Knowledge, Awareness, Attitude and Practice of Secondary School Students Toward Cardiopulmonary Resuscitation (CPR): An Intervention Study

Authors

  • Mohd. Said Nurumal Department of Critical Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
  • Thandar Soe @ Sumaiyah Jamaludin Department of Medical Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
  • Ema Waliyanti Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
  • Kyu Kyu Win Faculty of Medicine and Health Sciences, UCSI University, Negeri Sembilan, Malaysia
  • Henri Setiawan Department of Nursing, STIKes Muhammadiyah Ciamis, Jawa Barat, Indonesia

DOI:

https://doi.org/10.31436/ijcs.v9i2.559

Keywords:

Cardiopulmonary resuscitation, Drowning, Secondary school students, Knowledge, Attitude, Practice, CPR education

Abstract

Background: Cardiopulmonary resuscitation (CPR) is an essential life-saving skill for emergencies such as drowning and asphyxia among school-aged children. Early CPR education may improve students’ readiness to respond during emergencies. This study evaluated the knowledge, awareness, attitudes, and practices (KAAP) of secondary school students towards CPR before and after a structured training intervention.

Methods: A pre- and post-intervention study was conducted among 121 students at Maktab Rendah Sains MARA (MRSM) Kuantan, Pahang, Malaysia. Data were collected using a self-administered questionnaire on CPR knowledge, awareness, attitudes, practices, and barriers. Students participated in theoretical and supervised hands-on CPR training. Descriptive statistics were used to compare outcomes before and after the intervention.

Results: Before training, students showed moderate CPR knowledge but limited practical skills. After the intervention, practice scores improved from 42.3% to 68.3%, while awareness scores increased from 42.3% to 49%. Although students demonstrated positive attitudes towards CPR, fear of harming the victim and low confidence remained major barriers.

Conclusion: Structured CPR training improves knowledge, awareness, and practical skills among secondary school students. Regular hands-on training and refresher sessions are recommended to enhance confidence and emergency preparedness.

References

Böttiger BW, Lockey A, Georgiou M, et al. Kids save lives: educating schoolchildren in cardiopulmonary resuscitation worldwide. European Journal of Anaesthesiology. 2020;37(4):302-308. https://doi.org/10.1097/EJA.0000000000001146.

Piva? S, Gradišek P, Skela-Savi? B. The impact of cardiopulmonary resuscitation (CPR) training on schoolchildren and their CPR knowledge, attitudes toward CPR, and willingness to help others and to perform CPR: a mixed-methods research design. BMC Public Health. 2020;20:915. https://doi.org/10.1186/s12889-020-09072-y.

Perkins GD, Graesner JT, Semeraro F, et al. European Resuscitation Council guidelines 2021: executive summary. Resuscitation. 2021;161:1-60. https://doi.org/10.1016/j.resuscitation.2021.02.003.

Topjian AA, Raymond TT, Atkins D, et al. Part 4: pediatric basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16 Suppl 2):S469-S523. https://doi.org/10.1161/CIR.0000000000000901.

Nurumal MS, Jamaludin TSS, Shamsudin LA, Ramli MZ. Attitudes and barriers of primary school children on cardiopulmonary resuscitation for drowning victims. Jurnal Pendidikan Keperawatan Indonesia. 2021;7(2):104-111. https://doi.org/10.17509/jpki.v7i2.39994.

Jamaludin TSS, Nurumal MS, Hasan MKC, Firdaus MKZH, Rahman NHA. Knowledge and practice of cardiopulmonary resuscitation (CPR) for drowning victims among primary school children. International Journal of Care Scholars. 2022;5(2):35-45. https://doi.org/10.31436/ijcs.v5i2.246.

Fariduddin MN, Siau CS. Readiness to teach and perform CPR: a survey amongst secondary school teachers in Malaysia. Journal of Public Health and Development. 2022;20(1):267-276.

World Health Organization. Drowning. Published 2024. Accessed May 8, 2026. World Health Organization

Zinckernagel L, Malta Hansen C, Rod MH, et al. A qualitative study of barriers and facilitators for willingness to perform cardiopulmonary resuscitation among schoolchildren. BMJ Open. 2022;12(3):e057593. https://doi.org/10.1136/bmjopen-2021-057593.

Zenani NE, Bello B, Molekodi M. Effectiveness of school-based cardiopulmonary resuscitation training among adolescents: a systematic review. Curationis. 2022;45(1):e1-e10. https://doi.org/10.4102/curationis.v45i1.2325

Onbasilar U, von Groote T, Brülle R, Sadjadi M. Skill retention after school-based CPR training: a systematic review and meta-analysis. BMC Public Health. 2025;25:3798. https://doi.org/10.1186/s12889-025-25024-w.

Smith AJ, Jones DR, Lee C. Attitudes and willingness toward out-of-hospital CPR and AED usage among middle school students. Heliyon. 2024;9(4):e15430. https://doi.org/10.1016/j.heliyon.2023.e1543.

Tung Y, Chen H, Wu J. Awareness, practices, and factors of pediatric cardiopulmonary resuscitation knowledge in community settings. Medicine. 2025;104:e15240.

Kose S, et al. The effect of cardiopulmonary resuscitation education on CPR self-efficacy, knowledge, and confidence among schoolchildren. Healthcare. 2022;11(14):2047. https://doi.org/10.3390/healthcare11142047.

Zhang Y, Zhou J, Hua X. Knowledge, training, and willingness to perform bystander CPR among university students in Chongqing, China: a cross-sectional study. BMC Public Health. 2021; 21:1128.

Hamednia M, Yaghoobzadeh A, Moradzadeh R, Sayahi S. Evaluation of the effectiveness of basic cardiopulmonary resuscitation training on willingness to perform CPR among high school students. BMC Cardiovascular Disorders. 2025;25(1). https://doi.org/10.1186/s12872-025-04783-9.

Abraham SV, Krishnan SV, George T, et al. Baseline knowledge and change in confidence after learning first aid from emergency physicians: a pre-post interventional study of 2462 high school Junior Red Cross cadets. Indian Journal of Public Health. 2025;69(2):153-158. https://doi.org/10.4103/ijph.ijph_1458_22.

Sakamoto M, Ogawa T, Hasumi J. Evaluation of confidence and knowledge regarding chest compression training among children at a health promotion event. Cureus. 2024;16(9):e68412. https://doi.org/10.7759/cureus.68412

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Published

2026-06-01

How to Cite

Nurumal, M. S., Thandar Soe @ Sumaiyah Jamaludin, Ema Waliyanti, Kyu Kyu Win, & Henri Setiawan. (2026). Knowledge, Awareness, Attitude and Practice of Secondary School Students Toward Cardiopulmonary Resuscitation (CPR): An Intervention Study. INTERNATIONAL JOURNAL OF CARE SCHOLARS, 9(2), 40–50. https://doi.org/10.31436/ijcs.v9i2.559

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