基于不同人群心肺复苏培训效果研究及其影响因素分析

雷泠; 胡磊; 任菁菁

doi:10.16766/j.cnki.issn.1674-4152.003812

基于不同人群心肺复苏培训效果研究及其影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003812

雷泠¹,
胡磊²,
任菁菁^3, ,

1.
杭州市临安区第一人民医院质量管理办公室，浙江杭州 311399
2.
杭州市临安区第一人民医院急诊科
3.
浙江大学医学院附属第一医院全科医学科，浙江杭州 310003

基金项目:

浙江省医药卫生科技计划项目 2024KY1456

详细信息

通讯作者:
任菁菁，E-mail：3204092@zju.edu.cn

中图分类号: R192.3 R541.78
计量
- 文章访问数: 16
- HTML全文浏览量: 9
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-03-06
- 网络出版日期: 2025-01-20

Research on the effectiveness of cardiopulmonary resuscitation training cross different populations and analysis of its influencing factors

LEI Ling¹,
HU Lei²,
REN Jingjing^{3
, ,}

1.
Emergency Medicine, the First People's Hospital of Hangzhou Lin'an district, Hangzhou, Zhejiang 311399, China

摘要

摘要: 目的借助实施心肺复苏(CPR)教育和培训来提高公众CPR普及率和医务人员急救水平。方法以分层整群随机抽样的方式选取2020—2022年接受本区技能中心统一安排的美国心脏协会标准化CPR培训课程的4类人群共800名作为研究对象，最终纳入医疗组312人次，社区组168人次，住培医生组120人次，社会大众组200人次进行研究。收集各类人员的一般情况和培训结果，分析培训效果和影响培训通过率的相关因素。结果 4组人群在CPR关键操作环节普遍存在掌握不足，但培训后对CPR知识掌握、认知和实施意愿均有明显提高。单因素分析结果显示，影响人群CPR培训通过率的因素有年龄、学历、人群类别、培训经历、培训前知识掌握调查得分、培训前认知实施意愿调查得分(P＜0.05)。多因素logistic回归分析显示，CPR培训经历(OR=3.184，95% CI：1.893~5.357，P<0.001)、培训前知识掌握调查得分(OR=1.061，95% CI：1.037~1.086，P<0.001)、培训前认知实施意愿调查得分(OR=1.839，95% CI：1.484~2.279，P<0.001)为CPR培训通过率的独立影响因素。结论 (1) 4类人群普遍存在CPR关键操作环节掌握不足的问题，开展培训可有效提高人群知识和技能水平、认知和实施意愿。(2)有CPR培训经历、培训前有一定的CPR知识、认知和实施意愿的人群往往更容易通过培训。
- 心肺复苏 /
- 培训 /
- 医务人员 /
- 公众
Abstract: Objective By implementing cardiopulmonary resuscitation (CPR) education and training, we aim to improve the prevalence of CPR and the level of emergency response among healthcare workers. Methods A total of 800 individuals from four categories who received American Heart Association-standardized CPR training courses between 2020 and 2022 were selected as the research subjects. Finally, 312 patients were included in the medical group, 168 in the community group, 120 in the resident training doctor group, and 200 in the public group. General information and training results were collected for each group to analyze the training effectiveness and related factors affecting the training pass rate. Results All four groups exhibited a general lack of mastery in key CPR operational steps. The results of univariate analysis showed that the factors affecting the pass rate of CPR training among the population include age, education level, population category, training experience, pre-training knowledge mastery survey score, and pre-training cognitive implementation intention survey score (P<0.05). Multivariate logistic regression analysis showed that CPR training experience (OR=3.184, 95% CI: 1.893-5.357, P<0.001), pre-training knowledge mastery survey score (OR=1.061, 95% CI: 1.037-1.086, P<0.001), and pre-training cognitive implementation intention survey score (OR=1.839, 95% CI: 1.484-2.279, P<0.001) were independent factors influencing the CPR training pass rate. Conclusion (1) There is a widespread problem of insufficient mastery of the key CPR operational steps among the four groups. Conducting training effectively improve knowledge, skills, cognition, and willingness to perform CPR. (2) Individuals with prior CPR training experience, pre-training CPR knowledge, and higher cognitive awareness and willingness to implement CPR are more likely to pass the training.
- Cardiopulmonary resuscitation /
- Training /
- Medical staff /
- The public

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表 1 各组人群培训前后认知、实施意愿得分比较

Table 1. Comparison of differences in cognitive and implementation willingness scores among different groups before and after training

组别	例数	时间	知识掌握调查得分 [M(P₂₅, P₇₅), 分]	知识掌握调查得分达标[例(%)]	认知、意愿调查得分 [M(P₂₅, P₇₅), 分]	认知、意愿调查得分达标[例(%)]
医疗组	312	培训前	70(70，80)	269(86.2)	21(20，22)	305(97.8)
		培训后	85(85，90)	298(95.5)	22(21，23)	311(99.7)
统计量			-18.503^c	16.238^e	-11.388^c	4.558^e
P值			< 0.001	< 0.001	< 0.001	0.033
社区组	168	培训前	60(60，70)	131(78.0)	20(19，21)	160(95.2)
		培训后	85(85，85)	152(90.5)	21(21，22)	167(99.4)
统计量			-15.876^c	9.879^e	-7.652^c	5.594^e
P值			< 0.001	0.002	< 0.001	0.018
住培医生组	120	培训前	70(60，70)	93(77.5)	20(20，21)	117(97.5)
		培训后	85(85，85)	111(92.5)	23(21，23)	120(100.0)
统计量			-13.808^c	10.588^e	-10.662^c	3.038^e
P值			< 0.001	0.001	< 0.001	0.081
社会大众组	200	培训前			18(18，18)	171(85.5)
		培训后			20(19，21)	197(98.5)
统计量					-12.113^c	22.962^e
P值					< 0.001	< 0.001
统计量^a			183.963^d	35.063^e	322.439^d	37.194^e
P值^a			< 0.001	< 0.001	< 0.001	< 0.001
统计量^b			262.018^d	35.041^e	290.796^d	26.765^e
P值^b			< 0.001	< 0.001	< 0.001	< 0.001
注: ^a为4组培训前总体比较，^b为4组培训后总体比较。^c为Z值，^d为H值, ^e为χ²值。

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表 2 各组人群CPR操作培训中各项目考核结果比较[例(%)]

Table 2. Comparison of the assessment results of each item in CRP operation training of each group [cases (%)]

组别	例数	按压及时性	按压频率	按压深度	通气质量	按压中断时间	回弹充分率	AED使用
医疗组	312	292(93.6)	221(70.8)	168(53.8)	284(91.0)	234(75.0)	204(65.4)	309(99.0)
社区组	168	160(95.2)	89(53.3)	69(41.1)	141(83.9)	98(58.3)	106(63.1)	154(91.7)
住培医生组	120	111(92.5)	64(53.8)	52(43.3)	111(92.5)	61(50.8)	63(52.5)	112(93.3)
社会大众组	200	182(91.0)	101(50.5)	63(31.5)	168(84.0)	103(51.5)	114(57.0)	166(83.0)
χ²值		2.761	27.642	25.565	10.673	39.049	7.807	46.224
P值		0.430	< 0.001	< 0.001	0.014	< 0.001	0.050	< 0.001

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表 3 变量赋值情况

Table 3. Variable assignment

变量	赋值方法
年龄	以实际值赋值
性别	男性=1，女性=0
学历	硕士及以上=0，本科=1，大专及以下=2
人群类别	医疗组=(1, 0, 0)，社区组=(0, 1, 0)，住培医生组=(0, 0, 1)，社会大众组=(0, 0, 0)
CPR培训经历	有培训经历者=1，无培训经历者=0
培训前认知、意愿调查得分	得分达标=1，得分不达标=0
培训前知识掌握调查得分	得分达标=1，得分不达标=0
培训是否通过	通过=1，未通过=0

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表 4 影响人群培训通过率的单因素分析

Table 4. Single factor analysis on the impact of population training pass rate

变量	B	SE	Waldχ²	P值	OR值	95% CI
年龄	-0.057	0.013	18.430	< 0.001	0.945	0.920~0.970
性别	0.228	0.175	1.704	0.192	1.256	0.892~1.769
学历
本科	0.511	0.180	8.038	0.005	1.667	1.171~2.373
专科及以下	0.781	0.425	3.380	0.066	2.184	0.950~5.023
人群类别
社区组	-0.520	0.265	3.849	0.050	0.595	0.354~1.000
住培医生组	-0.396	0.301	1.733	0.188	0.673	0.373~1.214
社会大众组	-1.559	0.227	47.001	< 0.001	0.210	0.135~0.329
CPR培训经历	1.827	0.192	90.628	< 0.001	6.214	4.266~9.051
培训前认知、意愿调查得分	0.749	0.073	105.853	< 0.001	2.115	1.834~2.440
培训前知识掌握调查得分	0.098	0.010	94.146	< 0.001	1.103	1.081~1.125
注：学历以硕士及以上，人群类别以医疗组为参照。

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表 5 影响人群培训通过率的多因素logistic回归分析

Table 5. Multivariate logistic regression analysis on the impact of population training pass rate

变量	B	SE	Waldχ²	P值	OR值	95% CI
年龄	-0.024	0.015	2.359	0.125	0.977	0.948~1.007
学历
本科	-0.491	0.235	4.357	0.037	0.612	0.386~0.970
专科及以下	-1.002	0.525	3.645	0.056	0.367	0.131~1.027
人群类别
社区组	0.399	0.345	1.337	0.248	1.490	0.758~2.928
住培医生组	0.099	0.366	0.074	0.786	1.104	0.539~2.261
社会大众组	0.988	0.371	7.110	0.008	2.687	1.299~5.555
CPR培训经历	1.158	0.265	19.046	< 0.001	3.184	1.893~5.357
培训前认知、意愿调查得分	0.609	0.109	31.050	< 0.001	1.839	1.484~2.279
培训前知识掌握调查得分	0.059	0.012	24.831	< 0.001	1.061	1.037~1.086
注：学历以硕士及以上为参照，人群类别以医疗组为参照。

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