Psychological barriers to bystander AED use: Associations of empathy with willingness to perform bystander rescue behaviors.

BACKGROUND

Despite public access to automated external defibrillators (AEDs), bystander use remains limited. The psychological factors influencing rescue behaviors are not well understood.

OBJECTIVE

To examine how three empathy dimensions (empathic concern, perspective-taking, and personal distress) are associated with willingness to intervene in bystander rescue behaviors.

METHODS

A cross-sectional survey of laypersons from Japan recruited using a nationwide online research panel operated by a commercial company was conducted using hypothetical train-station cardiac arrest scenarios. Participants rated their willingness to perform three rescue behaviors-running up to the victim or calling for help, retrieving an AED, and using an AED-on a 5-point Likert scale, with high willingness indicated by scores of 4-5. Univariable and multivariable logistic regression analyses were performed to examine associations between empathy dimensions and willingness to intervene.

RESULTS

Overall, 1050 participants were included. High willingness was most frequent for running up to the victim or calling for help (72.6%), followed by retrieving an AED (40.6%), and using an AED (25.7%). Higher empathic concern was associated with greater willingness across all three rescue behaviors. Similar patterns were observed in univariable analyses and after multivariable adjustment. Perspective-taking was positively associated mainly with AED-related behaviors, whereas personal distress was inversely associated with willingness to retrieve and use an AED.

CONCLUSIONS

Distinct empathy dimensions may play different roles depending on the type of rescue behavior. Empathic concern and perspective-taking may facilitate AED-related actions, whereas personal distress may represent a psychological barrier. Interventions targeting emotion regulation and perspective-taking may help improve bystander AED use.