心肺复苏和除颤自助训练模式的构建及初步应用

The effects of a self-oriented training for cardiopulmonary resuscitation and defibrillation

目的构建心肺复苏和除颤自助训练模式,并通过随机对照试验检验该模式的应用效果,为创新公众心肺复苏普及形式提供参考。方法以美国心脏协会提出的教育策略为理论指导,借鉴自助服务理念,通过搭建自助训练场所、制作教学视频、建立反馈模型、制订管理机制,构建心肺复苏和除颤自助训练模式。通过招募学生志愿者进行随机对照试验,比较该模式与传统集中培训的效果差异,主要结局指标为胸外按压质量,次要结局指标包括其他操作质量、知识水平和训练时长,并调查试验组志愿者对该模式的评价。结果共119名受试者完成研究,其中试验组53名,对照组66名。两组胸外按压频率正确率、按压足够深度率、按压位置正确率以及胸外按压总分等指标的差异,均无统计学意义(P>0.05);在胸外按压充分回弹率方面,试验组高于对照组(92.09%±18.35%,73.36%±29.20%,t=4.266,P<0.001)。试验组知识水平得分低于对照组(11.92±1.64,13.12±1.22,t=4.420,P<0.001);试验组自助训练时长小于对照组[(37.49±4.61)min,(63.44±2.24)min,t=37.568,P<0.001]。调查结果显示,试验组19名受试者对教学视频内容、场地设施等提出了建议,23名受试者对自助训练模式给予了积极评价。结论自助训练模式有助于推广和普及单纯胸外按压技术,其效果相当于集中培训模式。应因地制宜配置软硬件以利于自助训练模式充分发挥功效,基于用户需求,加快心肺复苏和除颤自助训练模式的优化与应用研究。

Objective To develop a self-oriented training of cardiopulmonary resuscitation and defibrillation(CPR-D).The effects of the training were examined by a randomized controlled study to provide references to promote the popularization of cardiopulmonary resuscitation in public.Methods Guided by the educational strategy proposed by the American Heart Association and drew by the modern"kiosk"self-service concept,the CPR-D self-oriented training model was constructed,which mainly included setting up self-service training venues,making teaching videos,establishing feedback models,and formulating management mechanisms.The effects of the training model were evaluated by a randomized controlled trial among students.The main outcome was the performance of chest compressions.The secondary outcomes included the performance of the other skills,CPR-D knowledge and the total training time.The evaluation of participants on the self-oriented training was investigated by interviews.Results A total of 119 students were finally included in the study with 53 in the experimental group and 66 in the control group.There were no significant differences in the percentage of the correct rate,adequate depth,correct hand position and the total score of chest compressions between the two groups(P>0.05).As to the percentage of full chest rebound,the experimental group displayed superior to the control group(92.09%±18.35%,73.36%±29.20%,t=4.266,P<0.001).The experimental group scored lower on the knowledge level than the control group(11.92±1.64,13.12±1.22,t=4.420,P<0.001).The duration of training in the experimental group was less than that in the control group[(37.49±4.61)min,(63.44±2.24)min,t=37.568,P<0.001].The results showed that 19 participants in the experimental group gave some suggestions on the teaching videos and venue facilities,etc.Twenty-three students gave a positive evaluation to the self-oriented training.Conclusion Self-oriented training is helpful to promote and popularize hands-only CPR,and it can get the similar effect with the instructor-oriented training.The configuration of software and hardware according to local conditions is conducive to give full play to the effectiveness of self-help training.It is necessary to optimize the self-oriented training and promote its related researches.