PUB - Publikationen an der Universität Bielefeld

Background and Objectives: Psychological state of bystanders is key for cardiopulmonary resuscitation (CPR) behaviour in emergencies [1]. However, despite CPR training initiatives have been initiated globally, bystander CPR rates are still too low in most of the countries [2]. This is the first study to summarize psychological aspects and their training didactics addressing the psychological state of bystanders in educational campaigns, worldwide.

Methods: A mixed-method study was performed combining literature and expert based summary of training didactics and psychological aspects in global bystander resuscitation education initiatives. Literature search in PubMed was conducted (01-01-1992 and 16-10-2018) before the World Restart a Heart Day was established in 2018 as an international CPR training and awareness campaign. The search terms ‘resuscitation’, ‘bystander’, ‘initiative’, training program’, and ‘campaign’ were combined with the Boolean Operator ‘AND’ and ‘OR’. International CPR campaigns were included in analysis if they offer specially tailored CPR training for non-professionals in a nation-wide initiative with a duration of minimum one year. Experts from the University Hospital of Cologne (emergency medical professionals, anaesthesiologist, and health scientists) and from the Bielefeld University (Pedagogics) screened eligible campaigns and developed a didactic matrix with twelve educational design elements, that can be used in CPR trainings (Table 1). Included training concepts were evaluated according to this matrix. The development of bystander CPR rates before and after educational campaigns was surveyed. Two-sided student’s t-test was performed with IBM SPSS.

Results: Globally, nine Asian, European and North American countries (Canada, Denmark, Germany, Japan, Korea, Norway, Singapore, Sweden) were identified, which offered a national bystander CPR campaign until 2018. Norway and Germany scored highest with ten out of twelve pre-defined educational design elements to address the psychological state of bystanders in their educational campaigns. Less than 50% of the educational design elements were fulfilled by Sweden (5), Japan (4), Canada (3), and Singapore (2) (Table 1 - not given here). Simplification of teaching content, materials and algorithm, which manly reduces fear, is the most common didactic method. Countries’ bystander CPR rates increased significantly after the campaigns. Every year of an educational campaign resulted in an increase of bystander CPR rates.

Discussion and Conclusion: A set of educational design elements affecting the psychological state of bystanders for CPR training is presented. However, only few countries consider the bundle of methods in their educational campaigns. Overcoming psychological barriers in bystanders still needs more consideration in training activities to foster willingness and engagement [3,4].