Knowledge and Attitude on Basic Life Support Among Childcare Providers From Registered Childcare Centres in Shah Alam, Selangor: A Questionnaire Study

Pengetahuan dan Sikap terhadap Sokongan Hidup Asas dalam Kalangan Pengasuh Kanak-Kanak di Pusat Jagaan Berdaftar di Shah Alam, Selangor: Satu Kajian Soal Selidik

Abstract

Background: Basic Life Support (BLS) is essential in emergencies, as it provides immediate care that can prevent fatalities, reduce the severity of medical conditions, and improve survival rates before professional help arrives. The increasing number of children in day care centres makes it clear that safety and emergency preparedness must be improved. While childcare providers are the first responders to emergencies such as airway obstruction or cardiac arrest, many childcare providers lack sufficient knowledge and skills in cardiopulmonary resuscitation (CPR). Although Malaysia has required first aid training for childcare providers since 2013 as part of the PERMATA Childcare Course (KAP), CPR certification is still not mandatory. Recent guidelines from the Ministry of Women, Family and Community Development now require the presence of at least one staff member certified in CPR to improve safety in childcare settings. Objectives: This study aims to measure the childcare providers’ BLS knowledge and attitudes using a questionnaire, identify knowledge gaps and areas where additional training or education in BLS may be needed, and explore factors that may influence childcare providers’ attitudes towards BLS training and its implementation in childcare settings. Methods: A cross-sectional survey was conducted to assess the knowledge and attitudes of BLS among childcare providers in childcare centres in Shah Alam.  210 participants took part in the study. A self-administered questionnaire, adapted from a previous study by Tamur et al. (2023), was used to collect data. Results: The study included 210 participants; 99.0% were female, and the largest group was 25–35 years old (44.8%). Most participants held a certificate/diploma (38.1%) or had completed secondary education (35.7%), which could influence their learning style and access to training. In addition, 78.6% of participants had already completed CPR training, indicating that childcare providers had a solid foundation of BLS training. The study revealed gaps in the participants' knowledge and skills in CPR. Only 32.4% of participants knew how deeply and quickly to compress the chest. While 66.7% knew the correct ratio of compression to breathing, only 17.6% recognised the correct compression rate. Previous CPR training had a significant impact on knowledge (p=0.02), yet 39.4% of those trained still had poor knowledge. Most participants (98.1%) felt that CPR training should be mandatory, and 93.8% were in favour of more training. Childcare providers’ reluctance to perform CPR is due to a lack of knowledge, fear of harm, and legal concerns. Although 78.6% of respondents have attended training courses, more than half do not know where they can attend courses. Conclusions: This study reveals significant gaps in the CPR knowledge and skills of childcare providers in registered childcare centres in Shah Alam despite a high percentage (78.6%) having attended prior training. Although many participants knew the basic principles of CPR, critical deficiencies were identified, particularly in the depth, rate and frequency of chest compressions. The findings indicate that prior CPR training has a positive effect on knowledge (p=0.02), but a significant proportion of those trained still showed poor understanding. Most participants (98.1%) recognised the importance of CPR training and were in favour of making it mandatory. 93.8% expressed a desire for further training. However, uncertainty about where to access CPR courses remains a challenge. These findings highlight the need for improved training programmes, easier access to courses and more vigorous enforcement of CPR course certification requirements for childcare providers to improve emergency preparedness and child safety in day care settings.