한국학교보건학회지제 30 권제 3 호, 2017 년 12 월 J Korean Soc Sch Health Vol.30 No.3, 194-201, December 2017 p-issn 1225-9608 e-issn 2288-9957 https://doi.org/10.15434/kssh.2017.30.3.194 대학생의심폐소생술수행자신감에영향을미치는요인 김유정 이은미 호서대학교생명보건대학간호학과 기초과학연구소 Influencing Factors of Confidence in Performing Cardiopulmonary Resuscitation (CPR) among University Students Yu Jeong Kim Eun Mi Lee Department of Nursing Research Institute for Basic Sciences, Hoseo University ABSTRACT Purpose: The aim of the study was to identify factors influencing confidence in performing cardiopulmonary resuscitation (CPR) of university students. Methods: Data were collected from 261 students recruited from 2 cities using a questionnaire covering confidence, knowledge and attitude in regard to CPR. Results: There was a significant positive correlation between confidence and knowledge (r=.37, p<.001), between attitude and confidence (r=.61, p<.001), and between knowledge and attitude (r=.61, p<.001). Confidence in performance increased as knowledge, attitude, grade, CPR training frequency and educational satisfaction increased. Conclusion: There is a need for CPR training programs that can improve practical training and educational satisfaction of university students. Key Words: Cardiopulmonary resuscitation, Knowledge, Attitude, Confidence 서론 1. 연구의필요성 최근심폐소생술교육을받은경험이있는일반인들이성공적인심폐소생술을통해심정지환자를소생시킨신문기사나방송을접하는기회가많아지고있다. 인구고령화와서구화된식생활로인하여심혈관질환및급성심정지가증가하고있으며급성심정지는 2006년의인구 10만명당 37.5명에서 2015년 10만명당 44.2명으로꾸준히증가되었다 [1]. 따라서병원내에서뿐만아니라병원환경이아닌곳에서발생하는급성심정지도증가할수밖에없는상황이다. 그러나병원밖급성심정지라도즉각적이고적절한응급처치가있다면사망률을낮출수있다 [2]. 적절한심폐소생술 (CardioPulmonary Resuscitation, CPR) 은심정지환자의사망의진행을막을수있을뿐만아니라생존율을높일수있다. 2015년급성심장정지조사에따르면우리나라급성심정지환자의생존입원율은 17.3%, 생존퇴원율은 5.0% 이다 [1]. 우리나라의병원외심정지환자의생존율은 3.0% 로미국, 유럽, 일본등에비해아직은낮은수준이다 [3-6]. 따라서병원밖에서의심정지환자의생존율을높이기위해서는최초목격자의효율적이고적극적인초기대처가필요하다. 급성심정지가발생한현장에서즉각적으로시도되는목격자심폐소생술 (Bystander Cardiopulmonary Resuscitation, BCPR) 은효과적인교육을바탕으로수행의지가높아질때심폐소생술의시도가많아지며이는병원밖심정지환자의생존율을높인다 [7]. 이러한심폐소생술수행의지에영향을미치는요인들로는성별, 연령, 직업, 교육경험, 긍정적인태도, 자신감등이있으며이중가장중요한요인이 Corresponding author: Eun Mi Lee Department of Nursing, Hoseo University, 20 Hoseo-ro, 79 beon-gil, Asan 31499, Korea. Tel: +82-41-540-9531, Fax: +82-41-540-9558, E-mail: eunmilee@hoseo.edu Received: Aug 7, 2017 / Revised: Sep 24, 2017 / Accepted: Sep 25, 2017 This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 194 Journal of the Korean Society of School Health
대학생의심폐소생술수행자신감에영향을미치는요인 수행자신감이다 [8,9]. 따라서심폐소생술의수행자신감을높이는것은목격자심폐소생술의시도를높이는데중요한부분인데기존심폐소생술과관련한지식, 태도, 수행능력및자신감에관한연구들은기본심폐소생술을교육하고그효과를확인하는것에머문연구들이많았다 [10-16]. 그렇지않은경우는대상자가보건공무원 [17] 이나병원직원 [18], 선박승무원 [15], 보건교사 [13,19], 보육교사 [20] 등직업의특성상심폐소생술의숙지가필요한경우이거나학생은대부분초 중등학생 [9,11,12] 이었다. 2013년개정된학교보건법에따르면심폐소생술을포함한응급처치와관련된보건교육이강화되었으나초 중학생및교직원에한정되어있어대학생은대상에서제외되어있는상황이다 [21]. 또한기존대학생을대상으로하는연구의경우도대부분간호학과를비롯한보건계열대학생으로국한되어있는경우가많았다 [14,22,23]. 그러나일반인이행하게되는목격자심폐소생술의수행율을높이기위해서는보건계열학생뿐만아니라비보건계열대학생까지확장시켜교육하고자신감및심폐소생술수행의지를높이는것이필요하다. 따라서본연구는대학생을대상으로심폐소생술수행자신감에영향을미치는요인을파악하고이를교육프로그램개발을위한기초자료로활용하기위해시행되었다. 2. 연구목적본연구의목적은대학생의심폐소생술수행자신감과지식, 태도를확인하고수행자신감의영향요인을파악하고자하며, 구체적목적은다음과같다. 대상자의일반적특성에따른심폐소생술의수행자신감차이를확인한다. 대상자의심폐소생술관련특성에따른심폐소생술의수행자신감차이를확인한다. 대상자의심폐소생술의지식, 태도, 수행자신감정도와세변수간의상관관계를확인한다. 대상자의심폐소생술수행자신감에대한영향요인을파악한다. 연구방법 1. 연구설계 본연구는대학생들의심폐소생술에대한수행자신감의영향요인을파악하기위한서술적조사연구이다. 2. 연구대상및자료수집본연구의대상자는충남 A시와 C시에위치한대학교학생을대상으로하였으며, 자료수집은 2016년 11월 23일에서 12 월 7일까지실시하였다. 해당대학교 2학년재학생 2명을설문조사요원으로선정하여연구자가연구의목적과문항을설명하여교육한후설문조사요원이대상자에대한설문을수행하였다. 설문은채플수업또는일반교양수업후대상자의허락을받고시행되었으며, 다양한전공의대학생을대상으로하였다. 대상자에대한윤리적고려를위해대상자에게연구에강제로참여하지않아도되는점과설문내용은연구목적외에는다른목적으로사용되지않음을설명하였다. 설문조사시간은 1인당약 10~15분정도소요되었다. 표본의수는 G*Power 프로그램을이용하여산출하였다. 다중회귀분석을위해유의수준.05, 검정력.80, 효과크기는회귀분석의중간수준인.15, 독립변수의수를최대 10개정도로감안하여필요한표본수는 172명이었다. 탈락률을고려하여총 280명의대상자에게설문지를배부하였고, 272부가수집되었으나내용이미흡한 11부를제외하여최종분석대상자수는총 261명이었다. 대상자선정기준은다음과같다. 현재대학교에재학중인자 의사소통이가능하고본설문지의내용을이해하고답할수있는자 본연구목적을이해하고연구에참여하기로동의한자 3. 연구도구 1) 일반적특성및심폐소생술관련특성인구학적특성으로성별, 연령, 종교, 전공, 가족중심장질환자여부를포함하였다. 심폐소생술관련특성으로는심폐소생술실기교육경험여부, 실기교육회수, 교육만족도, 심폐소생술목격경험을포함하였다. 2) 심폐소생술수행자신감심폐소생술수행자신감은응급상황에서심폐소생술을얼마나효과적으로수행할수있는지에대한자신감을의미하며, Yang과 Kwon [20] 의심폐소생술에대한수행자신감측정도구 12문항을사용하였다. 질문지의각문항은 전혀자신이없다 (1점) 에서 매우그렇다 (5점) 까지의 5단계 Likert 척도이며, 점수가높을수록심폐소생술에대한수행자신감이높음을의미한다. 측정도구의신뢰도는 Yang과 Kwon [20] 의 Vol. 30 No. 3, 2017 195
김유정 이은미 연구에서는.89였고, 본연구에서는.96이었다. 3) 심폐소생술지식심폐소생술에대한지식은 Park [24] 이개발한 20개문항중심폐소생술수행과직접적관련이높은 10개문항을선택하여미국심장협회 (American Heart Association) 의 Basic life support 2015 가이드라인에따라수정 보완하여측정하였다. 수정된 10개문항은 Basic life support, Advanced cardiac life support instructor 자격이있으면서의료진대상심폐소생술실기교육을하고있는상급종합병원중환자실수간호사 3명과응급전문간호사 1인으로부터내용타당도를검증받았다. 각문항의정답은 1점, 오답은 0점이며, 점수가높을수록심폐소생술지식이높음을의미한다. Park [24] 의연구에서사용된본척도의신뢰도 Cronbach s 는.78이었으며, 본연구의 Cronbach s 는.70으로나타났다. 4) 심폐소생술태도심폐소생술에대한태도는 Park 등 [25] 이개발한 11문항을사용하였다. 질문지의각문항은 전혀그렇지않다 (1점) 에서 매우그렇다 (5점) 까지의 5단계 Likert 척도에따라응답하도록되어있으며, 총점의합이높을수록심폐소생술에대한대상자의태도가긍정적이며, 적극적임을의미한다. Park 등 [25] 의연구에서는도구의신뢰도가기술되지않았으며, 본도구를수정 보완한 Lee 등 [26] 의연구에서 Cronbach s 는.80 이었으며, 본연구의 Cronbach s 는.87로나타났다. 4. 자료분석수집된자료는 IBM SPSS/WIN 20.0 통계프로그램을사용하여분석하였다. 대상자의일반적특성과심폐소생술관련특성을빈도분석하고심폐소생술수행자신감, 지식, 태도의기술통계량을작성하여각각의분포를살펴보았다. 일반적특성및심폐소생술관련특성에따른심폐소생술수행자신감, 지식, 태도의차이는독립표본 t-test (independent two samples t-test), 일원배치분산분석 (oneway ANOVA) 로분석하였으며, 사후검정 (Scheffe test) 를시행하였다. 대상자의심폐소생술수행자신감, 지식, 태도의관계를 Pearson s correlation coefficient를통해알아보았다 넷째, 심폐소생술수행자신감에영향을미치는요인을확 인하기위해다중회귀분석 (multiple regression) 을시행하였다. 5. 윤리적고려본연구는대상자의윤리적보호를위해설문지에연구참여동의서를첨부하였다. 동의서에는연구의목적과내용, 연구참여의자율성및익명성보장, 설문지응답도중언제라도참여를중단할수있고, 참여중단으로인한불이익이없으며, 수집된자료는연구목적이외에사용하지않는점등을포함하고, 이를대상자에게설명하여연구의윤리적인측면을고려하였다. 연구결과 1. 대상자의일반적특성및심폐소생술관련특성 본연구에참여한대상자의특성은 Table 1과같다. 대상자의일반적특성으로성별은여학생이 146명 (55.9%), 남학생이 115명 (44.1%) 이었다. 학년은 2학년이 152명 (58.2%) 였으며, 전공계열은보건계열학과 ( 간호학과, 물리치료학과, 임상병리학과 ) 학생이 68명 (26.1%), 그외비보건계열학과학생이 193명 (73.9%) 이었다. 최근 5년이내입원경험은 209명 (80.1%) 이없었으며, 가족중심장질환자는없는경우가 232 명 (88.9%) 로나타났다. 대상자의심폐소생술관련특성으로심폐소생술실기교육을받은횟수는평균 2.69회였고, 교육을한번도받지못한경우가 32명 (12.3%) 이었다. 심폐소생술교육만족도는다소만족이 88명 (33.7%), 보통이 82명 (31.4%) 이었고 5점만점에평균 3.49점으로나타났다. 심폐소생술을목격한경험에대해 10 명 (3.8%) 이목격한적이있다고응답하였다. 2. 심폐소생술수행자신감, 지식과태도정도심폐소생술수행자신감, 지식및태도의정도는 Table 2와같다. 응답자들의심폐소생술수행자신감은 5점척도로평균 3.08점이었고, 심폐소생술관련지식은 10점만점중평균 5.63 점, 심폐소생술태도는 5점척도중평균 3.63점이었다. 3. 일반적특성심폐소생술관련특성에따른심폐소생술수행자신감, 지식과태도의차이 196 Journal of the Korean Society of School Health
대학생의심폐소생술수행자신감에영향을미치는요인 Table 1. General Characteristics and Cardiopulmonary Resuscitation related Characteristics (N=261) Variables Characteristics Categories n (%) or M±SD General characteristics Gender Male Female 115 (44.1) 146 (55.9) Grade 1 2 109 (41.8) 152 (58.2) Major Experience of admission Family history of heart disease Healthcare major Non-healthcare major None 1 No Yes 68 (26.1) 193 (73.9) 209 (80.1) 52 (19.9) 232 (88.9) 29 (11.1) CPR related characteristics Number of CPR practice education 0 1~2 3~4 5 32 (12.3) 101 (38.7) 88 (33.7) 40 (15.3) 2.69±2.15 CPR learning satisfaction Experience of CPR bystander Very dissatisfied Dissatisfied Moderate Satisfied Very satisfied No Yes 6 (2.3) 58 (22.2) 82 (31.4) 88 (33.7) 27 (10.3) 3.49±0.92 251 (96.2) 10 (3.8) Table 2. Descriptive Statistics of Performance Confidence, Knowledge, and Attitude about Cardiopulmonary Resuscitation (N=261) Variables M±SD Max Min Performance confidence of CPR 3.08±0.86 5.00 1.00 Knowledge of CPR 5.63±1.69 9.00 1.00 Attitude of CPR 3.63±0.62 5.00 1.45 일반적특성및심폐소생술관련특성에따른심폐소생술수행자신감, 지식및태도의차이는 Table 3과같다. 심폐소생술수행자신감은학년 (t=15.11, p<.001), 전공계열 (t=18.62, p<.001), 심폐소생술실기교육횟수 (F=6.63, p<.001) 와교육만족도 (F=17.87, p<.001) 에따라유의한차이가있었고, 그외변수는유의한차이가없는것으로나타났다. 심폐소생술관련지식은전공계열 (t=8.16, p=.005), 심폐소생술실기교육횟수 (F=4.83, p=.003) 와교육만족도 (F=3.28, p=.012) 에따라유의한차이가있었고, 그외변수는유의한차이가없는것으로나타났다. 심폐소생술태도는전공계열 (t=21.54, p<.001), 심장질환가족유무 (t=4.76, p=.030), 교육만족도 (F=14.15, p<.001) 에따라유의한차이가있었고, 그외변수는유의한차이가없는것으로나타났다. 4. 심폐소생술수행자신감, 지식과태도간의상관관계심폐소생술수행자신감, 지식과태도간의상관관계는 Table 4와같다. 심폐소생술수행자신감은심폐소생술지식과유의한양의상관관계가있었고 (r=.37, p<.001), 이는심폐소생술관련지식이많을수록수행자신감이높음을의미한다. 또한심폐소생술태도도심폐소생술수행자신감과유의한양의상관관계가있었으며 (r=.61, p<.001), 심폐소생술지식과 Vol. 30 No. 3, 2017 197
김유정 이은미 Table 3. Differences in Performance Confidence, Knowledge, and Attitude about Cardiopulmonary Resuscitation according to General Characteristics and Cardiopulmonary Resuscitation related Characteristics (N=261) Variables Categories Performance confidence of CPR M±SD t or F (p) Scheffe Knowledge of CPR M±SD t or F (p) Scheffe Attitude of CPR M±SD t or F (p) Scheffe General characteristics Gender Male Female 3.08±0.96 3.08±0.78 0.00 (.992) 5.48±1.68 5.74±1.70 1.60 (.207) 3.62±0.64 3.65±0.60 0.15 (.702) Grade 1 2 2.85±0.71 3.26±0.90 15.11 5.51±1.59 5.70±1.77 0.82 (.367) 3.56±0.56 3.69±0.65 2.59 (.109) Major Healthcare major Non-healthcare major 2.71±0.80 3.21±0.84 18.62 5.13±1.84 5.80±1.60 8.16 (.005) 3.35±0.56 3.74±0.60 21.54 Experience of admission None 1 3.08±0.87 3.11±0.85 0.05 (.818) 5.57±1.69 5.87±1.69 1.29 (.256) 3.64±0.62 3.60±0.62 0.21 (.650) Family history of heart disease No Yes 3.06±0.88 3.27±0.72 1.48 (.225) 5.59±1.74 5.93±1.22 1.06 (.305) 3.61±0.61 3.87±0.62 4.76 (.030) CPR related characteristics Number of CPR practice education 0 a 1~2 b 3~4 c 5 d 2.51±0.67 6.63 3.13±0.91 3.13±0.83 a<b, c, d 3.35±0.73 4.72±1.55 5.72±1.50 5.63±1.83 6.18±1.66 4.83 (.003) a<b, c, d 3.49±0.51 3.72±0.60 3.60±0.66 3.61±0.64 1.38 (.249) CPR learning satisfaction Very dissatisfied a Dissatisfied b Moderate c Satisfied d Very satisfied e 3.01±0.78 2.53±0.54 2.81±0.73 3.39±0.80 3.97±0.79 17.87 a, b, c <d<e 4.83±1.47 5.62±1.69 5.40±1.70 5.93±1.66 6.56±1.45 3.28 (.012) a, b, c, d<e 3.59±0.80 3.60±0.54 3.33±0.54 3.78±0.58 4.20±0.55 14.15 a, b, c, d<e Experience of CPR bystander No Yes 3.09±0.88 2.96±0.58 0.22 (.643) 5.40±1.58 5.64±1.70 0.20 (.655) 3.68±0.63 3.64±0.62 0.05 (.829) Table 4. Correlations between Performance Confidence, Knowledge, and Attitude about Cardiopulmonary Resuscitation (N=261) Variables Performance confidence of CPR Knowledge of CPR Knowledge of CPR r(p) Attitude of CPR r(p).366.607.250 태도사이에도유의한양의상관관계가있는것으로나타났다 (r=.25, p<.001). 분석을시행하였다. 앞서분석한분산분석결과, 심폐소생술수행자신감은학년, 전공, 심폐소생술실기교육횟수, 교육만족도에영향을받으므로설명변수에추가하였다. 심폐소생술관련지식, 태도만을설명변수로사용한모형 (model 1) 에서는심폐소생술관련지식과태도가증가하면심폐소생술수행자신감이증가하는것으로분석되었고, 모형의설명력은 41% 였다. 학년, 전공, 심폐소생술실기교육횟수, 교육만족도를설명변수에추가한모형 (model 2) 에서는심폐소생술관련지식과태도, 학년, 심폐소생술실기교육횟수, 교육만족도가높을수록심폐소생술수행자신감이증가하며, 전공계열은유의한영향이나타나지않았다 (Table 5). 5. 심폐소생술수행자신감의영향요인 논 의 심폐소생술수행자신감에영향을미치는요인을알아보기위하여설명변수로심폐소생술관련지식, 태도, 학년, 전공, 심폐소생술실기교육횟수, 교육만족도를사용하여다중회귀 본연구는대학생을대상으로심폐소생술의수행자신감에영향을미치는요인을파악함으로서목격자심폐소생술시도를높이는데중요한심폐소생술수행자신감을높이는교육프 198 Journal of the Korean Society of School Health
대학생의심폐소생술수행자신감에영향을미치는요인 Table 5. Influences of Performance Confidence effected Knowledge, Attitude about Cardiopulmonary Resuscitation Performance confidence of CPR Response variables Model 1 Model 2 β t(p) β t(p) Knowledge of CPR.23 4.67.13 2.72 (.007) Attitude of CPR.55 11.22.54 10.78 Grade.16 3.24 (.001) Major -.04-0.76 (.451) Number of CPR practice education.15 3.02 (.003) CPR learning satisfaction.18 3.45 (.001) Adjusted R 2 =.41, F=92.6, p<.001 Adjusted R 2 =.54, F=42.71, p<.001 로그램개발의기초자료로활용하고자수행되었다. 연구결과에의하면심폐소생술수행자신감은학년이높고비보건계열이며교육횟수가많고교육만족도가높을때더높았다. 수행자신감은학년이높은경우에더높았는데이는초 중 고등학생을대상으로한연구에서는학년이올라갈수록심폐소생술수행의도가높아진다는결과가있었고성인을대상으로는연령이낮아질수록수행의도가높아진다는상반된연구결과들이있어정확한파악을위해서는대학생을대상으로하는추가적인연구가필요하다 [8,9]. 비보건계열이수행자신감이더높은것은보건계열이더높았다는기존연구결과와달라보건계열과비보건계열학생을비교하는연구를통한확인이필요하다 [27]. 또한교육횟수가증가할수록심폐소생술수행자신감이높아지는것은기존의연구결과들과같았으며이는대학생을대상으로하는일회성교육보다는주기적이고반복적인교육이필요함을의미한다 [16,19]. 특히, 교육후경과기간에따라지식의차이가있고재교육시기가 3~6개월정도만벌어져도수행자신감이저하된다는연구결과들이있어기존 2~3년간격의심폐소생술교육프로그램을제고할필요가있으며학교보건법에의해초 중등학교시기에심폐소생술교육을받았다고하더라도이것이고등학교및대학교까지주기적, 반복적교육으로이어지는것이중요할것이다 [14,15,17]. 심폐소생술지식은보건계열보다는비보건계열학생이더높았는데이는 1, 2학년및임상실습을나가기전간호대학생의심폐소생술지식과태도가낮음을보여준연구가뒷받침한다 [22]. 따라서대학교 1, 2학년을대상으로하는심폐소생술교육의경우보건계열과비보건계열학생의구분을둘필요는없을것으로생각된다. 심폐소생술교육횟수의증가는심폐소생술지식을높이고이는수행자신감과이어지며심폐소생술 교육만족도가높을때지식이더높아지는것으로나타났다. 이는교육만족도와지식간의관계를살펴본선행연구와도같으며그중에서도이론교육보다는반복된실습교육에대한만족도가높으며실습교육은심폐소생술에대한두려움을낮춰실제상황에서의수행을높인다는연구들이있다 [16,18,20]. 심폐소생술태도는심장질환가족이있는경우에긍정적이었는데이는심폐소생술지식이태도에양의상관관계가있다는연구결과에연결하여생각하였을때가족의질환으로인한교육노출기회및교육경험은심폐소생술수행능력정도가높아진다는기존의연구결과와그의미가같다고생각된다 [18]. 따라서심장질환자의경우가족을대상으로하는심폐소생술교육프로그램을계획하여시행할때병원밖에서의환자뿐만아니라일반인심폐소생술수행을높이는일석이조의효과가있을것이라고생각된다. 결론적으로심폐소생술수행자신감은심폐소생술지식이많고태도가긍정적일수록높아지고그중에서도태도와수행자신감간의상관관계가더높게나타났으며이는선행연구결과와도일치한다 [17,19,28]. 또한교육횟수가많고교육만족도가높을수록심폐소생술수행자신감이높아져주기적인심폐소생술교육을하되교육만족도를높이기위한다양한프로그램이개발되어야할것이다. 그러나주기적이고반복적인교육을통한수행자신감의상승을위해서필요한재교육의기간에대한연구결과가다양하여재교육시기와관련한추가적인연구가필요하다고생각된다. 또한심폐소생술협회나소방서와같은전문교육기관을통해교육받은경우가학교에서교육받은경우보다교육만족도가높다는선행연구결과를바탕으로전문성있는교육프로그램을개발하고학교와전문교육기관간의연계가활발히이루어져야할것이다 [17,27]. Vol. 30 No. 3, 2017 199
김유정 이은미 본연구의제한점은일개지역의한대학에재학중인학생들을대상으로하여대학생전체로일반화하기에는어려움이있고전공은다양하였으나 1~2학년학생으로만치우쳐다양한연령의학생들의연구결과를살펴보는데한계가있다. 결론 본연구는대학생들의심폐소생술에대한수행자신감의영향요인을파악하여심폐소생술수행을높이는교육프로그램개발에필요한기초자료를제공하고자수행되었다. 심폐소생술수행자신감, 지식과태도는양의상관관계가있어지식이많고태도가긍정적일수록심폐소생술자신감은높아진다. 심폐소생술수행자신감에영향을미치는요인으로는지식, 태도, 학년, 심폐소생술실기교육횟수, 교육만족도가있었으며이러한요인들이높아질수록수행자신감이증가하는것으로파악되었다. 따라서본연구결과를통해확인된변인들을고려한교육프로그램개발을통해목격자심폐소생술의수행을높이는것이필요하다. 이해관계 The authors declared no conflict of interest. REFERENCES 1. 2015 Sudden Cardiac Death Research. Cheongju: Korea Centers for Disease Control and Prevention; 2016. 2. Cave DM, Aufderheide TP, Beeson J, Ellison A, Gregory A, Hazinski MF, et al. Importance and implementation of training in cardiopulmonary resuscitation and automated external defibrillation in schools: A science advisory from the American Heart Association. Circulation. 2011;123(6):691-706. https://doi.org/10.1542/peds.2011-1258 3. 2015 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (for professional). Cheongju: Korea Centers for Disease Control and Prevention; 2016. 4. Tibballs J, Kinney S. Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of a pediatric medical emergency team. Pediatric Critical Care Medicine. 2009; 10(3):306-318. https://doi.org/10.1097/pcc.0b013e318198b02c 5. Brown LH, Manring EA, Kornegay HB, Prasad NH. Can prehospital personnel detect hypoxemia without the aid of pulse oximeters?. American Journal Of Emergency Medicine. 1996;14 (1):43-44. https://doi.org/10.1016/s0735-6757(96)90012-1 6. Cristofani C. Out-of-hospital endotracheal intubation of children. The Journal of the American Medical Association. 2000;283 (21):2790-2792. https://doi.org/10.1001/jama.283.21.2790 7. Ritter G, Wolfe RA, Goldstein S, Landis JR, Vasu CM, Acheson A, et al. The effect of bystander CPR on survival of out-of-hospital cardiac arrest victims. American Heart Journal. 1985;110 (5):932-937. https://doi.org/10.1016/0002-8703(85)90187-5 8. Kang KH, Yim J. A population health characteristic analysis of willingness to perform cardiopulmonary resuscitation. Journal of Korean Society for Health Education and Promotion. 2008; 25(4):43-54. 9. Sohn HS, Kim YH. Factors influencing willingness to perform bystander cpr among elementary, middle and high school students. Korean Review of Crisis & Emergency Management. 2015;11(11):247-259. https://doi.org/10.14251/krcem.2015.11.11.247 10. Yoon MO. The effects of basic life support education on CPR knowledge and attitude of undergraduates. Journal of Korean Society of School Health. 2011;24(1):1-11. 11. Kang HE, Kim HS, Kim YS. A study of the effectiveness of basic CPR (cardiopulmonary resuscitation) education of primary school children. Journal of Korean Society of School Health. 2011;24(1):118-128. 12. Ahn MJ, Kim YI. Comparison of educational effects on hands-only cardiopulmonary resuscitation (CPR) with basic cardiopulmonary resuscitation (CPR) by elementary school students. Journal of Korean Society of School Health. 2014;27(3):130-139. https://doi.org/10.15434/kssh.2014.27.3.130 13. Jun HS, Sohn HS. Effect of cardiopulmonary resuscitation (CPR) education performed by health teachers on middle school students. Journal of Digital Convergence. 2015;13(10):385-395. https://doi.org/10.14400/jdc.2015.13.10.385 14. Hong JS, Ahn R, Kim SH, Kim WY, Kim SO, Hong ES. Retention of CPR skills by nursing students received training in AHA BLS course for healthcare providers. Journal of the Korean Society of Emergency Medicine. 2009;20(6):609-614. 15. Kim JH. The effects and continuum of CPR education program on cpr knowledge, attitude and performance in seafarers. Studies on Education of Fisheries and Marine Sciences. 2016;28(5): 1301-1307. https://doi.org/10.13000/jfmse.2016.28.5.1301 16. Kim SM, Jeong SH. The effect of cpr practice education of personal assistants for the disabled. The Journal of Korean Academic Society of Nursing Education. 2017;23(1):86-94. https://doi.org/10.5977/jkasne.2017.23.1.86 17. Hwang SH. Knowledge, attitude, confidence, and experiences of community health practitioner regarding cardiopulmonary resuscitation. The Korean Journal of Emergency Medical Service. 2014;18(1):55-66. https://doi.org/10.14408/kjems.2014.18.1.055 18. Lee JH, Sung MH. Factors influencing performance ability of cpr of hospital staffs. Journal of East-West Nursing Research. 2013;19(2):96-103. https://doi.org/10.14370/jewnr.2013.19.2.96 200 Journal of the Korean Society of School Health
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