The Establishment And Implementation Of A Community Self-aid And Mutual Aid System

ObjectivesThis study is designed to evaluate a training the trainer program and establishment of a community self-aid and mutual aid system.Methods(1) Phase I:Prevalence survey1) The epidemiological data of the patients treated by Ningbo120Emergency Center in2010was collected and analyzed in this phase. The main purpose is to investigate the status of pre-hospital emergency care in Ningbo city, including the type of acute diseases or accidental injury, the time of ambulance arrival, the rescue of the first responder, the survival rate and so on.2) A questionnaire designed was applied on a1,000sample from the residents of Ningbo City to understand their first aid knowledge, attitude, practice (KAP), as well as source and demand of first-aid knowledge.(2)Phase II:Quasi-experimental studies1) Two communities were selected separately as the experimental group and control group.For the experimental group, a project of training the trainers was conducted for121trainees. After passing the training, the trainees became the trainers and delivered the first-aid training for823residents. The Community Self-aid and Mutual Aid System was established after the training.The control group was not intervened.2) The residents of the experimental group were distributed the first aid KAP questionnaire before and after the training. The same amount of the questionnaires was distributed during the same period to the residents of the control group.Six month after the establishment of the Community Self-aid and Mutual Aid System, the pre-hospital emergency data of the four communities in this period was collected from the database of Ningbo120Emergency Center.Results(1) The status of pre-hospital emergency care in Ningbo City1)The epidemiological data of Ningbo120Emergency Center in2010①The average time of ambulance arrival was10.41±6.62min. The morbidity of men was higher than women in each age group. The ratio of futile visits is15.84%. ②The top three causes of emergency call and death were trauma, neuron-system disease, and cardio-vascular system disease.③94.26%of the incidence of sudden death was at home. The reaction time of first responder (the time from witnessing the accident to call120) was12.87±15.72min in average. The rate of the first responder performed CPR was1.67%.2) The results of the first aid KAP questionnaire of residents in Ningbo City①The average score of the first aid knowledge was9.29±2.19(total score is15); the average score of the attitude was19.67±1.61(total score is25); the average score of the practice was17.17±3.94(total score is35).②The main ways to acquire first aid knowledge were television/radio; only17.49%of the respondents get first aid knowledge through first-aid training. The reason for never participating in first-aid training was "do not know where to train".③78.26%of the respondents were willing to participate in the first aid training which was organized by the community. A majority of the respondents wanted to be trained in the form of lectures and practice and during the weekend.(2) The establishment of the Community Self-aid and Mutual Aid System1) The evaluation of carrying out first aid training①The evaluation of training the trainersa.The first aid KAP scores of the trainees after the training were higher than that before the training (P<0.01).b.Examinations, including the first aid theory test, CPR examination, trauma care examination and teaching skills examination, were performed for the trainees, and the average scores were:86.77±4.06;84.18±3.55;83.72±3.34;81.89±3.81.②The evaluation of the first aid training delivered by the trainersa.Before training, the experimental and control group had no significant difference (P>0.05) in general information and the scores of first aid KAP.b.In the experimental group, the scores of first aid KAP after the training were higher than that before the training (P<0.05).c. After training, the scores of first aid KAP in the experimental group were higher than the control group (P<0.01).d. In the control group, the score of first aid knowledge after training is higher than that before the training (0.01<P<0.05). In first aid attitude and practice, there were no significant difference (P>0.05) between before and after training. 2) The evaluation of the Community Self-aid and Mutual Aid System①The rate of residents’awareness of the Community Self-aid and Mutual Aid System was between40%to70%after the system was established for two, four and six months.②Six months after the establishment of the Community Self-aid and Mutual Aid System, the first responder’ reaction time of the experimental group was shorter than that of the control group.③The number of pre-hospital emergency futile visits in the experimental group was0while the control group was3(7.69%).④There was no significant difference (P>0.05) between the experimental group and the control group in the calling120staff, the self-aid and mutual aid implementation, the disease spectrum and so on.Conclusion(1) The status of pre-hospital emergency care in Ningbo City1) The average time of ambulance arrival is long and the ratio of futile visits is high.2) The top three causes of emergency call and death were trauma, neuron-system disease and cardio-vascular system disease.3) The ambulance arrival time and reaction time in sudden death cases are longer than the Emergency golden time. Sudden death occurs mostly at home. The rate of first responder performed CPR is low.4) The scores of the respondents’first aid KAP are low.5) Most of respondents were willing to participation in the first aid training organized by the community.(2) The establishment of the Community Self-aid and Mutual Aid System1) Training the trainers can effectively improve the trainees’first aid KAP and training skill.2) The first aid training delivered by trainers can improve the first aid KAP of the residents.3) The establishment of the Community Self-aid and Mutual Aid System can have some help in improving residents’ first aid behavior.