|Year : 2019 | Volume
| Issue : 3 | Page : 171-175
The efforts of health-care professionals in preparing their families for situations requiring first aid
Sahar Khalid1, Anas Khan1, Adel Altamimi1, Osama Samarkandi2
1 Department of Emergency Medicine, College of Medicine and University Medical City, King Saud University, Riyadh, Saudi Arabia
2 Department of Basic Sciences, Prince Sultan College forEmergency Medical Services, King Saud University, Riyadh, Saudi Arabia
|Date of Web Publication||1-Jul-2019|
Department of Emergency Medicine, College of Medicine and University Medical City, King Saud University, P. O. Box: 2925, Riyadh 11451
Source of Support: None, Conflict of Interest: None
Objective: The aim of the study is to assess the efforts of health-care professionals (HCPs) in preparing their families for situations requiring first aid (FA). We hypothesized that if HCPs are genuinely committed and convinced of the importance of FA, then they will be more likely to share this belief and knowledge and act in a way that will positively affect their family members, social surroundings, and consequently, the community. Materials and Methods: This was a cross-sectional survey conducted in Saudi Arabia from December 2017 to January 2018. The calculated sample size was 384. An online form was uploaded on Twitter to allow any willing HCP to participate. HCPs who responded to the survey were included in the study. Exclusion criteria were being a non-HCP or a HCP from outside of Saudi Arabia. Results: Among 655 participants, 352 (53.7%) taught family members at least one of the FA maneuvers in a detailed manner, including cardiopulmonary resuscitation, seizure or choking management, and control of excessive bleeding. Participants were more inclined to have a positive attitude toward teaching FA if their family members had witnessed a situation, in which a FA intervention was required (250 [38.2%]; P < 0.001). Majority (479, 73.1%) of the participants knew that 70% of out-of-hospital cardiac arrests happen at homes and were significantly more likely to have a positive attitude (P < 0.001). Conclusion: The majority of HCPs have made and contributed to preparing their families for situations requiring FA.
Keywords: Awareness, cardiopulmonary resuscitation, family members, first aid, health-care professionals, preparation and training
|How to cite this article:|
Khalid S, Khan A, Altamimi A, Samarkandi O. The efforts of health-care professionals in preparing their families for situations requiring first aid. J Nat Sci Med 2019;2:171-5
|How to cite this URL:|
Khalid S, Khan A, Altamimi A, Samarkandi O. The efforts of health-care professionals in preparing their families for situations requiring first aid. J Nat Sci Med [serial online] 2019 [cited 2020 Jan 29];2:171-5. Available from: http://www.jnsmonline.org/text.asp?2019/2/3/171/254483
| Introduction|| |
The importance of first aid (FA) in the community cannot be overestimated or overemphasized. According to the International Federation of Red Cross and Red Crescent Societies (IFRC), FA is defined as “a vital initial step for providing effective and rapid intervention that helps to reduce serious injuries and improve the chances of survival.” Another definition suggested by the French National Academy of Medicine is “a set of recognized measures aimed, in an emergency setting, at preserving the physical and psychological integrity of the victim of an accident or illness, notably pending the arrival of professional medical assistance.” This latter definition is consistent with the definition of the Saudi Red Crescent Authority.
According to the 2016 statistics from the World Health Organization, heart disease and road traffic injuries are the leading causes of death worldwide. As ≥50% of deaths due to traffic injuries occur within the first few minutes of the incident, according to the IFRC, it is essential to ensure that bystanders (i.e., members of the public) have adequate FA knowledge and skills. Furthermore, the incidence of out-of-hospital cardiac arrests is ≥350,000 per year in the United States (US) and Canada. In Saudi Arabia, heart disease mortality accounts for 16.04% of the overall mortality., According to the American Heart Association (AHA), 90% of people die from out-of-hospital cardiac arrests. Of these, around 70% occur in homes, and only 46% of such patients have a bystander perform cardiopulmonary resuscitation (CPR). The survival rate of CPR for out-of-hospital cardiac arrest is only 12%. In Saudi Arabia, the mortality rate for out-of-hospital cardiac arrest is higher, equaling 96%, and the bystander CPR rate is even lower, at only 20%. The factors contributing to this low rate are not well understood because of the limited number of studies on this topic in Saudi Arabia. However, a recent study by Bin Salleeh et al. recommended further investigation of the topic to better understand the factors and the characteristic affecting bystanders' decisions to provide CPR.
The AHA recommends that CPR training should be included in high school curricula, as the survival rate of cardiac arrest could be doubled or tripled, if CPR were performed within the first few minutes of having a cardiac arrest. This is consistent with the recommendations of the Saudi Ministry of Health (MOH) that each minute of delay in performing CPR is associated with a 10% decrease in survival rate–as such, a delay of 10 min is associated with a very limited to nonexistent likelihood of survival.
Studies have been conducted both nationally and internationally to assess public knowledge and attitudes toward CPR. Outcomes have varied between the locations, with higher rates of CPR knowledge being found in the US, Poland, and Australia (79%, 75%, and 58%, respectively),,, but much lower rates being found in Ireland, New Zealand, and Hong Kong (28%, 27%, and 21%, respectively).,, In Saudi Arabia, only 11% of individuals know CPR. A recent local study emphasized the need for further efforts to deliver knowledge of CPR to the community. Nevertheless, poor public knowledge of FA remains a global issue according to researchers in different countries, including Saudi Arabia. These studies mostly recommended reinforcing the importance of FA by raising public awareness, encouraging the publics' participation in FA training and refresher courses, and implementing FA in the school curricula.,,,,,,,
In this study, we aimed to assess the efforts of health-care professionals (HCPs) in preparing their families for situations requiring FA. Particularly, we examined whether they taught particular FA maneuvers in a detailed manner, including CPR (with or without an automated external defibrillator), seizure, choking management, and control of excessive bleeding.
To the best of our knowledge, this may be the first study to focus on this specific question, as we were unable to find any literature regarding this issue in PubMed, Medline, or Google Scholar. Since the background literature review revealed a lack of publications on HCPs' provision of FA training to family members, our results might contribute to the current body of knowledge regarding the attitude, use, and knowledge of FA.
| Materials and Methods|| |
We performed a cross-sectional online survey of HCPs in Saudi Arabia from December 2017 to January 2018, examining their efforts to prepare family members for situations requiring FA. The study was approved by the Institutional Review Board of King Saud University, College of Medicine (Approval No. E-17-2697). Here, we defined HCPs according to the code of conduct of the Saudi MOH. A convenience sample was used. We determined the necessary sample size to be 384 using an online calculator, based on an estimated population size of 384636 with a confidence level of 95% and a margin of error of 5%.
An online Google form (questionnaire) was uploaded on Twitter using the accounts of the authors to allow any willing HCP to participate. Followers were asked to retweet and participate in the study. All HCPs who responded to the survey were included in the study. Exclusion criteria were being a non-HCP or a HCP from outside of Saudi Arabia. HCPs who had taught any member of their family a FA maneuver were counted as having a positive attitude (made a satisfactory effort to prepare their family members for situations requiring FA), while HCPs who had never taught FA maneuvers to family members were considered to have a negative attitude. FA maneuvers included in the study were CPR (with and without automated external defibrillator), seizure, choking management, and control of excessive bleeding.
The data were obtained through an original questionnaire. The questionnaire comprised 19 questions, divided into two sections: demographics and FA-related questions to assess the efforts of HCPs. The collected data were verified, the variables coded and entered into Microsoft Excel, and then managed for analytical purposes and analyzed with SPSS Statistics 22 (IBM Corp., New York, USA). The Chi-square test was employed for the analysis (with a significance level [alpha] of 0.05).
The survey form advised participants that any information they provided would be treated confidentially. To limit potential privacy risks, we did not request specific personal information about participants. The questionnaire took <2 min to complete.
| Results|| |
A total of 655 participants took part in this study. The demographic data of participants are shown in [Table 1] with specific age data given in [Figure 1].
Based on the classification described above, 352 (53.7%) of participants had a positive attitude, as they had taught their family members at least one FA maneuver in a detailed manner, as demonstrated in [Figure 2]. Meanwhile, 303 (46.3%) of participants were regarded as having a negative attitude.
|Figure 2: First aid maneuvers taught to family members by health-care professionals|
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Participant profession had a statistically significant (P < 0.001) association with participant attitude. A more positive attitude was noted by nurses and paramedics than by other professionals. These data are not shown.
Participants with family members who had previously witnessed a FA maneuver (250 [38.2%]) had a statistically significant (P < 0.001) increased positive attitude than those participants who had family members who had not witnessed any FA maneuvers 405 (61.8%). This is shown in [Figure 3].
|Figure 3: First aid maneuvers witnessed by family members of health-care professionals|
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Of the total participants, 289 (44.1%) offered to teach their family members any of the FA maneuvers, while 57 (8.7%) had been asked by their family members to teach FA maneuvers. Family members who received FA training by participants were mothers 124 (19%), fathers 62 (9.5%), children 96 (14.8%), sisters 126 (19.3%), brothers 117 (17.9%), uncles/aunts 28 (4.3%), wives/husbands 154 (23.7%), grandparents 9 (1.4%), housemaids/drivers 16 (2.5%), and others 10 (1.7%).
Participants who did not provide any training to their families were given a number of choices as the expected reasons for this attitude, in which they could select ≥1 reason. The choices were: “You are not confident that you are able to teach FA” 31 (4.7%); “Your family members are not interested/you think they will not take you seriously” 65 (9.9%); “You think it's not important, for them to know it” 8 (1.2%), “You never thought about it” 145 (22.1%); “It will make them more anxious to have such responsibility” 37 (5.6%); and “I don't think they will maintain the knowledge or the skills” 38 (5.8%). These data are not shown.
Of all the study participants, 271 (41.4%) had participated in campaigns to teach FA to the community, while 384 (58.6%) have never been involved in such campaigns.
Participant knowledge that 70% of out-of-hospital cardiac arrests occur in homes had a statistically significant (P < 0.001) association with participant attitude, and 479 (73.1%) of participants knew this information. A positive attitude was noted by almost 80% of these participants.
Of all participants, 332 (50.7%) indicated that their families had received FA training. Although 418 (63.8%) of participants have encouraged their families to undertake FA training, the remaining 237 (36.2%) did not encourage their families to receive FA training.
About 361 (55.1%) of participants felt that they had fulfilled their duty as health-care advocates, while 277 (42.3%) did not. The remaining 17 (2.6%) gave detailed statements, such as “yes with others but not with my family,” “no but I will,” and “I don't talk about these topics at home.”
| Discussion|| |
We believe that teaching family is one of the many ways, in which HCPs are helping overcome the poor public awareness of FA. We hypothesized that if HCPs are genuinely committed and convinced of the importance of FA, then they will be more likely to share this belief and knowledge and act in a way that will positively affect their family members, social surroundings, and consequently, the community.
We believe that HCPs should have an integral role in preparing the community for emergency situations and should have a great contribution to the health education level in their immediate social setting. Although the focus of this study was to evaluate, using a convenience sample of HCPs, their training of their family members in FA, we did not collect enough information about their involvement in training the public, that is, individuals who are not their family members.
Of all HCPs included in this study, 352 (53.7%) had a positive attitude toward teaching their family members FA. But due to the lack of literature that we have mentioned before, a comparison between other studies was not possible to determine whether this is an acceptable or expected result. However, this shows that the majority of our study population had a positive contribution in preparing their families for emergency situations.
One of our major objectives was to study the factors associated with positive and negative attitudes of HCPs. We found that HCPs were significantly more likely to teach their family members FA maneuvers, if a family member had prior exposure to a situation requiring FA. This could be a result of curiosity by the family member, or the possibility that the aforementioned situation involved a family member, resulting in the family, including the HCP, having a sentimental motive.
Knowing that 70% of out-of-hospital cardiac arrests happen in homes had a significant influence on the attitude of HCPs. Increased positive attitudes were noted by HCPs who knew this information. Taking this into consideration, we believe that reinforcement of this information to HCPs may lead to an increase in positive attitudes toward teaching FA to family members.
A more positive attitude was noted by nurses and paramedics. We think this may be because some HCPs, such as pharmacists and radiologists, might not be well versed in CPR or comfortable enough to teach their families about it. Or maybe, nurses and paramedics had more first-hand exposure to similar events that have increased their awareness and motivation for further contribution.
Furthermore, participants were by far, more likely to provide training to their partners, sisters, mothers, brothers, children, and fathers (23.7%, 19.3%, 19%, 17.9%, 14.8%, and 9.5%, respectively), than to their aunts/uncles and grandparents (4.3% and 1.4%). This variation may be attributed to the degree of responsibility, the participants feel toward their family members, as they were more inclined to train their first-degree relatives than their second-degree relatives.
Interestingly, 16 (2.5%) had taught a housemaid or a driver. This may be the result of the high level of awareness those participants have toward FA and the degree of involvement those housemaids and drivers have in the family. Certainlly, we cannot exactly determine the factors that influenced the participants' preference of training of family members as we have not collected enough information about that, but this is our simple explanation.
On the other hand, when participants who had a negative attitude were given multiple statements, the statement “You never thought about it” was most frequently chosen. This further drives us to believe that there may be a need to reinforce the role of HCPs in this regard.
The limitations of our study were as follows. The convenience sampling resulted in an overwhelming proportion, 517 (79.5%) of our participants being from the central region of Saudi Arabia. In addition, we have tried our best to be specific, yet, some statements in our questionnaire (e. g., “detailed manner”) may have been interpreted differently by different HCPs.
| Conclusion|| |
In this study, we assessed one factor that could contribute to the preparedness of the community to react to situations requiring FA and found that the majority of our study population have made efforts to teach FA to their family members. However, we cannot estimate or make a comparison, due to the lack of literature, whether this contribution is enough or if HCPs could play a larger role to help overcome poor community awareness. Nevertheless, we believe that further studies are needed to investigate solutions that are appropriate for HCPs to assist them in providing a greater contribution to overcome this issue. We hope that this study gives an approximate estimation of the situation in our community and may encourage HCPs to contribute to community FA training.
We would like to thank the College of Medicine Research Center, Deanship of Scientific Research at King Saud University for supporting this research.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Larcan A, Julien H. First-aid in France. Current situation and future perspectives. Bull Acad Natl Med 2010;194:1071-93.
Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al.
Heart disease and stroke statistics-2012 update: A report from the American Heart Association. Circulation 2012;125:e2-220.
Memish ZA, Jaber S, Mokdad AH, AlMazroa MA, Murray CJ, Al Rabeeah AA, et al.
Burden of disease, injuries, and risk factors in the Kingdom of Saudi Arabia, 1990-2010. Prev Chronic Dis 2014;11:E169.
Bin Salleeh HM, Gabralla KA, Leggio WJ, Al Aseri ZA. Out-of-hospital adult cardiac arrests in a university hospital in central Saudi Arabia. Saudi Med J 2015;36:1071-5.
Cave DM, Aufderheide TP, Beeson J, Ellison A, Gregory A, Hazinski MF, et al.
Importance and implementation of training in cardiopulmonary resuscitation and automated external defibrillation in schools: A science advisory from the American Heart Association. Circulation 2011;123:691-706.
Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation 2010;81:1479-87.
Sipsma K, Stubbs BA, Plorde M. Training rates and willingness to perform CPR in King County, Washington: A community survey. Resuscitation 2011;82:564-7.
Rasmus A, Czekajlo MS. A national survey of the polish population's cardiopulmonary resuscitation knowledge. Eur J Emerg Med 2000;7:39-43.
Celenza T, Gennat HC, O'Brien D, Jacobs IG, Lynch DM, Jelinek GA, et al.
Community competence in cardiopulmonary resuscitation. Resuscitation 2002;55:157-65.
Jennings S, Hara TO, Cavanagh B, Bennett K. A national survey of prevalence of cardiopulmonary resuscitation training and knowledge of the emergency number in Ireland. Resuscitation 2009;80:1039-42.
Larsen P, Pearson J, Galletly D. Knowledge and attitudes towards cardiopulmonary resuscitation in the community. N
Z Med J 2004;117:U870.
Chair SY, Hung MS, Lui JC, Lee DT, Shiu IY, Choi KC, et al.
Public knowledge and attitudes towards cardiopulmonary resuscitation in Hong Kong: Telephone survey. Hong Kong Med J 2014;20:126-33.
Al-Turkistani HK. Awareness and knowledge of pediatric cardio- pulmonary resuscitation in the community of Al-Khobar City. J Family Community Med 2014;21:125-9.
Alshudukhi A, Alqahtani A, Alhumaid A, Alfakhri A, Aljerian N. Knowledge, attitudes, and behavior of the general Saudi population regarding cardiopulmonary resuscitation: A survey. Int J Curr Res Life Sci 2018;7:1699-704.
Goel S, Singh N, Lal V, Singh A. Knowledge, attitude and practices of students about first aid epilepsy seizures management in a Northern Indian city. Ann Indian Acad Neurol 2013;16:538-43.
] [Full text]
Brooks B, Chan S, Lander P, Adamson R, Hodgetts GA, Deakin CD, et al.
Public knowledge and confidence in the use of public access defibrillation. Heart 2015;101:967-71.
Davies M, Maguire S, Okolie C, Watkins W, Kemp AM. How much do parents know about first aid for burns? Burns 2013;39:1083-90.
Saleem AH, Alahwal AM, Al-Sayed AA, Bin-Manie MI, Marzouki HZ. Epistaxis: What do people know and what do they do? J Natl Sci Med 2018;1:22-7.
Mobarak A, Afifi R, Qulali A. First aid knowledge and attitude of secondary school students in Saudi Arabia. Health 2015;7:1366-78.
De Buck E, Van Remoortel H, Dieltjens T, Verstraeten H, Clarysse M, Moens O, et al.
Evidence-based educational pathway for the integration of first aid training in school curricula. Resuscitation 2015;94:8-22.
Aljerian N, Al Anazi M, Alotaibi A, Alangari A, Alanazi R, Alabdullah F,et al
. Applying first aids curriculum in Riyadh high schools. J Med Sci Clin Res 2017;5:30537-42.
General Authority for Statistics. Saudi Statistical Yearbook of 2015. Riyadh: General Authority for Statistics; 2015. Available from: https://www.stats.gov.sa/en/403
. [Last accessed on 2018 Jun 15].
[Figure 1], [Figure 2], [Figure 3]