中国是一个特殊群体，在公共场所作为旁观者发挥着重要作用。然而，对于他们在B-CPR意愿和实施方面的经历了解较少。本研究旨在探讨中国保安对B-CPR的经历和看法，并确定实施B-CPR的障碍。
对医院、居民区、办公楼和公交站点等不同公共场所的保安进行了15次深度访谈。所有访谈均进行了录音。两名研究人员通过演绎和归纳内容分析独立分析了访谈记录。以B-CPR实施的“意愿导向”模型为依据，首先进行演绎内容分析，以识别与理论框架相符的类别，从而验证该理论。随后，应用归纳内容分析对新发现的内容进行编码，从而丰富该理论。
构建了一个B-CPR的“意愿与实施导向”模型。结果显示，当受害者是受信任的人时，保安人员更倾向于毫不犹豫地进行心肺复苏。然而，当面对不熟悉的人时，他们往往会因各种障碍而退缩。具体而言，确定了实施心肺复苏的四层障碍，包括保安人员因素、受害者相关因素、组织因素和社会因素。参与者还分享了他们对理想的心肺复苏培训的看法，包括培训人员、培训内容、培训形式和培训激励措施。
保安应接受全面的心肺复苏培训，以最大化其职业价值。除了加强包括理论知识和实践操作在内的心肺复苏相关培训外，应对强烈情绪的心理应对技巧和了解相关法律也是不可忽视的重要培训内容。在制定相关干预策略、政策和法规时，考虑国家背景以及保安所在组织的合作至关重要。本研究构建的模型可为设计干预措施和政策提供参考，以提高其他特定群体的B-CPR意愿和实施情况。
