Attitudes and Behaviors Toward Cardiopulmonary Resuscitation Among Healthcare and Non-healthcare Workers in Japan: A Cross-Sectional Study Using a Web-Based Questionnaire

Abstract

Background Cardiopulmonary arrest is a leading cause of death and requires swift intervention for survival. Previous studies have highlighted the critical importance of initiating cardiopulmonary resuscitation (CPR) and defibrillation within a limited timeframe. Improving outcomes depends on widespread CPR training, accessible automated external defibrillators (AEDs), and increased public awareness. Japan's universal healthcare system and accessible emergency medical services create an ideal environment for timely intervention. While global research has examined CPR hesitancy, few studies have focused on this issue in Japan. This study investigated willingness and attitudes toward CPR among various occupational groups in Japan, emphasizing the initial steps in responding to cardiopulmonary arrest. Objective This study explored the willingness and attitudes toward CPR among diverse occupational groups in Japan, focusing on the initial steps in responding to patients with cardiopulmonary arrest. Methods A cross-sectional survey was conducted through an Internet panel research company. Participants, stratified by occupation, age, and sex, completed a web-based questionnaire on CPR knowledge and willingness to act in a cardiac arrest scenario. Data were analyzed using univariate and multivariate linear regressions to identify factors influencing CPR attitudes and behaviors. Results Data from 1,648 respondents revealed differences in CPR attitudes and behaviors based on sex and occupational group. High resuscitation skills increased the likelihood of action, whereas concerns and worries reduced it. Self-evaluation of skills had a less significant effect. Variations existed in performing artificial respiration, with concerns about specific techniques influencing decisions. Multivariate regression analysis demonstrated an inverse relationship between the likelihood of action and worries about resuscitation. Sex and moral values also affected responses. Male medical doctors and nurses with lower moral values and higher resuscitation concerns were less likely to take action. However, they were more inclined to assist if the patient was familiar rather than unfamiliar. Conclusions The study identified notable differences in willingness and attitudes toward CPR between medical professionals (e.g., doctors and nurses) and non-medical professionals (e.g., the general public and care workers) as well as between men and women. Non-medical professionals were more likely to seek help when concerned about resuscitation techniques, whereas medical professionals showed hesitation due to worries about their performance. Women with uncertainties about resuscitation procedures were less likely to assist despite demonstrating a strong moral sense.

Keywords: cardiopulmonary resuscitation; occupation; out-of-hospital; web survey; willingness.

Figure 1. Results of substituting possible values of the explanatory variables into formulas derived from the multivariate linear regression analyses, shown with subfigures: (a) when the person experiencing cardiopulmonary arrest was unfamiliar and (b) when the person was familiar.

Figure 2. Results of substituting possible values of the explanatory variables into formulas derived from the multivariate linear regression analysis, where the target variable is "to an unfamiliar person," with subfigures segmented by both occupation and sex. The X-axis represents responses to "Q4S4: Worrying whether the resuscitation techniques are appropriate," and the Y-axis represents responses to "Call out to check the unfamiliar person's condition." The lines represent responses to "Q5S4: I have a strong sense of morality." Subfigures are as follows: (a) medical doctor, male; (b) nurse, male; (c) care worker, male; (d) general public, male; (e) medical doctor, female; (f) nurse, female; (g) care worker, female; and (h) general public, female.

Figure 3. Results derived from the multivariate linear regression analysis, in which the target variable is "to a familiar person," with subfigures segmented by both occupation and sex. The X-axis represents the responses to "Q4S4: Worrying whether the resuscitation techniques are appropriate," and the Y-axis represents "Call out to check the familiar person's condition." The lines correspond to the answers to "Q5S4: I have a strong sense of morality." Subfigures are as follows: (a) medical doctor, male; (b) nurse, male; (c) care worker, male; (d) general public, male; (e) medical doctor, female; (f) nurse, female; (g) care worker, female; and (h) general public, female.