Influence of the COVID-19 Pandemic and Bystander-victim Relationship on the Willingness of Thai Healthcare Providers and Laypersons to Perform Cardiopulmonary Resuscitation: a Cross-sectional Online Survey

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a significant health problem in many Asian countries. Bystander cardiopulmonary resuscitation (CPR) can reduce mortality from OHCA. The willingness of bystanders to initiate aid is also critical. During the COVID-19 pandemic, CPR eases to spread of COVID-19 with negatively affect the decision. The objectives were to study the influence of the COVID-19 pandemic and bystander-victim relationship on the willingness of Thai healthcare providers (HCPs) and laypersons to perform CPR and associated factors.Methods: The cross-sectional online survey was conducted between August to November 2020 in a Thai population. A structured questionnaire was developed and given to volunteers as an online survey. We recorded participant characteristics and willingness to perform compression-only CPR (W-COC) and conventional CPR (W-CC) on family members, acquaintances, and strangers during the pandemic and in a non-pandemic situation and analyzed associated factors.Results: We included 419 laypersons and 716 HCPs. Lay-participants expressed less W-COC on acquaintances and strangers (risk ratio [RR] 0.74-0.85), but not on family members. By contrast, the HCPs were less W-COC across the board (RR 0.84-0.92). Both groups were less W-CC on all recipients (RR 0.43-0.54). There was no difference in participants’ W-COC and W-CC on family members and acquaintances, except that HCPs expressed greater W-CC on family members. Participants in all groups were less W-COC and W-CC on strangers. W-COC was correlated with CPR knowledge (Odds ratio [OR] 2.32), self-efficacy (OR 1.96), single marital status (OR 1.91), and being an HCP (OR 2.00). W-CC on family members was related to CPR knowledge (OR 2.16).Conclusion: Participants were less willing during the COVID-19 pandemic on all groups except family members of lay participants. The victim’s relationship to the participant was more important in conventional CPR than compression-only CPR, especially in HCPs. CPR knowledge, self-efficacy, single marital status, and being an HCP related to higher willingness.Trial registration: TCTR20210330003 (Thai Clinical Trials Registry)