Knowledge and attitudes toward cardiopulmonary resuscitation on women in Arab countries: An international cross-sectional survey study

To assess the knowledge and attitudes of individuals in Arab countries toward performing cardiopulmonary resuscitation (CPR) on women and to explore sex-based differences. Also, to identify potential factors that may hinder or improve CPR rates. This cross-sectional study used a questionnaire specifically designed to address the study objectives. The participants were adults aged ≥18 years and residing in an Arab country. Descriptive statistics were used and sex-based differences were examined. In total, 558 participants were included. The mean age was 31.7 years (Standard deviation (SD): 12.3), 63.4% were female, and 75.8% were healthcare workers. The mean total knowledge score for the participants was 3.9/5.0 (SD: 1.1) and there were generally positive attitudes (mean score: 4.6/5, SD: 0.52) toward providing CPR on women. Female sex of participants was independently associated with significantly higher knowledge scores (β = -0.29, p = 0.001). Attitudes did not significantly differ by sex. Three major barriers were identified to perform CPR on women: fear of legal accountability, not practising on clearly female manikins during CPR training, and fear of being blamed by the injured person’s relatives. Participants suggested that having specific CPR training and using female manikins, community awareness, and legal protection may serve as potential motivators to increase the provision of CPR on women. Although attitudes toward CPR on women were favourable across sex among Arab survey participants, significant knowledge disparities remain. Sex-sensitive, culturally adapted CPR training programs and legal policy efforts would be essential to address identified barriers and improve equitable response for women in cardiac arrest to improve survival rates.