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Abstract
Study aimRates of out of hospital cardiac arrest are higher in deprived communities. Bystander Cardiopulmonary Resuscitation (BCPR) can double the chance of survival but occurs less often in these communities in comparison to more affluent communities. People living in deprived communities are, therefore, doubly disadvantaged and there is limited evidence to explain why BCPR rates are lower. The aim of this paper is to examine the barriers to administering BCPR in deprived communities.MethodMixed method qualitative study with ten single sex focus groups (n = 61) conducted in deprived communities across central Scotland and 18 semi-structured interviews with stakeholders from the UK, Europe and the USA.ResultsTwo key themes related to confidence and environmental factors were identified to summarise the perceived barriers to administering BCPR in deprived communities. Barriers related to confidence included: self-efficacy; knowledge and awareness of how, and when, to administer CPR; accessing CPR training; having previous experience of administering BCPR; who required CPR; and whether the bystander was physically fit to give CPR. Environmental barriers focused on the safety of the physical environment in which people lived, and fear of reprisal from gangs or the police.ConclusionsBarriers to administering BCPR identified in the general population are relevant to people living in deprived communities but are exacerbated by a range of contextual, individual and environmental factors. A one-size-fits-all approach is not sufficient to promote ‘CPR readiness’ in deprived communities. Future approaches to working with disadvantaged communities should be tailored to the local community.
Highlights
IntroductionThe link between socio-economic deprivation and out of hospital cardiac arrest (OHCA) is widely documented, with the rate of OHCA occurrence being significantly higher in economically deprived areas [1,2,3]
Two key themes related to confidence and environmental factors were identified to summarise the perceived barriers to administering Bystander Cardiopulmonary Resuscitation (BCPR) in deprived communities
Barriers related to confidence included: self-efficacy; knowledge and awareness of how, and when, to administer CPR; accessing CPR training; having previous experience of administering BCPR; who required CPR; and whether the bystander was physically fit to give CPR
Summary
The link between socio-economic deprivation and out of hospital cardiac arrest (OHCA) is widely documented, with the rate of OHCA occurrence being significantly higher in economically deprived areas [1,2,3]. Reasons for this centre on the risk factors for cardiac arrest being more prevalent in socio-economic deprived populations. Dobbie et al (2018) found that people with a higher social grade were more likely to be trained in CPR than those with a lower social grade (57% compared with 48%). Similar findings were found when they looked at confidence to administer CPR if talked through a by a call handler; respondents with higher social grade were more confident than those with a lower social grade (86% compared with 78%) [18]
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