Factors and Barriers on Cardiopulmonary Resuscitation and Automated External Defibrillator Willingness to Use among the Community: A 2016-2021 Systematic Review and Data Synthesis

Amsyar Daud; Azmawati Mohammed Nawi; Azimatun Noor Aizuddin; Mohammad Fadhly Yahya

doi:10.5334/gh.1255

Factors and Barriers on Cardiopulmonary Resuscitation and Automated External Defibrillator Willingness to Use among the Community: A 2016-2021 Systematic Review and Data Synthesis

Glob Heart. 2023 Aug 25;18(1):46. doi: 10.5334/gh.1255. eCollection 2023.

Authors

Amsyar Daud¹, Azmawati Mohammed Nawi¹, Azimatun Noor Aizuddin¹, Mohammad Fadhly Yahya²

Affiliations

¹ Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur 56000, Malaysia.
² Emergency and Trauma Department, Malacca General Hospital, Jalan Mufti Haji Khalil, Malacca 75450, Malaysia.

Abstract

Background: Bystander cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) can improve out-of-hospital cardiac arrest survival. However, bystander CPR and AED rates remained consistently low. The goal of this systematic review was to assess factors influencing community willingness to perform CPR and use an AED for out-of-hospital cardiac arrest survival (OHCA) victims, as well as its barriers.

Methods: The review processes (PROSPERO: CRD42021257851) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review protocol; formulation of review questions; systematic search strategy based on identification, screening, and eligibility using established databases including Scopus, Web of Science, and Medline Complete via EBSCOhost; quality appraisal; and data extraction and analysis. There is identification of full-text journal articles that were published between 2016 and 2021 and written in English.

Results: Of the final 13 articles, there are six identified factors associated with willingness to perform CPR and use an AED, including socio-demographics, training, attitudes, perceived norms, self-efficacy, and legal obligation. Younger age, men, higher level of education, employed, married, having trained in CPR and AED in the previous 5 years, having received CPR education on four or more occasions, having a positive attitude and perception toward CPR and AED, having confidence to perform CPR and to apply an AED, and legal liability protection under emergency medical service law were reasons why one would be more likely to indicate a willingness to perform CPR and use an AED. The most reported barriers were fear of litigation and injuring a victim.

Conclusions: There is a need to empower all the contributing factors and reduce the barrier by emphasizing the importance of CPR and AEDs. The role played by all stakeholders should be strengthened to ensure the success of intervention programs, and indirectly, that can reduce morbidity and mortality among the community from OHCA.

Keywords: automated external defibrillator; barrier; cardiopulmonary resuscitation; community willingness; factor.

Publication types

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

MeSH terms

Cardiopulmonary Resuscitation*
Child, Preschool
Databases, Factual
Educational Status
Emergency Medical Services*
Humans
Male
Out-of-Hospital Cardiac Arrest* / therapy

Grants and funding

This research was funded by the National University of Malaysia (UKM), under the Faculty of Medicine Fundamental Grant [FF-2021-253]. The funder has played no role in the research.