Abstract / Summary
Cardiopulmonary resuscitation (CPR) is life‑saving, yet its effectiveness is often compromised by challenges beyond clinical guidelines. In Iran, survival rates following cardiac arrest remain low, underscoring the need to identify barriers to effective resuscitation. This study explored the contextual and perceptual challenges affecting CPR effectiveness, as perceived by resuscitation team members in emergency departments of selected educational‑therapeutic centers in Kermanshah. This qualitative study utilized conventional content analysis from early February to early June 2026. Twenty‑one resuscitation team members, including supervisors (team coordination), anesthesiologist nurses (airway management), and clinical nurses (chest compressions, medication, monitoring, and defibrillation), were selected via purposive sampling based on at least two years of experience, active team membership, and participation in five or more CPR operations in the prior three months. Data were collected through semi‑structured interviews, analyzed using Graneheim and Lundman’s approach with MAXQDA software, and reported following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. A conceptual model, ‘Multilevel Contextual–Perceptual Factors in CPR Compromise’, was developed, comprising four interrelated categories. Physical and Environmental Threats form the outermost layer, triggering Cognitive and Motivational Barriers. These barriers interact with Psychological and Ethical Stressors at the team level, while Socio‑Cognitive Challenges extend these barriers beyond the hospital. This nested structure illustrates how environmental, cognitive, psychological, and sociocultural factors interact across multiple levels to collectively compromise CPR performance. This study’s specific contribution lies in revealing how environmental, cognitive, psychological, and socio‑cultural factors interact across multiple levels to compromise CPR performance, rather than merely cataloging barriers. These findings suggest that targeted interventions in scene safety, psychological support, legal clarity, and public education may help improve resuscitation outcomes. Not applicable