First aid in mountainous areas is the key and difficult point in the construction of the basic emergency rescue network in China. As the main resident population in mountainous areas, the elderly in mountainous rural areas have a high mortality and disability rate of cardiovascular and cerebrovascular emergencies and understanding the real experience of this group when witnessing acute cardiovascular and cerebrovascular diseases is an important supplement to the relevant research on mountain first aid literacy.

To analyze the real experience of elderly people in rural areas under the witness situation of acute cardiovascular and cerebrovascular events to deeply understand the first-aid literacy level of elderly people in rural areas and to provide practical reference for the management of cardiovascular and cerebrovascular diseases in mountainous areas for grass-roots public health service personnel.

From January to February 2024, purpose sampling was used to select rural elderly people in Zunyi Mountain area of Guizhou Province as the research objects for face-to-face and semi-structured in-depth interviews. The directed content analysis method was used to analyze the data based on the knowledge-attitude-practice (KAP) theory.

Three themes and eight sub-themes were summarized: (1) Personal first aid knowledge and skills: serious lack of first aid knowledge, weak ability of information screening, information support needs exist. (2) Beliefs and attitudes towards rescue in emergency situations: negative response to life first aid, lack of confidence in the role of rescue, more rescue concerns. (3) Specific behavior in emergent situations: poor response to illness, wrong rescue behavior.

The problems of low first aid literacy, poor treatment level, and insufficient rescue initiative among elderly people in mountainous rural areas who witness acute cardiovascular and cerebrovascular events have become prominent. Grassroots health service organizations should focus on improving the relevant work of this group's ability to treat acute cardiovascular and cerebrovascular diseases.

山区急救是我国基层紧急救援网络建设中的难点，山区农村老年人作为山区主要常住人口，心脑血管急症死亡率、致残率均处于高水平，了解该群体在心脑血管事件目击情境下真实体验是对山区急救素养研究的重要补充。

剖析山区农村老年人在急性心脑血管事件目击情境下的真实体验，重点深入了解山区农村老年人急救素养水平，为基层公共卫生服务人员山区心脑血管疾病管理工作提供现实参考。

采用目的抽样法，2024年1—2月选取在贵州省遵义山区的农村老年人为研究对象进行面对面、半结构式深入访谈，使用定向内容分析法，以知信行（KAP）理论为框架进行资料分析。

共凝练出3个主题8个亚主题：（1）个体急救知识与技能：急救知识严重匮乏、信息甄别能力弱、信息支持需求存在。（2）紧急情况下施救信念与态度：对生命急救消极应对、对施救作用缺乏信心、施救顾虑较多。（3）突发情境中具体行为：病情反应力差、施救行为问题凸显。

山区农村老年人在心脑血管急性事件目击情境中急救素养低、救治水平差、施救主动性不足等问题凸显，基层卫生服务组织应当注重提升该群体急性心脑血管疾病救治能力的相关工作。