Evaluation of knowledge, attitudes, and practice of basic life support among laypersons

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) constitutes a significant public health challenge accounting for the majority of deaths globally. There is an improved chance of survival when bystander cardiopulmonary resuscitation (CPR) is incorporated into the OHCA chain of survival. There is a paucity of local data on the knowledge, attitudes, and practice of basic life support (BLS) among laypersons. This study aimed to evaluate the knowledge, attitudes, and practice of BLS among laypersons in a church community in Johannesburg, South Africa. Methods: This was a prospective descriptive cross-sectional study. A self-administered questionnaire was used among the convenience sample of 205 participants. Adult worshippers of a church in South Africa who were 18 years and above were included. The study was conducted between December 06, 2020, and March 28, 2021. Results: The mean ± SD age of the participants was 36.6 ± 12.6, with the majority of 128 (62.4%) below 40 years. There were 104 (50.7%) females and the males were 101 (49.3%). A total of 30 (14.6%) participants had previous CPR training. Only 24 (11.7%) respondents knew all the signs of cardiac arrest, while the signs for evaluating unconsciousness and absent respiration were correctly identified by 51 (24.9%) and 114 (55.6%) participants respectively. Knowledge of CPR practical application was generally poor. The proportion of subjects who identified the correct answers are reflected as follows: compression to ventilation ratio (15.6%), compression site (11.7%), compression rate (20%), compression depth (22.9%), how to determine the adequacy of artificial breathing (31.7%), the meaning of CPR (19.1%) and function of an automated external defibrillator (AED) (11.2%). About one-third (34.1%) of the participants reported that they can perform both chest compression and mouth-to-mouth ventilation. Previous CPR training was associated with better knowledge of BLS and confidence in responding to OHCA. Overall, most of the participants stated that they would perform CPR on family members and friends without hesitation than on strangers, while 74.6% indicated a willingness to learn CPR. Age and sex generally had no significant effect on the knowledge, attitude, and skills of BLS among the respondents. The most important barrier to performing CPR was the fear of making a mistake. Conclusion: This study reflected insufficient knowledge but positive attitudes with regard to the practice of CPR. Knowledge of BLS is better among those with previous CPR training. The fear of making a mistake was the biggest concern for why participants will be reluctant to provide CPR. Programs, campaigns, and training targeting different segments of the community/society may improve knowledge of bystander CPR/BLS.