Challenges and Opportunities in Cardiopulmonary Resuscitation (CPR) Training and Implementation in Tibet: A Qualitative Study on Knowledge Gaps, Cultural Barriers, and Digital Solutions (Preprint)

BACKGROUND Background: Cardiopulmonary resuscitation is a key technology to save the lives of patients with cardiac arrest. In Tibet, due to its unique geographical environment, cultural customs, medical and health conditions, and underdeveloped economic conditions, the current application status of CPR technology may be significantly different from other regions, which may represent that the public in Tibet receives worse rescue medical services. OBJECTIVE Objective: This study aims to gain an in-depth understanding of the current status, existing problems and influencing factors of CPR technology application in Tibet through qualitative surveys, as well as the understanding and views of doctors, patients and the public on CPR technology, so as to provide a basis for improving the level of CPR technology and the success rate of treatment of patients with cardiac arrest in the region. METHODS Methods: Using the purposive sampling method, we interviewed 48 citizens in Tibet using a combination of online social media platform recruitment (Xiaohongshu, Weibo, BILIBILI, Baidu Tieba) and offline face-to-face interviews, using a semi-structured interview outline. The interview content focused on in-depth inquiries on the public's cognition of CPR technology, training experience or use or observation experience, actual application, and existing difficulties and suggestions. With the consent of the interviewees, we recorded and transcribed the interviews, and used content analysis to organize and analyze the data to extract themes and categories. RESULTS Results: The interviewees mainly came from urban areas in Tibet, such as Lhasa, Shigatse and Nyingchi, totaling 48 people, of which 24 were professional doctors or nurses and other medical personnel (including tertiary hospitals, secondary hospitals and community health service centers), and the remaining 24 were university professors, traffic police, administrative personnel, monks and other workers, of which there was 1 monk. There were only 8 users from rural towns and villages, and their sources were widely distributed in the north and south of the Tibetan area. The interviews found that the level of awareness of CPR technology among people in Tibet is generally low, and a considerable number of doctors interviewed have not received complete and systematic CPR training. Except for medical personnel, the proportion of other groups who have received professional CPR training is extremely small (almost not 0), and most of the interviewees from rural areas have very limited knowledge of CPR technology and even heart diseases. In addition, even in the actual application of CPR technology, there are many difficulties in Tibetan areas, such as insufficient medical equipment, inconvenient transportation affecting the timeliness of emergency treatment, and cultural concepts restricting the implementation of CPR. Based on the above situation, we put forward suggestions such as strengthening publicity and education, increasing training opportunities, and equipping more emergency equipment. CONCLUSIONS Conclusions: The current application status of CPR technology in Tibet is not optimistic. Citizens in Tibet have limited awareness of cardiac accidents and limited profound understanding of the significance of CPR technology. Doctors and other citizens in Tibet have limited access to good CPR technology education and training. We need to take targeted measures to improve the awareness and understanding of CPR technology among people in the region, and on this basis, improve the CPR technology level and emergency rescue capabilities of the public in the region.