title: Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study.
abstract: BACKGROUND
  Survival rates after out-of-hospital cardiac arrest (OHCA) vary considerably among regions. The chance of survival is increased significantly by lay rescuer cardiopulmonary resuscitation (CPR) before Emergency Medical Services (EMS) arrival. It is well known that for bystanders, reasons for not providing CPR when witnessing an OHCA incident may be fear and the feeling of being exposed to risk. The aim of this study was to gain a better understanding of why barriers to providing CPR are overcome.
  
  
  METHODS
  Using a semi-structured interview guide, 10 lay rescuers were interviewed after participating in eight OHCA incidents. Qualitative content analysis was used. The lay rescuers were questioned about their CPR-knowledge, expectations, and reactions to the EMS and from others involved in the OHCA incident. They also were questioned about attitudes towards providing CPR in an OHCA incident in different contexts.
  
  
  RESULTS
  The lay rescuers reported that they were prepared to provide CPR to anybody, anywhere. Comprehending the severity in the OHCA incident, both trained and untrained lay rescuers provided CPR. They considered CPR provision to be the expected behavior of any community citizen and the EMS to act professionally and urgently. However, when asked to imagine an OHCA in an unclear setting, they revealed hesitation about providing CPR because of risk to their own safety.
  
  
  CONCLUSIONS
  Mutual trust between community citizens and towards social institutions may be reasons for overcoming barriers in providing CPR by lay rescuers. A normative obligation to act, regardless of CPR training and, importantly, without facing any adverse legal reactions, also seems to be an important factor behind CPR provision. Mathiesen WT , Bjørshol CA , Høyland S , Braut GS , Søreide E . Exploring how lay rescuers overcome barriers to provide cardiopulmonary resuscitation: a qualitative study. Prehosp Disaster Med. 2017;32(1):27-32.
authors.affiliation: 1Department of Anesthesiology and Intensive Care,Stavanger University Hospital,Stavanger,Norway.
authors.forename: Wenche Torunn
authors.initials: WT
authors.lastname: Mathiesen
authors.affiliation: 1Department of Anesthesiology and Intensive Care,Stavanger University Hospital,Stavanger,Norway.
authors.forename: Conrad Arnfinn
authors.initials: CA
authors.lastname: Bjørshol
authors.affiliation: 4University of Stavanger,Stavanger,Norway.
authors.forename: Sindre
authors.initials: S
authors.lastname: Høyland
authors.affiliation: 6Department of Research,Stavanger University Hospital,Stavanger,Norway.
authors.forename: Geir Sverre
authors.initials: GS
authors.lastname: Braut
authors.affiliation: 1Department of Anesthesiology and Intensive Care,Stavanger University Hospital,Stavanger,Norway.
authors.forename: Eldar
authors.initials: E
authors.lastname: Søreide
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation; D003256:Community Participation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009664:Norway; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D055815:Young Adult
keywords:  CPR cardiopulmonary resuscitation;  EMS Emergency Medical Services;  OHCA out-of-hospital cardiac arrest; attitude; cardiopulmonary resuscitation; emotions; fear; out-of-hospital cardiac arrest