Knowledge and Willingness to Perform Cardiopulmonary Resuscitation by Bystanders in Jordan; A Nationwide Cross-sectional Study

Introduction: Bystander-initiated Cardiopulmonary Resuscitation (CPR) strongly influences the Out-of-hospital cardiac arrest (OHCA) survival outcomes; but substantial disparities persist in knowledge levels and willingness to perform CPR. This study aimed to evaluate the CPR knowledge and willingness of bystanders to perform standard versus hands-only CPR among Jordanian adults. Methods: A nationwide cross-sectional study was conducted using a validated questionnaire developed in accordance with American Heart Association (AHA) guidelines. The questionnaire assessed demographic characteristics, prior CPR training, knowledge (10 items), and willingness (attitude) of bystanders to perform CPR (12 items). Descriptive statistics were used to present the findings, while chi-square and McNemar tests were used to compare groups. Results: A total of 1,242 participants with a mean age of 27.38 ± 9.3 (range: 18-70) years, completed the survey (65.6% female). The mean knowledge score was 4.2 ± 2.3 (range: 0–10), with trained individuals scoring significantly higher than untrained participants (6.1 vs. 3.2, p<0.001). Trained participants exhibited greater willingness to perform CPR across all scenarios (p<0.001), whereas untrained individuals showed higher willingness to provide hands-only CPR, particularly for strangers and neighbors (p<0.01). Males were significantly more inclined to perform CPR across all scenarios (p<0.01), whereas females were more willing to provide hands-only CPR in certain scenarios (p<0.01). Nevertheless, most of the differences became statistically insignificant after restricting the analysis to respondents who witnessed a cardiac arrest event. Conclusion: Trained individuals showed higher levels of willingness, yet untrained participants demonstrated unexpected willingness to perform hands-only CPR, while female participants were consistently less willing to perform standard CPR. However, sensitivity analysis restricted to respondents who had witnessed a cardiac arrest showed that real-life exposure substantially reduces hesitation and narrows group disparities.