Abstract
BACKGROUND: In-hospital cardiac arrest represents a significant public health challenge, with bystander cardiopulmonary resuscitation (CPR) being crucial for survival. While rehabilitation hospitals primarily focus on chronic care, cardiac emergencies remain a critical concern due to patient vulnerability. However, limited research has investigated CPR competency among healthcare professionals in rehabilitation settings, particularly in developing countries where training resources may be constrained. OBJECTIVE: To evaluate CPR knowledge levels and training willingness among healthcare professionals in a tertiary rehabilitation hospital in China, identify factors independently associated with competency, and provide evidence-based recommendations for targeted training program development. METHODS: A cross-sectional survey was conducted at a 500-bed tertiary rehabilitation hospital in China from March to June 2024. Using stratified random sampling, 372 healthcare professionals (response rate: 93.9%) were recruited from six clinical departments. The study was approved by the Institutional Review Board (WZ-2024-045). A validated questionnaire comprising demographic characteristics, CPR knowledge assessment (50 items), and learning willingness evaluation was administered. The questionnaire was operationalized within the Health Belief Model (HBM) and Technology Acceptance Model (TAM) frameworks. Statistical analyses were performed using SPSS 26.0, including descriptive statistics, ANOVA, multivariate linear regression with multicollinearity diagnostics, and residual analysis. RESULTS: The overall CPR knowledge score was 62.45 ± 15.73 (range: 28-94), significantly below the 80-point competency threshold recommended by the 2020 American Heart Association Guidelines. Significant variations were observed across professional titles (F = 15.624, P < 0.001) and departments (F = 12.357, P < 0.001). Cardiopulmonary rehabilitation department achieved the highest score (75.62 ± 12.45), followed by pediatric rehabilitation (68.34 ± 13.56). Multivariate analysis identified professional title (β = 0.324, P < 0.001), department type (β = 0.287, P < 0.001), years of experience (β = 0.156, P = 0.012), and recent CPR training (β = 0.134, P = 0.018) as independently associated with CPR knowledge scores (R(2) = 0.423). Multicollinearity testing revealed all VIF values < 2.5 and tolerance values > 0.4, confirming model validity. Despite knowledge gaps, 91.4% acknowledged the necessity of CPR training, and 83.2% expressed willingness to participate. Simulation-based training was preferred by 89.5% of participants. Major barriers included heavy workload (78.5%) and scheduling conflicts (65.3%). Age- stratified analysis revealed non-significant but notable declining trends in older age groups (≥ 46 years: 59.78 ± 17.23 vs. ≤ 25 years: 63.12 ± 15.45, P = 0.087), warranting further investigation. CONCLUSION: Healthcare professionals in rehabilitation hospitals demonstrate suboptimal CPR knowledge with significant interdepartmental variations, falling substantially below international standards. Despite knowledge gaps, high training willingness (> 90%) provides opportunities for successful program implementation. Professional title, department type, years of experience, and recent training are independently associated with CPR competency. Department-specific, competency-based training programs addressing unique rehabilitation scenarios are urgently needed. Implementation should prioritize: (1) simulation-based quarterly sessions targeting staff with scores < 60 points, (2) flexible scheduling with micro-learning modules to address workload barriers, and (3) age-stratified training protocols for staff ≥ 45 years. Long-term strategies should include inter-institutional research networks and certification programs to establish specialized emergency care standards.