Confidence and willingness among laypersons in the UK to act in a head injury situation: a qualitative focus group study

Stefan Tino Kulnik; Mary Halter; Ann Hilton; Aidan Baron; Stuart Garner; Heather Jarman; Barry Klaassen; Emily Oliver

doi:10.1136/bmjopen-2019-033531

Confidence and willingness among laypersons in the UK to act in a head injury situation: a qualitative focus group study

BMJ Open. 2019 Nov 4;9(11):e033531. doi: 10.1136/bmjopen-2019-033531.

Authors

Stefan Tino Kulnik¹, Mary Halter², Ann Hilton², Aidan Baron², Stuart Garner³, Heather Jarman⁴, Barry Klaassen^{5

6}, Emily Oliver⁵

Affiliations

¹ Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK s.t.kulnik@sgul.kingston.ac.uk.
² Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK.
³ Talbot Primary School, Bournemouth, UK.
⁴ Emergency Department, St George's University Hospitals NHS Foundation Trust, London, UK.
⁵ British Red Cross, London, UK.
⁶ Ninewells Hospital and Medical School, Dundee, UK.

Abstract

Objectives: To explore factors influencing confidence and willingness among laypersons in the UK to act in a head injury situation, in order to inform first aid education offered by the British Red Cross.

Design: Qualitative focus group study.

Setting: South East England.

Participants: Forty-four laypersons (37 women, 7 men) were purposively recruited from the general public using snowball sampling, into one focus group each for six population groups: parents of young children (n=8), informal carers of older adults (n=7), school staff (n=7), sports coaches (n=2), young adults (n=9) and 'other' adults (n=11). The median (range) age group across the sample was 25-34 years (18-24, 84-95). Participants were from Asian (n=6), Black (n=6), Mixed (n=2) and White (n=30) ethnic backgrounds.

Results: The majority of participants described being confident and willing to act in a head injury scenario if that meant calling for assistance, but did not feel sufficiently confident or knowledgeable to assist or make decisions in a more involved way. Individuals' confidence and willingness presented as fluid and dependent on an interplay of situational and contextual considerations, which strongly impacted decision-making: prior knowledge and experience, characteristics of the injured person, un/observed head injury, and location and environment. These considerations may be framed as enablers or barriers to helping behaviour, impacting decision-making to the same extent as-or even more so than-the clinical signs and symptoms of head injury. An individual conceptual model is proposed to illustrate inter-relationships between these factors.

Conclusions: Our findings show that confidence and willingness to act in a head injury scenario are dependent on several contextual and situational factors. It is important to address such factors, in addition to knowledge of clinical signs and symptoms, in first aid education and training to improve confidence and willingness to act.

Keywords: brain concussion; craniocerebral trauma; decision-making; first aid; head injury; health education; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Craniocerebral Trauma / therapy*
Decision Making*
England
Female
First Aid*
Focus Groups
Health Education
Health Knowledge, Attitudes, Practice*
Humans
Male
Middle Aged
Qualitative Research
Young Adult