Public perceptions and experiences of myocardial infarction, cardiac arrest and CPR in London.

INTRODUCTION: The lay public have limited knowledge of the symptoms of myocardial infarction ("heart attack"), and inaccurate perceptions of cardiac arrest survival rates. Levels of CPR training and willingness to intervene in cardiac emergencies are also low. AIMS: To explore public perceptions of myocardial infarction and cardiac arrest; investigate perceptions of cardiac arrest survival rates; assess levels of training and attitudes towards CPR, and explore the types of interventions considered useful for increasing rates of bystander CPR among Greater London residents. METHODS: A quantitative interview survey was conducted with 1011 Greater London residents. Eight focus groups were also conducted to explore a range of issues in greater depth and validate trends that emerged in the initial survey. RESULTS: Chest pain was the most commonly recognised symptom of "heart attack". Around half of the respondents were aware that a myocardial infarction differs from a cardiac arrest, although their ability to explain this difference was limited. The majority overestimated that at least a quarter of cardiac arrest patients in London survive to hospital discharge. Few participants had received CPR training, and most were hesitant about performing the procedure on a stranger. CONCLUSIONS: Awareness and knowledge of CPR, and reactions to cardiac emergencies, reflect relatively low levels of CPR training in London. Publicising cardiac arrest survival figures may be instrumental in prompting members of the public to train in CPR and motivating those who have been trained to intervene in a cardiac emergency.

Intention to breastfeed and other important health-related behaviour and beliefs during pregnancy.

BACKGROUND: It is widely accepted that breastfeeding is the best form of infant feeding for the first 4-6 months of life. OBJECTIVE: This study explored whether intention to breastfeed is associated with other positive maternal health-related behaviours and beliefs during pregnancy. METHOD: A cross-sectional survey was carried out with 789 women attending antenatal clinics at Leicester Royal Infirmary NHS Trust. A structured questionnaire assessed feeding intention, use of folic acid, vitamin and iron supplementation, smoking status, smoking stage of change, and fetal health locus of control during pregnancy. RESULTS: Forty percent of the women stated that they intended to breastfeed exclusively, 27% planned to bottle feed, 23% intended to combine breast and bottle feeding and 10% were undecided. Women planning to breastfeed (either exclusively or in combination with bottle feeding) were more likely than those with alternative feeding plans to: have increased their folic acid intake, taken vitamin/iron supplements and have a primarily internal locus of control (perceive themselves to have control over the health of their unborn baby). Women intending to breastfeed were also less likely to smoke. Of the women who did smoke, those planning to breastfeed were more likely to be either considering or preparing to quit smoking during their pregnancy. CONCLUSION: In addition to educating pregnant smokers about the risks of maternal smoking, primary health care practitioners could also usefully address their knowledge, health beliefs and feeding intentions during antenatal care.