Journal List > Korean J Adult Nurs > v.30(1) > 1076521

Park and Jun: The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease

Abstract

Purpose

The purpose of this study was to investigate the effects of knowledge, attitude, and self-efficacy of cardiopulmonary resuscitation (CPR) and the willingness of family members to perform the CPR to their loved one with heart disease.

Methods

226 participants whose family member is hospitalized with heart disease were recruited from two hospitals in Daegu city. Data were collected by using questionnaires which included demographic charac-teristics, factors including knowledge, attitude, and self-efficacy and the willingness to perform CPR.

Results

Participants reported on their level of knowledge, attitude, and self-efficacy of CPR at the following levels: 9.16±2.66, 35.55±5.56, and 63.83±19.37 respectively. Only 53% of the participants reported prior CPR training, and 67.7% indicated that they would be willing to perform CPR to their family member with heart disease. Of the participants without prior CPR training, 34% reported that they did not recognize the importance of CPR training. Participants reported attitude (p=.002) and self-efficacy (p=.040) predicted willingness to perform CPR. Age (p<.001), gender (p=.004), educational level (p<.001), occupation (p<.001), prior CPR training (p<.001) were related to willingness to perform CPR.

Conclusion

This study findings suggest that it is necessary to develop educational programs for public to improve competent CPR performance.

REFERENCES

1.Park WS., Ko DS. Correlations between knowledge, attitude and performance ability to in cardiopulmonary resuscitation of youth about medical industry. Journal of the Korea Enter-tainment Industry Association. 2015. 9(3):349–55. https://doi.org/10.21184/jkeia.2015.09.9.3.349.
crossref
2.Statistics Korea. Survey of acute cardiac arrest [Internet]. Seoul: Statistics Korea;2015. [cited 2017 May 16]. Available from. http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE&parmTabId=M_01_01&parentId=D.1;D1.2;D1_11788.3;#dhtmlgoodies_treeNode64.2.
3.Huikuri HV., Castellanos A., Myerburg RJ. Sudden death due to cardiac arrhythmias. The New England Journal of Medicine. 2001. 345(20):1473–82. https://doi.org/10.1056/NEJMra000650.
crossref
4.Park SH., Choi HJ., Kang BS., Im TH., Yeom SR. A study assessing the knowledge and attitude of first responders about car-diopulmonary resuscitation. Journal of the Korean Society of Emergency Medicine. 2006. 17(6):545–58.
5.Berdowski J., Blom MT., Bardai A., Tan HL., Tijssen JGP., Koster RW. Impact of onsite or dispatched automated external defib-rillator use on survival after out-of-hospital cardiac arrest. Circulation. 2011. 124:2225–32. https://doi.org/10.1161/CIRCULATIONAHA.110.015545.
crossref
6.Kang KH., Yim J. A population health characteristic analysis of willingness to perform cardiopulmonary resuscitation. Koren Journal of Health Education and Promotion. 2008. 25(4):43–54.
7.Sohn HS., Kim YH. Factors influencing willingness to perform bystander CPR among elementary, middle and high school students. Crisisonomy. 2015. 11(11):247–59. https://doi.org/10.14251/krcem.2015.11.11.247.
crossref
8.Lee MJ., Park KN., Kim H., Shin JH., Yang HJ., Rho TH. Analysis of factors contributing to reluctance and attitude toward car-diopulmonary resuscitation in the community. Journal of The Korean Society of Emergency Medicine. 2008. 19(1):31–6.
9.Jung HK., Uhm TH. Factors that influence kindergarten teachers' willingness to perform cardiopulmonary resuscitation. The Korean Journal of Emergency Medical Services. 2015. 19(2):19- 27.https://doi.org/10.14408/KJEMS.2015.19.2.019.
crossref
10.Glanz K., Rimer BK., Viswanath K. Health behavior: theory, re-search, and practice. 5th ed.San Francisco, CA: Jossey-Bass & Pfeiffer Imprints, Wiley;2015.
11.An HS., Park IH. The effect of smoking prevention education program based on activities with elementary school students on their knowledge and attitude toward smoking and smoking refusal self-efficacy. The Journal of Learner-Centered Cur-riculum and Instruction. 2016. 16(5):465–86.
12.Jung DY., Kim HJ., Byun JY. A study of knowledge, attitude, and self-efficacy for preventing falls among long term care fa-cilities' direct care workers in Korea. Korean Journal of Wo-men Health Nursing. 2013. 14(1):81–96.
13.Korea Association of Cardiopulmonary Resuscitation. 2015 Ko-rean guidelines for cardiopulmonary resuscitation and emer-gency cardiovascular care [Internet]. Seoul: Korea Association of Cardiopulmonary Resuscitation;2015. [cited 2016 August 5]. Available from. http://www.kacpr.org/popup/file/2016_guidelines_1_0331.pdf.
14.Cho HY. Analysis of nurses' attitude toward basic life support and influencing factors. [master's thesis]. Seoul: Yonsei Uni-versity;. 2008.
15.Schlessel JS., Rappa HA., Lesser M., Pogge D., Ennis R., Mandel L. CPR knowledge, self-Efficacy, and anticipated anxiety as functions of infant/child CPR training. Annals of Emergency Medicine. 1995. 25(5):618–23. https://doi.org/10.1016/S0196-0644(95)70174-5.
crossref
16.Kang KH. Development and evaluation of a self-efficacy-based life support program for high-risk patients' family caregivers. [dissertation]. Seoul:. Seoul National University;2004.
17.Park JM. The effectiveness of competency and retention in car-diopulmonary resuscitation through self-directed learning. [dissertation]. Daegu: Kyungpook National University;2006. .S.
18.Seo HI., Park YS., Lee MJ., Ahn JY., Kim JK., Moon S, et al. Willingness variability of bystander cardiopulmonary resuscitation in special situations. Journal of the Korean Society of Emergency Medicine. 2017. 28(4):287–93.
19.Korea Centers for Disease Control and Prevention. Regional health statistics from 2008 to 2016. Community Health Survey. Seoul: Korea Centers for Disease Control and Prevention;2016. Report No.: 11-1352159-. p. 000033–10.
20.Chun YM., Park SH., Park SY. Effects on self efficacy in knowl-edge and attitude of basic cardiopulmonary resuscitation in the higher grade of elementary school students. Journal of East- West Nursing Research. 2013. 19(2):121–7. https://doi.org/10.14370/jewnr.2013.19.2.121.
crossref
21.Choi SH. Effect of cardiopulmonary resuscitation education on the knowledge, attitude and self-efficacy of elementary and middle school teachers. Journal of Korean Public Health Nursing. 2015. 29(1):18–28. https://doi.org/10.5932/JKPHN.2015.29.1.18.
crossref
22.Panchal AR., Fishman J., Camp-Rogers T., Starodub R., Merchant RM. An “ Intention-Focused” paradigm for improving bystander CPR performance. Resuscitation. 2015. 88:48–51. https://doi.org/10.1016/j.resuscitation.2014.12.006.
23.Ajzen I. The theory of planned behavior. Organizational Beha-vior and Human Decision Processes. 1991. 50(2):179–211. https://doi.org/10.1016/0749-5978(91)90020-T.
crossref

Table 1.
General Characteristics of Participants (N=226)
Characteristics Categories n (%) or M± SD
Gender Male 102 (45.1)
Female 124 (54.9)
Age (year)   45.50±12.97
20~29 31 (13.7)
30~39 47 (20.8)
40~49 65 (28.8)
50~59 53 (23.4)
≥60 30 (13.3)
Educational level ≤ Junior high school 22 (9.7)
High school 59 (26.1)
≥ College 145 (64.2)
Job status Unemployed, housewives, students 62 (27.4)
Office workers 59 (26.1)
Public officers 33 (14.6)
Professionals 30 (13.3)
Others (commerce, agriculture, self-employed, etc.) 42 (18.6)
Experience of CPR performance Yes 19 (8.4)
No 207 (91.6)
Experience of CPR training Yes 120 (53.1)
No 106 (46.9)
Participants with CPR training experience only (N=120)
Time passed since CPR training <6 months 13 (10.8)
6~12 months 27 (22.5)
1~2 years 21 (17.5)
>2 years 59 (49.2)
Latest CPR training site Working place 42 (35.0)
Military service 29 (24.2)
School/education institute 22 (18.3)
KACPR/The Red Cross/fire stations 10 (8.3)
Hospital education program 6 (5.0)
Others 11 (9.2)
Participants' comments to improve CPR training I wish I could have more practice time. 50 (41.7)
I wish they utilize more educational videos. 27 (22.5)
I wish they teach us with more detailed and professional training contents. 26 (21.6)
I wish instructors teach us more easily and better. 17 (13.2)
Participants without CPR training experience only (N=106)
Reasons not to take CPR training I didn't have a chance for CPR training although I have a need for it. 59 (55.7)
I have neither a need for CPR training nor a chance. 32 (30.2)
I felt the need for CPR training and had a chance, but I didn't for personal reasons. 11 (10.3)
I didn't have a need for CPR training although I had a chance for it. 4 (3.8)
Patients' diagnosis Anginal pectoris 72 (31.9)
Myocardial infarction 54 (23.9)
Arrhythmia 65 (28.7)
Heart failure 25 (11.1)
Endocarditis/valvular heart disease 10 (4.4)
Time since diagnosed (year) <5 86 (38.1)
5~10 56 (24.8)
>10 84 (37.1)
Patients' number of hospitalization due to heart disease (time) None 65 (28.8)
1~2 135 (59.7)
≥3 26 (11.5)
Patients' experience of cardiac arrest Yes 10 (4.4)
No 216 (95.6)

CPR=cardiopulmonary resuscitation; KACPR=Korean association of cardiopulmonary resuscitation.

Table 2.
CPR Knowledge, Attitude, Self-efficacy, and Performance Willingness (N=226)
Variables     n (%) or M± SD
CPR knowledge (0~15)   9.16±2.66
CPR attitudes (10~50)   35.55±5.56
CPR self-efficacy (0~120)   63.83±19.37
CPR performance willingness Yes   153 (67.7)
No   73 (32.3)
Reasons not doing CPR (n=73) I am afraid that I will not able to do CPR properly. 42 (57.5)
I will not be able to judge whether CPR is needed. 22 (30.1)
I will take legal responsibility. the disease is contagious. 5 (6.9)
4 (5.5)

CPR=cardiopulmonary resuscitation.

Table 3.
Differences between CPR Knowledge, Attitude and Self-efficiency and Performance Willingness according to Characteristics (N=226)
Characteristics   CPR knowledge CPR attitude CPR self-efficacy CPR Performance Willingness
M± SD t or F (p) Scheffé M± SD t or F (p) Scheffé M± SD t or F (p) Scheffé Yes (n=153) No (n=73) x2 (p)
n (%) n (%)
Gender Male 9.54±2.25 2.01 37.03±5.83 3.70 69.10±18.37 3.82 79 (51.6) 23 (31.5) 8.81
Female 8.85±2.93 (.046) 34.35±5.02 (<.001) 59.49±19.16 (<.001) 74 (48.4) 50 (68.5) (.004)
Age (year) 20~29a 11.06±2.26 10.10 35.55±5.42 0.23 68.19±17.23 1.74 27 (17.6) 4 (5.5) 22.90
30~39b 10.02±2.25 (<.001) 35.49±4.88 (.920) 67.45±19.72 (.141) 38 (24.9) 9 (12.3) (<.001)
40~49c 8.85±2.67 a> c, d, e 35.66±5.66   61.54±19.05   41 (26.8) 24 (32.9)  
50~59d 8.55±2.41 b> e 35.94±5.57   64.19±19.38   36 (23.5) 17 (23.3)  
≥60e 7.60±2.64   34.73±6.62   57.97±20.60   11 (7.2) 19 (26.0)  
Education level ≤ Junior high schoola 7.36±2.78 12.52 33.50±6.37 5.01 57.09±19.02 6.45 10 (6.5) 12 (16.4) 17.21
High schoolb 8.36±2.46 (<.001) 34.24±5.58 (.007) 58.05±17.61 (.002) 31 (20.3) 28 (38.4) (<.001)
≥ Collegec 9.76±2.52 a, b< c 36.40±5.26 b< c 67.20±19.41 b< c 112 (73.2) 33 (45.2)  
Job Office workersa 9.75±2.35 11.58 37.83±4.85 4.70 68.73±17.56 7.98 48 (31.3) 11 (15.1) 22.09
Public officersb 10.06±2.27 (<.001) 35.70±4.89 (.001) 67.73±19.25 (<.001) 26 (17.1) 7 (9.6) (<.001)
Professionalsc 10.93±2.27 a, b, c 35.33±5.32 a> d 73.60±20.75 a, b, c> d 25 (16.3) 5 (6.8)  
Unemployedd 8.15±2.79 > d, e 33.61±5.33   54.42±17.58   32 (20.9) 30 (41.1)  
Otherse 7.86±2.25   35.26±6.47   60.79±17.60   22 (14.4) 20 (27.4)  
Experience of CPR performance Yes 10.11±2.38 1.62 37.42±4.98 1.54 72.37±20.28 2.02 11 (7.2) 8 (11.0) 0.91
No 9.07±2.68 (.106) 35.38±5.59 (.126) 63.04±19.15 (.044) 142 (92.8) 65 (89.0) (.442)
CPR training experience Yes 10.42±2.17 8.72 37.13±5.20 4.74 71.14±17.57 6.58 98 (64.1) 22 (30.1) 22.83
No 7.74±2.45 (<.001) 33.77±5.43 (<.001) 55.55±18.01 (<.001) 55 (35.9) 51 (69.9) (<.001)
Patients' diagnosis Anginal pectoris 8.81±2.53 1.816 35.28±5.78 0.210 63.28±19.78 0.715 48 (31.4) 24 (32.9) 0.39
Myocardial infarction 9.50±2.70 (.127) 35.81±4.74 (.933) 67.46±17.56 (.582) 37 (24.2) 17 (23.2) (.983)
Arrhythmia 9.45±2.73   35.57±5.32   62.14±19.57   45 (29.4) 20 (27.4)  
Heart failure 8.28±2.49   36.12±6.63   61.44±20.62   17 (11.1) 8 (11.0)  
Endocarditis/valvular heart disease 10.20±2.94   34.60±7.46   65.10±22.45   6 (3.9) 4 (5.5)  
Time since diagnosed (year) <5 9.66±2.55 2.75 35.78±5.65 0.27 64.05±18.47 0.49 62 (40.5) 24 (32.9) 2.99
5~10 9.04±2.77 (.066) 35.73±5.12 (.767) 65.66±18.38 (.614) 40 (26.2) 16 (21.9) (.224)
>10 8.73±2.65   35.55±5.56   62.38±20.97   51 (33.3) 33 (45.2)  
Patients' number of hospitalization due to heart disease (time) None 9.63±2.37 1.75 35.77±5.93 0.07 65.23±21.92 0.82 47 (30.7) 18 (24.6) 1.63
1~2 8.90±2.82 (.176) 35.46±5.29 (.933) 62.54±18.36 (.444) 87 (56.9) 48 (65.8) (.443)
≥3 9.35±2.45   35.50±6.11   67.00±17.81   19 (12.4) 7 (9.6)  
Patients' experience of cardiac arrest Yes 9.20±2.62 -0.05 35.70±5.60 -0.09 63.10±23.37 0.12 5 (3.3) 5 (6.8) 1.50
No 9.16±2.67 (.961) 35.55±5.57 (.932) 63.86±19.23 (.904) 148 (96.7) 68 (93.2) (.299)

CPR=cardiopulmonary resuscitation.

Table 4.
Correlation between CPR Knowledge, Attitude and Self-efficacy (N=226)
Categories CPR Knowledge CPR Attitude CPR Self-efficacy
r (p) r (p) r (p)
CPR Knowledge 1    
CPR Attitude .27 (<.001) 1  
CPR Self-efficacy .39 (<.001) .57 (<.001) 1

CPR=cardiopulmonary resuscitation.

Table 5.
Effects of CPR Knowledge, Attitude, and Self-efficacy on CPR Performance Willingness (N=226)
Categories B SE OR 95% CI p
CPR knowledge 0.05 0.08 1.05 0.90~1.23 .530
CPR attitude 0.13 0.04 1.14 1.05~1.24 .002
CPR self-efficacy 0.02 0.01 1.02 1.00~1.05 .040
Cox & Snell R2     .27    
Nagelkerke R2     .38    

Adjusted variables: gender, age, education level, occupation, CPR training experience; CPR=cardiopulmonary resuscitation; SE=standard error;

OR=odds ratio; CI=confidence interval.

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