Factors Predicting the Intention to Perform Cardiopulmonary Resuscitation and Automated External Defibrillators among Community Volunteers:  A Cross-Sectional Study

Natchaya  Palacheewa; Duangkamol   Wattradul; Pramote  Thangkratok

doi:10.60099/prijnr.2026.278499

Authors

Natchaya Palacheewa Srisavarindhira Thai Red Cross Institute of Nursing, Thailand.
Duangkamol Wattradul School of Nursing, Rangsit University, Thailand. https://orcid.org/0009-0005-4103-0550
Pramote Thangkratok Srisavarindhira Thai Red Cross Institute of Nursing, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2026.278499

Keywords:

Automated external def ibrillator, Cardiopulmonary resuscitation, Community volunteers, Intention to Perform

Abstract

Out-of-hospital cardiac arrest is a major public health concern in Thailand. Despite the wider availability of automated external defibrillators, bystander use remains low. Understanding the factors predicting community volunteers’ intention to perform cardiopulmonary resuscitation and to use it is essential for improving emergency response capacity. This cross-sectional study aimed to analyze factors predicting the intention to perform cardiopulmonary resuscitation and to use automated external defibrillators among community volunteers in an urban district in Bangkok, Thailand. Purposive sampling, a non-probability sampling method, was employed to recruit 120 community volunteers. Data were collected between April and May 2024 using structured questionnaires comprising six sections: the Participant Characteristics, the CPR and AEDs Knowledge Test, the Attitudes towards CPR and AEDs Assessment, the Subjective Norms for CPR and AEDs Assessment, the Perceived Behavioral Control for CPR and AEDs Assessment, and Intention to Perform CPR and Use AEDs Assessment. Data were analyzed using multivariate logistic regression.

Results revealed that 72.5% of participants reported a high intention to perform cardiopulmonary resuscitation and to use automated external defibrillators, while 90% had no prior experience performing these procedures. Attitude towards cardiopulmonary resuscitation and automated external defibrillators, and subjective norms were statistically significant predictors of intention. The logistic regression model correctly classified 74.2% of intention outcomes. The findings highlight the importance of enhancing volunteers’ positive attitudes and strengthening community social support. Nurses can enhance readiness and confidence in performing cardiopulmonary resuscitation and using automated external defibrillators among community volunteers.

References

Srinivasan NT, Schilling RJ. Sudden cardiac death and arrhythmias. Arrhythm Electrophysiol Rev. 2018;7(2):111-17. doi: 10.15420/aer.2018:15:2. DOI: https://doi.org/10.15420/aer.2018:15:2

Lyon RM, Cobbe SM, Bradley JM, Grubb NR. Surviving out of hospital cardiac arrest at home: a postcode lottery? Emerg Med J. 2004 Sep;21(5):619-24. doi: 10.1136/emj.2003.010363. DOI: https://doi.org/10.1136/emj.2003.010363

Sirikul W, Piankusol C, Wittayachamnankul B, Riyapan S, Supasaovapak J, Wongtanasarasin W, et al. A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand. Resusc. Plus. 2022; (9):100196. doi.org/10.1016/j.resplu.2021.100196 DOI: https://doi.org/10.1016/j.resplu.2021.100196

Dong X, Zhang L, Wang Z, Zheng ZJ. Implementation of basic life support education for the lay public in China: barriers, enablers, and possible solutions. Front Public Health. 2024 Jun 27;12:1390819. doi: 10.3389/fpubh.2024.1390819. DOI: https://doi.org/10.3389/fpubh.2024.1390819

Srisuk P, Apiratwarakul K, Ienghong K, Rattanaseeha W, Kotruchin P, Buranasakda M. Effectiveness of basic life support and automated external defibrillator short-course training in undergraduate students. SRIMEDJ. 2017; 32(4):332-37. Available from: https://li01.tcithaijo.org/index.php/SRIMEDJ/article/view/96699 (in Thai).

Chaisongmuang P, Boonchuwong O, Kumpiriyapong N, Vichaipon C.The effect of a basic life support training program on the acquisition of knowledge and skills among village health volunteers: a case study of a northeastern sub-district. NJPH. 2023; 33(1):49-61. Available from: https://he02.tci-thaijo.org/index.php/tnaph/article/view/262717 (in Thai).

The Nation. Health Ministry to train 10 million Thais to save people experiencing heart attacks. [Internet]. 2019 May 14 [cited 2024 December 23]. Available from: https://www.nationthailand.com/in-focus/30369366

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211. https://doi.org/10.1016/0749-5978(91)90020-T DOI: https://doi.org/10.1016/0749-5978(91)90020-T

Sasson C, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63-81. doi: 10.1161/CIRCOUTCOMES.109.889576. DOI: https://doi.org/10.1161/CIRCOUTCOMES.109.889576

Mao J, Chen F, Xing D, Zhou H, Jia L, Zhang Y. Knowledge, training and willingness to perform bystander cardiopulmonary resuscitation among university students in Chongqing, China: a cross-sectional study. BMJ Open. 2021 Jun 23;11(6):e046694. doi: 10.1136/bmjopen-2020-046694. DOI: https://doi.org/10.1136/bmjopen-2020-046694

Cui S, Ye D, Yang H, Zhang L, Chen L. Knowledge, attitude, and willingness to perform on-site cardiopulmonary resuscitation among individuals trained in public CPR: a cross-sectional survey. PLoS One. 2025 May 28;20(5):e0319884. doi: 10.1371/journal.pone.0319884. DOI: https://doi.org/10.1371/journal.pone.0319884

Xia L, Zhang K, Huang F, Jian P, Yang R. The intentions and factors influencing university students to perform CPR for strangers based on the theory of planned behavior study. Heliyon. 2024 Sep19;10(19):e38135. doi: 10.1016/j.heliyon.2024.e38135. DOI: https://doi.org/10.1016/j.heliyon.2024.e38135

Tam VCW, Kwok AWL. Evaluation of the willingness to perform cardiopulmonary resuscitation (CPR) with automated external defibrillator (AED) among Hong Kong Chinese using the theory of planned behaviour framework: an online cross-sectional survey. BMJ Public Health. 2024;2(1):e000406. doi.org/10.1136/bmjph-2023-000406 DOI: https://doi.org/10.1136/bmjph-2023-000406

Mohd Hashim NI, Daud A, Mohammed Nawi A. Factors influencing willingness to perform cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED) among non-healthcare community participants in a CPR fun run. BMC Public Health. 2025 25, 2944. doi.org/10.1186/s12889-025-24412-6 DOI: https://doi.org/10.1186/s12889-025-24412-6

Magid KH, Ranney ML, Risica PM. Using the theory of planned behavior to understand intentions to perform bystander CPR among college students. J Am Coll Health.2019; 69(1), 47–52. doi.org/10.1080/07448481.2019.1651729 DOI: https://doi.org/10.1080/07448481.2019.1651729

Awawdeh M, Alanzi AM, Alhasoun M, Babtain A, Alshahrani N, Alhamdan A, et al. A cross-sectional study investigating the knowledge and attitude of health professions students in Saudi Arabia: are they ready for cardiopulmonary resuscitation? Cureus. 2023 Aug 6;15(8):e43048. doi:10.7759/cureus.43048. DOI: https://doi.org/10.7759/cureus.43048

Ajzen, I. Perceived behavioral control, self-efficacy, locus of control, and the Theory of Planned Behavior. J. Appl. Soc. Psychol. 2002; 32(4), 665–83. doi.org/10.1111/j.1559-1816.2002.tb00236.x DOI: https://doi.org/10.1111/j.1559-1816.2002.tb00236.x

Slabe D, Metelko Ž, Šparovec ED. The impact on users of an unfamiliar AED following a recent training experience: a randomized cross over simulation study. Resusc Plus. 2024 Aug 28;20:100758. doi:10.1016/j.resplu.2024.100758. DOI: https://doi.org/10.1016/j.resplu.2024.100758

Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009 Nov;41(4):1149-60. doi: 10.3758/BRM.41.4.1149. DOI: https://doi.org/10.3758/BRM.41.4.1149

Andrade C. Sample size and its importance in research. Indian J Psychol Med. 2020 Jan 6;42(1):102-3. doi: 10.4103/IJPSYM.IJPSYM_504_19 DOI: https://doi.org/10.4103/IJPSYM.IJPSYM_504_19

Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, et al. Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16_suppl_2): S337-S557. doi: 10.1161/CIR.0000000000000918 DOI: https://doi.org/10.1161/CIR.0000000000000918

Nasri AA, Bulushi AA. Examining nurses’ theoretical knowledge, attitude, and practice of cardio-pulmonary resuscitation in hospitals and primary health care settings in South Sharqiyah, Sultanate of Oman. Am. J. Nurs. Res. 2020;8(5):577-87. doi: 10.12691/ajnr-8-5-11 DOI: https://doi.org/10.12691/ajnr-8-5-11

Oteir A, Almhdawi K, Kanaan S, Alwidyan M. Attitudes towards CPR among allied health students in Jordan: a cross-sectional study. Australas. J. Paramed. 2020;17. doi.org/10.33151/ajp.17.860 DOI: https://doi.org/10.33151/ajp.17.860

Oteir AO, Kanaan SF, Alwidyan MT, Almhdawi KA, Williams B. Validity and reliability of a cardiopulmonary resuscitation attitudes questionnaire among allied health profession students. Open Access Emerg Med. 2021 Mar 2;13:83-90. doi: 10.2147/OAEM.S291904. DOI: https://doi.org/10.2147/OAEM.S291904

Jiang Y, Wu B, Long L, Li J, Jin X. Attitudes and willingness toward out-of-hospital cardiopulmonary resuscitation: a questionnaire study among the public trained online in China. BMJ Open. 2020 Oct 8;10(10):e038712. doi: 10.1136/bmjopen-2020-038712. DOI: https://doi.org/10.1136/bmjopen-2020-038712

Claflin SB, Klekociuk S, Fair H, Bostock E, Farrow M, Doherty K, Taylor BV. Assessing the impact of online health education interventions from 2010-2020: a systematic review of the evidence. Am J Health Promot. 2022 Jan;36(1):201-24. doi: 10.1177/08901171211039308. DOI: https://doi.org/10.1177/08901171211039308

Tang L, Wang J. Effects of new media use on health behaviors: a case study in China. Iran J Public Health. 2021;50(5):949-58. doi: 10.18502/ijph.v50i5.6112. DOI: https://doi.org/10.18502/ijph.v50i5.6112

Silverplats J, Strömsöe A, Äng B, Södersved Källestedt ML. Attitudes towards cardiopulmonary resuscitation situations and associations with potential influencing factors- a survey among in-hospital healthcare professionals. PloS one. 2022;17(7):e0271686. doi: 10.1371/journal.pone.0271686. DOI: https://doi.org/10.1371/journal.pone.0271686

Mohammed Z, Arafa A, Saleh Y, Dardir M, Taha A, Shaban H, et al. Knowledge of and attitudes towards cardiopulmonary resuscitation among junior doctors and medical students in upper Egypt: cross-sectional study. Int J Emerg Med. 2020 Apr 22;13(1):19. doi: 10.1186/s12245-020-00277-x. DOI: https://doi.org/10.1186/s12245-020-00277-x

Lee JH, Lee DE, Ryoo HW, Moon S, Cho JW, Kim YJ, et al. Public awareness and willingness to use automated external defibrillators in a metropolitan city. Clin Exp Emerg Med. 2021; 8(1): 1–8. doi: 10.15441/ceem.20.053 DOI: https://doi.org/10.15441/ceem.20.053

Bdiri Gabbouj S, Zedini C, Naija W. Effect of simulation-based education of adult BLS-CPR on nursing students' skills and knowledge acquisition. Adv Med Educ Pract. 2025 Apr 22;16:663-73. doi: 10.2147/AMEP.S500156. DOI: https://doi.org/10.2147/AMEP.S500156

Shah SS, Asghar Z. Dynamics of social influence on consumption choices: a social network representation. Heliyon. 2023;9(6):e17146. doi: 10.1016/j.heliyon.2023.e17146. DOI: https://doi.org/10.1016/j.heliyon.2023.e17146