民眾對於施行心肺復甦術、使用公眾電擊器與好撒馬利亞人法的知識、態度與意願

Knowledge and attitude toward to cardiopulmonary resuscitation、automated external defibrillator and Good Samaritan law in Taiwan

黃沛銓(Pei-Chuan Huang)

指導教授 ： 楊銘欽

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2013年)

https://doi.org/10.6342/NTU.2013.01946

摘要

研究背景與目的：心臟血管疾病一直是國人十大死因的前三名，而心室顫動是造成心因性猝死的最重要原因之一，及時施行心肺復甦術和使用自動電擊器將大幅提升心因性猝死的存活率；而國內調查發現，到院前死亡病患接受非救護員心肺復甦術的比例很低。本研究試圖調查一般民眾對以上急救技能的知識、態度與意願，以了解影響對陌生人施救意願的因素，供未來政策推行的參考。
研究方法：本研究為橫斷式研究設計，以全國住宅電話簿為抽樣清冊，縣市分層隨機抽樣，並以自行設計之結構式問卷對年滿20歲以上之成年人電話訪查，針對樣本之「性別」、「年齡」、「教育程度」及「地理區域」分佈進行多變數反覆加權法，直到符合母群體樣本分布。
研究結果：本研究共電訪9824次數，完成1,073份有效樣本。研究結果顯示，九成的民眾聽過心肺復甦術，只有五成的人會做；若會技術，有86.6%願意對陌生人施行。有四成民眾聽過自動電擊器，只有14%的人會使用自動電擊器；若會技術，有86.4%的人願意對陌生人使用。只有近一成的人聽過保護好心人規定，而不到3%知道規定內容是甚麼。造成不願意對陌生人施救的主要原因有：自覺技術不熟練或不會操作機器、害怕法律上的問題和擔心知識不足而傷害被救者。約八成的受訪者只願意花一小時去參加免費的急救訓練。而一般民眾對急救技術的知識、態度會影響其施行的意願。正向態度、男性與非從事醫療工作者，較願意對陌生人施行急救技術。
結論與建議：政府機關應持續推行”全民學習壓胸急救及自動電擊器”之計畫以促進國民健康；關於醫療工作人員的急救意願較低，應進一步研究並找出解決之道。此外，為提高學習意願，應努力縮短訓練課程時間至一小時、強化單純壓胸不對嘴、宣導急救對患者不會重大傷害與國內有保護好心人規定免除法律責任，去除一般民眾對他人施予急救之擔憂。另可考慮立法規範或鼓勵特定職業或證照應有參加急救訓練之證明，或要求發生心因性猝死機率較高之場所工作人員參加急救訓練。未來研究者應增加對自動電擊器之相關研究；或以本研究結果為基礎設計實驗性之研究，找出提高一般民眾對於陌生人施行心肺復甦術與使用自動電擊器意願的相關因素，作為未來推行救命技術建議。

關鍵字

路人心肺復甦術 ； 自動電擊器 ； 好心人保護規定 ； 電話訪問

並列摘要

Background: Cardiovascular disease is one of the three leading causes of death in Taiwan, and ventricular fibrillation accounts for most sudden cardiac deaths. Timely administration of cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AED) could significantly improve the survival rate. In previous studies, a low bystander CPR rate was noted in Taipei. This study aims to investigate the public knowledge and attitude towards CPR, AED, and the Good Samaritan law in Taiwan, and to determine factors associated with people’s willingness to perform CPR or apply AED on strangers.
Methods: A population-based random sample of household telephone numbers was selected from a validated national sampling frame. A structured questionnaire was developed to assess the knowledge, willingness, and attitude towards CPR, AED, and the Good Samaritan law. After stratified random sampling, a national telephone survey with a computer-assisted telephone interviewing system (CATIS) was performed in 22 cities and counties. Logistic regression analysis was performed to identify factors associated with willingness to perform bystander CPR and AED.
Results: A total of 9824 households were contacted, and 1,073 valid samples were collected. The results showed that 90% of respondents had heard of CPR, but only 50% of them had reliable skills. Among interviewees with qualified abilities, 86.6% were willing to perform CPR on strangers. Only 14% of respondents had heard of AED, and 86.4% of them were willing to apply AED on strangers. Few interviewees had heard of the Good Samaritan law (10%) and understood the legal provisions (3%). Factors related to the reluctance to perform first aid on strangers were lack of skills, fear of legal liability, and fear of causing injury to the victims. Factors most closely related with intention of bystander CPR and AED were being male, having a positive attitude, and non-medical staff.
Conclusions: Nationwide first-aid policies are still needed to promote citizens' awareness and willingness to perform bystander CPR and AED. Additionally, educational courses on CPR and AED should be shortened to one hour for higher public participation. For policy development and public access defibrillation (PAD) promotion, more AED-related studies are needed. Future implementation should deploy simple and streamlined educational strategies to facilitate dissemination, and focus more on the legal and safety aspects of CPR and AED.

並列關鍵字

bystander CPR ； public access defibrillation ； good Samaritan law ； telephone survey

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