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The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Research

The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease

Jung Min Park1, Sangeun Jun2
Korean Journal of Adult Nursing 2018;30(1):79-88.
Published online: February 18, 2018

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Corresponding author: Jun, Sangeun https://orcid.org/0000-0002-1988-0357 College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3923, Fax: +82-53-580-3916, E-mail: sejun2@kmu.ac.kr
- This manuscript is a revision of the first author's master's thesis from Keimyung University.
• Received: November 2, 2017   • Accepted: February 14, 2018

© 2018 Korean Society of Adult Nursing

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to investigate the effects of knowledge, attitude, and self-efficacy of cardiopulmonary resuscitation (CPR) and the willingness of family members to perform the CPR to their loved one with heart disease.
  • Methods
    226 participants whose family member is hospitalized with heart disease were recruited from two hospitals in Daegu city. Data were collected by using questionnaires which included demographic charac-teristics, factors including knowledge, attitude, and self-efficacy and the willingness to perform CPR.
  • Results
    Participants reported on their level of knowledge, attitude, and self-efficacy of CPR at the following levels: 9.16±2.66, 35.55±5.56, and 63.83±19.37 respectively. Only 53% of the participants reported prior CPR training, and 67.7% indicated that they would be willing to perform CPR to their family member with heart disease. Of the participants without prior CPR training, 34% reported that they did not recognize the importance of CPR training. Participants reported attitude (p=.002) and self-efficacy (p=.040) predicted willingness to perform CPR. Age (p<.001), gender (p=.004), educational level (p<.001), occupation (p<.001), prior CPR training (p<.001) were related to willingness to perform CPR.
  • Conclusion
    This study findings suggest that it is necessary to develop educational programs for public to improve competent CPR performance.
  • Key Words: Cardiopulmonary resuscitation; Knowledge; Attitude; Self efficacy; Intention
Table 1.
General Characteristics of Participants (N=226)
Characteristics Categories n (%) or M± SD
Gender Male 102 (45.1)
Female 124 (54.9)
Age (year)   45.50±12.97
20~29 31 (13.7)
30~39 47 (20.8)
40~49 65 (28.8)
50~59 53 (23.4)
≥60 30 (13.3)
Educational level ≤ Junior high school 22 (9.7)
High school 59 (26.1)
≥ College 145 (64.2)
Job status Unemployed, housewives, students 62 (27.4)
Office workers 59 (26.1)
Public officers 33 (14.6)
Professionals 30 (13.3)
Others (commerce, agriculture, self-employed, etc.) 42 (18.6)
Experience of CPR performance Yes 19 (8.4)
No 207 (91.6)
Experience of CPR training Yes 120 (53.1)
No 106 (46.9)
Participants with CPR training experience only (N=120)
Time passed since CPR training ＜6 months 13 (10.8)
6~12 months 27 (22.5)
1~2 years 21 (17.5)
＞2 years 59 (49.2)
Latest CPR training site Working place 42 (35.0)
Military service 29 (24.2)
School/education institute 22 (18.3)
KACPR/The Red Cross/fire stations 10 (8.3)
Hospital education program 6 (5.0)
Others 11 (9.2)
Participants' comments to improve CPR training I wish I could have more practice time. 50 (41.7)
I wish they utilize more educational videos. 27 (22.5)
I wish they teach us with more detailed and professional training contents. 26 (21.6)
I wish instructors teach us more easily and better. 17 (13.2)
Participants without CPR training experience only (N=106)
Reasons not to take CPR training I didn't have a chance for CPR training although I have a need for it. 59 (55.7)
I have neither a need for CPR training nor a chance. 32 (30.2)
I felt the need for CPR training and had a chance, but I didn't for personal reasons. 11 (10.3)
I didn't have a need for CPR training although I had a chance for it. 4 (3.8)
Patients' diagnosis Anginal pectoris 72 (31.9)
Myocardial infarction 54 (23.9)
Arrhythmia 65 (28.7)
Heart failure 25 (11.1)
Endocarditis/valvular heart disease 10 (4.4)
Time since diagnosed (year) ＜5 86 (38.1)
5~10 56 (24.8)
＞10 84 (37.1)
Patients' number of hospitalization due to heart disease (time) None 65 (28.8)
1~2 135 (59.7)
≥3 26 (11.5)
Patients' experience of cardiac arrest Yes 10 (4.4)
No 216 (95.6)

CPR=cardiopulmonary resuscitation; KACPR=Korean association of cardiopulmonary resuscitation.

Table 2.
CPR Knowledge, Attitude, Self-efficacy, and Performance Willingness (N=226)
Variables     n (%) or M± SD
CPR knowledge (0~15)   9.16±2.66
CPR attitudes (10~50)   35.55±5.56
CPR self-efficacy (0~120)   63.83±19.37
CPR performance willingness Yes   153 (67.7)
No   73 (32.3)
Reasons not doing CPR (n=73) I am afraid that I will not able to do CPR properly. 42 (57.5)
I will not be able to judge whether CPR is needed. 22 (30.1)
I will take legal responsibility. the disease is contagious. 5 (6.9)
4 (5.5)

CPR=cardiopulmonary resuscitation.

Table 3.
Differences between CPR Knowledge, Attitude and Self-efficiency and Performance Willingness according to Characteristics (N=226)
Characteristics   CPR knowledge CPR attitude CPR self-efficacy CPR Performance Willingness
M± SD t or F (p) Scheffé M± SD t or F (p) Scheffé M± SD t or F (p) Scheffé Yes (n=153) No (n=73) x2 (p)
n (%) n (%)
Gender Male 9.54±2.25 2.01 37.03±5.83 3.70 69.10±18.37 3.82 79 (51.6) 23 (31.5) 8.81
Female 8.85±2.93 (.046) 34.35±5.02 (＜.001) 59.49±19.16 (＜.001) 74 (48.4) 50 (68.5) (.004)
Age (year) 20~29a 11.06±2.26 10.10 35.55±5.42 0.23 68.19±17.23 1.74 27 (17.6) 4 (5.5) 22.90
30~39b 10.02±2.25 (＜.001) 35.49±4.88 (.920) 67.45±19.72 (.141) 38 (24.9) 9 (12.3) (＜.001)
40~49c 8.85±2.67 a＞ c, d, e 35.66±5.66   61.54±19.05   41 (26.8) 24 (32.9)  
50~59d 8.55±2.41 b＞ e 35.94±5.57   64.19±19.38   36 (23.5) 17 (23.3)  
≥60e 7.60±2.64   34.73±6.62   57.97±20.60   11 (7.2) 19 (26.0)  
Education level ≤ Junior high schoola 7.36±2.78 12.52 33.50±6.37 5.01 57.09±19.02 6.45 10 (6.5) 12 (16.4) 17.21
High schoolb 8.36±2.46 (＜.001) 34.24±5.58 (.007) 58.05±17.61 (.002) 31 (20.3) 28 (38.4) (＜.001)
≥ Collegec 9.76±2.52 a, b＜ c 36.40±5.26 b＜ c 67.20±19.41 b＜ c 112 (73.2) 33 (45.2)  
Job Office workersa 9.75±2.35 11.58 37.83±4.85 4.70 68.73±17.56 7.98 48 (31.3) 11 (15.1) 22.09
Public officersb 10.06±2.27 (＜.001) 35.70±4.89 (.001) 67.73±19.25 (＜.001) 26 (17.1) 7 (9.6) (＜.001)
Professionalsc 10.93±2.27 a, b, c 35.33±5.32 a＞ d 73.60±20.75 a, b, c＞ d 25 (16.3) 5 (6.8)  
Unemployedd 8.15±2.79 ＞ d, e 33.61±5.33   54.42±17.58   32 (20.9) 30 (41.1)  
Otherse 7.86±2.25   35.26±6.47   60.79±17.60   22 (14.4) 20 (27.4)  
Experience of CPR performance Yes 10.11±2.38 1.62 37.42±4.98 1.54 72.37±20.28 2.02 11 (7.2) 8 (11.0) 0.91
No 9.07±2.68 (.106) 35.38±5.59 (.126) 63.04±19.15 (.044) 142 (92.8) 65 (89.0) (.442)
CPR training experience Yes 10.42±2.17 8.72 37.13±5.20 4.74 71.14±17.57 6.58 98 (64.1) 22 (30.1) 22.83
No 7.74±2.45 (＜.001) 33.77±5.43 (＜.001) 55.55±18.01 (＜.001) 55 (35.9) 51 (69.9) (＜.001)
Patients' diagnosis Anginal pectoris 8.81±2.53 1.816 35.28±5.78 0.210 63.28±19.78 0.715 48 (31.4) 24 (32.9) 0.39
Myocardial infarction 9.50±2.70 (.127) 35.81±4.74 (.933) 67.46±17.56 (.582) 37 (24.2) 17 (23.2) (.983)
Arrhythmia 9.45±2.73   35.57±5.32   62.14±19.57   45 (29.4) 20 (27.4)  
Heart failure 8.28±2.49   36.12±6.63   61.44±20.62   17 (11.1) 8 (11.0)  
Endocarditis/valvular heart disease 10.20±2.94   34.60±7.46   65.10±22.45   6 (3.9) 4 (5.5)  
Time since diagnosed (year) ＜5 9.66±2.55 2.75 35.78±5.65 0.27 64.05±18.47 0.49 62 (40.5) 24 (32.9) 2.99
5~10 9.04±2.77 (.066) 35.73±5.12 (.767) 65.66±18.38 (.614) 40 (26.2) 16 (21.9) (.224)
＞10 8.73±2.65   35.55±5.56   62.38±20.97   51 (33.3) 33 (45.2)  
Patients' number of hospitalization due to heart disease (time) None 9.63±2.37 1.75 35.77±5.93 0.07 65.23±21.92 0.82 47 (30.7) 18 (24.6) 1.63
1~2 8.90±2.82 (.176) 35.46±5.29 (.933) 62.54±18.36 (.444) 87 (56.9) 48 (65.8) (.443)
≥3 9.35±2.45   35.50±6.11   67.00±17.81   19 (12.4) 7 (9.6)  
Patients' experience of cardiac arrest Yes 9.20±2.62 -0.05 35.70±5.60 -0.09 63.10±23.37 0.12 5 (3.3) 5 (6.8) 1.50
No 9.16±2.67 (.961) 35.55±5.57 (.932) 63.86±19.23 (.904) 148 (96.7) 68 (93.2) (.299)

CPR=cardiopulmonary resuscitation.

Table 4.
Correlation between CPR Knowledge, Attitude and Self-efficacy (N=226)
Categories CPR Knowledge CPR Attitude CPR Self-efficacy
r (p) r (p) r (p)
CPR Knowledge 1    
CPR Attitude .27 (＜.001) 1  
CPR Self-efficacy .39 (＜.001) .57 (＜.001) 1

CPR=cardiopulmonary resuscitation.

Table 5.
Effects of CPR Knowledge, Attitude, and Self-efficacy on CPR Performance Willingness (N=226)
Categories B SE OR 95% CI p
CPR knowledge 0.05 0.08 1.05 0.90~1.23 .530
CPR attitude 0.13 0.04 1.14 1.05~1.24 .002
CPR self-efficacy 0.02 0.01 1.02 1.00~1.05 .040
Cox & Snell R2     .27    
Nagelkerke R2     .38    

Adjusted variables: gender, age, education level, occupation, CPR training experience; CPR=cardiopulmonary resuscitation; SE=standard error;

OR=odds ratio; CI=confidence interval.

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    The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease
    Korean J Adult Nurs. 2018;30(1):79-88.   Published online February 28, 2018
    DOI: https://doi.org/10.7475/kjan.2018.30.1.79
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    The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease
    Korean J Adult Nurs. 2018;30(1):79-88.   Published online February 28, 2018
    DOI: https://doi.org/10.7475/kjan.2018.30.1.79
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    The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease
    The Effects of Knowledge, Attitude, and Self-efficacy of CPR on Willingness to Perform CPR in Family Members of Patients with Heart Disease

    General Characteristics of Participants (N=226)

    Characteristics Categories n (%) or M± SD
    Gender Male 102 (45.1)
    Female 124 (54.9)
    Age (year)   45.50±12.97
    20~29 31 (13.7)
    30~39 47 (20.8)
    40~49 65 (28.8)
    50~59 53 (23.4)
    ≥60 30 (13.3)
    Educational level ≤ Junior high school 22 (9.7)
    High school 59 (26.1)
    ≥ College 145 (64.2)
    Job status Unemployed, housewives, students 62 (27.4)
    Office workers 59 (26.1)
    Public officers 33 (14.6)
    Professionals 30 (13.3)
    Others (commerce, agriculture, self-employed, etc.) 42 (18.6)
    Experience of CPR performance Yes 19 (8.4)
    No 207 (91.6)
    Experience of CPR training Yes 120 (53.1)
    No 106 (46.9)
    Participants with CPR training experience only (N=120)
    Time passed since CPR training ＜6 months 13 (10.8)
    6~12 months 27 (22.5)
    1~2 years 21 (17.5)
    ＞2 years 59 (49.2)
    Latest CPR training site Working place 42 (35.0)
    Military service 29 (24.2)
    School/education institute 22 (18.3)
    KACPR/The Red Cross/fire stations 10 (8.3)
    Hospital education program 6 (5.0)
    Others 11 (9.2)
    Participants' comments to improve CPR training I wish I could have more practice time. 50 (41.7)
    I wish they utilize more educational videos. 27 (22.5)
    I wish they teach us with more detailed and professional training contents. 26 (21.6)
    I wish instructors teach us more easily and better. 17 (13.2)
    Participants without CPR training experience only (N=106)
    Reasons not to take CPR training I didn't have a chance for CPR training although I have a need for it. 59 (55.7)
    I have neither a need for CPR training nor a chance. 32 (30.2)
    I felt the need for CPR training and had a chance, but I didn't for personal reasons. 11 (10.3)
    I didn't have a need for CPR training although I had a chance for it. 4 (3.8)
    Patients' diagnosis Anginal pectoris 72 (31.9)
    Myocardial infarction 54 (23.9)
    Arrhythmia 65 (28.7)
    Heart failure 25 (11.1)
    Endocarditis/valvular heart disease 10 (4.4)
    Time since diagnosed (year) ＜5 86 (38.1)
    5~10 56 (24.8)
    ＞10 84 (37.1)
    Patients' number of hospitalization due to heart disease (time) None 65 (28.8)
    1~2 135 (59.7)
    ≥3 26 (11.5)
    Patients' experience of cardiac arrest Yes 10 (4.4)
    No 216 (95.6)

    CPR=cardiopulmonary resuscitation; KACPR=Korean association of cardiopulmonary resuscitation.

    CPR Knowledge, Attitude, Self-efficacy, and Performance Willingness (N=226)

    Variables     n (%) or M± SD
    CPR knowledge (0~15)   9.16±2.66
    CPR attitudes (10~50)   35.55±5.56
    CPR self-efficacy (0~120)   63.83±19.37
    CPR performance willingness Yes   153 (67.7)
    No   73 (32.3)
    Reasons not doing CPR (n=73) I am afraid that I will not able to do CPR properly. 42 (57.5)
    I will not be able to judge whether CPR is needed. 22 (30.1)
    I will take legal responsibility. the disease is contagious. 5 (6.9)
    4 (5.5)

    CPR=cardiopulmonary resuscitation.

    Differences between CPR Knowledge, Attitude and Self-efficiency and Performance Willingness according to Characteristics (N=226)

    Characteristics   CPR knowledge CPR attitude CPR self-efficacy CPR Performance Willingness
    M± SD t or F (p) Scheffé M± SD t or F (p) Scheffé M± SD t or F (p) Scheffé Yes (n=153) No (n=73) x2 (p)
    n (%) n (%)
    Gender Male 9.54±2.25 2.01 37.03±5.83 3.70 69.10±18.37 3.82 79 (51.6) 23 (31.5) 8.81
    Female 8.85±2.93 (.046) 34.35±5.02 (＜.001) 59.49±19.16 (＜.001) 74 (48.4) 50 (68.5) (.004)
    Age (year) 20~29a 11.06±2.26 10.10 35.55±5.42 0.23 68.19±17.23 1.74 27 (17.6) 4 (5.5) 22.90
    30~39b 10.02±2.25 (＜.001) 35.49±4.88 (.920) 67.45±19.72 (.141) 38 (24.9) 9 (12.3) (＜.001)
    40~49c 8.85±2.67 a＞ c, d, e 35.66±5.66   61.54±19.05   41 (26.8) 24 (32.9)  
    50~59d 8.55±2.41 b＞ e 35.94±5.57   64.19±19.38   36 (23.5) 17 (23.3)  
    ≥60e 7.60±2.64   34.73±6.62   57.97±20.60   11 (7.2) 19 (26.0)  
    Education level ≤ Junior high schoola 7.36±2.78 12.52 33.50±6.37 5.01 57.09±19.02 6.45 10 (6.5) 12 (16.4) 17.21
    High schoolb 8.36±2.46 (＜.001) 34.24±5.58 (.007) 58.05±17.61 (.002) 31 (20.3) 28 (38.4) (＜.001)
    ≥ Collegec 9.76±2.52 a, b＜ c 36.40±5.26 b＜ c 67.20±19.41 b＜ c 112 (73.2) 33 (45.2)  
    Job Office workersa 9.75±2.35 11.58 37.83±4.85 4.70 68.73±17.56 7.98 48 (31.3) 11 (15.1) 22.09
    Public officersb 10.06±2.27 (＜.001) 35.70±4.89 (.001) 67.73±19.25 (＜.001) 26 (17.1) 7 (9.6) (＜.001)
    Professionalsc 10.93±2.27 a, b, c 35.33±5.32 a＞ d 73.60±20.75 a, b, c＞ d 25 (16.3) 5 (6.8)  
    Unemployedd 8.15±2.79 ＞ d, e 33.61±5.33   54.42±17.58   32 (20.9) 30 (41.1)  
    Otherse 7.86±2.25   35.26±6.47   60.79±17.60   22 (14.4) 20 (27.4)  
    Experience of CPR performance Yes 10.11±2.38 1.62 37.42±4.98 1.54 72.37±20.28 2.02 11 (7.2) 8 (11.0) 0.91
    No 9.07±2.68 (.106) 35.38±5.59 (.126) 63.04±19.15 (.044) 142 (92.8) 65 (89.0) (.442)
    CPR training experience Yes 10.42±2.17 8.72 37.13±5.20 4.74 71.14±17.57 6.58 98 (64.1) 22 (30.1) 22.83
    No 7.74±2.45 (＜.001) 33.77±5.43 (＜.001) 55.55±18.01 (＜.001) 55 (35.9) 51 (69.9) (＜.001)
    Patients' diagnosis Anginal pectoris 8.81±2.53 1.816 35.28±5.78 0.210 63.28±19.78 0.715 48 (31.4) 24 (32.9) 0.39
    Myocardial infarction 9.50±2.70 (.127) 35.81±4.74 (.933) 67.46±17.56 (.582) 37 (24.2) 17 (23.2) (.983)
    Arrhythmia 9.45±2.73   35.57±5.32   62.14±19.57   45 (29.4) 20 (27.4)  
    Heart failure 8.28±2.49   36.12±6.63   61.44±20.62   17 (11.1) 8 (11.0)  
    Endocarditis/valvular heart disease 10.20±2.94   34.60±7.46   65.10±22.45   6 (3.9) 4 (5.5)  
    Time since diagnosed (year) ＜5 9.66±2.55 2.75 35.78±5.65 0.27 64.05±18.47 0.49 62 (40.5) 24 (32.9) 2.99
    5~10 9.04±2.77 (.066) 35.73±5.12 (.767) 65.66±18.38 (.614) 40 (26.2) 16 (21.9) (.224)
    ＞10 8.73±2.65   35.55±5.56   62.38±20.97   51 (33.3) 33 (45.2)  
    Patients' number of hospitalization due to heart disease (time) None 9.63±2.37 1.75 35.77±5.93 0.07 65.23±21.92 0.82 47 (30.7) 18 (24.6) 1.63
    1~2 8.90±2.82 (.176) 35.46±5.29 (.933) 62.54±18.36 (.444) 87 (56.9) 48 (65.8) (.443)
    ≥3 9.35±2.45   35.50±6.11   67.00±17.81   19 (12.4) 7 (9.6)  
    Patients' experience of cardiac arrest Yes 9.20±2.62 -0.05 35.70±5.60 -0.09 63.10±23.37 0.12 5 (3.3) 5 (6.8) 1.50
    No 9.16±2.67 (.961) 35.55±5.57 (.932) 63.86±19.23 (.904) 148 (96.7) 68 (93.2) (.299)

    CPR=cardiopulmonary resuscitation.

    Correlation between CPR Knowledge, Attitude and Self-efficacy (N=226)

    Categories CPR Knowledge CPR Attitude CPR Self-efficacy
    r (p) r (p) r (p)
    CPR Knowledge 1    
    CPR Attitude .27 (＜.001) 1  
    CPR Self-efficacy .39 (＜.001) .57 (＜.001) 1

    CPR=cardiopulmonary resuscitation.

    Effects of CPR Knowledge, Attitude, and Self-efficacy on CPR Performance Willingness (N=226)

    Categories B SE OR 95% CI p
    CPR knowledge 0.05 0.08 1.05 0.90~1.23 .530
    CPR attitude 0.13 0.04 1.14 1.05~1.24 .002
    CPR self-efficacy 0.02 0.01 1.02 1.00~1.05 .040
    Cox & Snell R2     .27    
    Nagelkerke R2     .38    

    Adjusted variables: gender, age, education level, occupation, CPR training experience; CPR=cardiopulmonary resuscitation; SE=standard error;

    OR=odds ratio; CI=confidence interval.
    Table 1. General Characteristics of Participants (N=226)

    CPR=cardiopulmonary resuscitation; KACPR=Korean association of cardiopulmonary resuscitation.

    Table 2. CPR Knowledge, Attitude, Self-efficacy, and Performance Willingness (N=226)

    CPR=cardiopulmonary resuscitation.

    Table 3. Differences between CPR Knowledge, Attitude and Self-efficiency and Performance Willingness according to Characteristics (N=226)

    CPR=cardiopulmonary resuscitation.

    Table 4. Correlation between CPR Knowledge, Attitude and Self-efficacy (N=226)

    CPR=cardiopulmonary resuscitation.

    Table 5. Effects of CPR Knowledge, Attitude, and Self-efficacy on CPR Performance Willingness (N=226)

    Adjusted variables: gender, age, education level, occupation, CPR training experience; CPR=cardiopulmonary resuscitation; SE=standard error;

    OR=odds ratio; CI=confidence interval.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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