Nurses' attitudes and knowledge regarding organ and tissue donation and transplantation in a provincial hospital: A descriptive and multivariate analysis

Do ethical views of end-of-life patients' family members impact organ donation decisions?

Background: The relatives of patients who decide to donate their loved one's organs experience dilemmas about organ donation and are affected by culture, religion, and individual views.Aim: The aim of this study was to determine the relationship between the ethical position and personal characteristics of the family members of the patients receiving end-of-life care and their thoughts about organ donation in Turkey.Research design and participants: The study was completed with 158 family members. For data collection, a personal information form and the Ethics Position Questionnaire were used.Ethical considerations: This study was obtained from the ethics committee of the faculty of medicine in Turkey. It was based on voluntary participation, informed consent, confidentiality, and anonymity.Results: All participants in the study shared the same faith and were Muslims. The idealism and relativism tendencies of the participants tended to be high. The number of children, the participants have, participants' status of waiting for an organ transplant, the view that the clergy and health personnel will increase interest in organ donation were identified as factors associated with idealism tendencies. Participants' status of having children, the number of children participants have, participants' status of organ transplant waiting, the view that the health personnel will increase interest in organ donation were identified as factors associated with relativism tendencies (p < 0.0.5).Conclusion: The results of this study demonstrated a relationship between participants' idealism and relativism tendencies, among those with a large number of children, waiting for organ donation, advocating for clergy guidance to increase organ donations, and believing healthcare professionals need not guide to increase organ donations. In light of this finding, it may be recommended to establish a multidisciplinary team, including healthcare professionals and clergy, and to inform the society with accurate information to increase the number of organ donations.

Opinion of surveyed nurses on transplantation and reasons for negative public attitudes toward organ donation

Organ transplantation saves thousands of lives every year. Despite growing awareness of transplantation, the issue of obtaining organs for transplantation has been controversial for years. Hundreds of people are waiting in lines all the time for transplantation, for whom it is the only hope for a cure. One extremely important factor contributing to the low number of transplants is the low number of organ donations from deceased donors. Nurses are considered key facilitators of the organ procurement and transplantation process. Their knowledge of and attitudes toward organ donation can influence public opinion, as well as the decisions of their families to donate the organs of the deceased. The purpose of our study was to determine the opinions of surveyed nurses about transplantation and the reasons for negative public attitudes toward organ donation. The survey included 793 nurses employed in surgical wards across Poland with varying levels of job seniority. The survey was conducted between September and October 2022. The research tool was a survey questionnaire, consisting of three parts: socio-demographic data, questions assessing the respondents' knowledge of behavior about transplantation, and a non-standardized tool to measure respondents' emotional and motivational attitudes toward transplantation. Participation in the survey was anonymous and voluntary. The statistical analysis for independence of variables used the χ 2 test. On the other hand, coefficients based on the Phi and Cramer's V test, as well as Kruskal Wallis non-parametric tests for assessing differences (for more than 2 samples) were used to determine the strength of the relationship. During these analyses, in addition to standard statistical significance, the corresponding "p" values were calculated using the Monte Carlo method. According to the nurses surveyed, transplantation is a life-saving procedure. A significant proportion of the nurses (85.6%) believe that there are too few donors in Poland. According to 41.8% of the respondents, this is due to the fear of misdiagnosis of death, for 23.4% it is incompatible with their worldview or religion and 31.8% believe it is due to the belief in the inviolability of the human body after death. The survey showed that, in the nurses' opinion, the reason for objections to organ transplantation is the deficit in public's knowledge of cell, tissue and organ donation from both living and dead donors. Therefore it is extremely important to conduct educational campaigns in this regard.

Intervention programme to improve knowledge, attitudes, and behaviour of nursing students towards organ donation and transplantation: A randomised controlled trial

AIM

To develop and evaluate an educational programme aimed at undergraduate training to increase and improve knowledge, attitudes and behaviour towards the organ and tissue donation and transplants (OTDT).

BACKGROUND

The request for OTDT falls on the health personnel and the reduction of family refusals depends on their attitude and competence, which is vital to increase OTDT. The evidence highlights the efficacy of starting training at early stages and the implementation of educational programmes in universities is recommended to reduce family refusals.

DESIGN

A randomised controlled trial.

METHODS

A randomised controlled trial with an experimental group (EG) -theory class and round table- and a control group (CG) -theory class- that transitions to a delayed experimental group. A sample of 73 students was distributed in parallel randomised groups.

RESULTS

The groups increased their knowledge and improved their attitude, significantly changing their behaviour in the follow-up. These changes in the experimental groups were more significant than in CG in perceived quality of information (z = -4.948; p = <0.001), level of knowledge (EG1 and CG z = -2.245; p = 0.025) (EG2 and CG z = -2.215; p = 0.027), attitude (EG1 and CG z = -2.687; p = 0.007) (EG2 and CG z = -2.198; p = 0.028) and behaviour (EG1 and CG t = 2.054; p = 0.044) (EG2 and CG z = -2.797; p = 0.005).

CONCLUSIONS

The education programme has proven effective, promoting knowledge, change and entrenchment of attitudes, facilitating conversations with families, enabling willingness to donate and increasing potential donors.

Healthcare Professionals’ Understandings of the Definition and Determination of Death: A Scoping Review

Background.

During the 1950s, advances in critical care, and organ transplantation altered the relationship between organ failure and death. There has since been a shift away from traditional cardiocirculatory based to brain-based criteria of death, with resulting academic controversy, despite the practice being largely accepted worldwide. Our objective is to develop a comprehensive description of the current understandings of healthcare professionals regarding the meaning, definition, and determination of death.

Methods.

Online databases were used to identify papers published from 2003 to 2020. Additional sources were searched for conference proceedings and theses. Two reviewers screened papers using predefined inclusion and exclusion criteria. Complementary searches and review of reference lists complemented the final study selection. A data extraction instrument was developed to iteratively chart the results of the review. A qualitative approach was conducted to thematically analyze the data.

Results.

Seven thousand four hundred twenty-eight references were identified. In total, 75 papers met the inclusion criteria. Fourteen additional papers were added from complementary searches. Most were narratives (35%), quantitative investigations (21%), and reviews (18%). Identified themes included: (1) the historical evolution of brain death (BD), (2) persistent controversies about BD and death determination, (3) wide variability in healthcare professionals’ knowledge and attitudes, (4) critical need for BD determination revision.

Conclusions.

We concluded that although BD is widely accepted, there exists variation in healthcare providers’ understanding of its conceptual basis. Death determination remains a divisive issue among scholars. This review identified a need for increased opportunities for formal training on BD among healthcare providers.

The ethical obligation to provide care to patients diagnosed with brain death until the end stages based on grounded theory

Nurses are faced with tremendous pressure when providing brain-dead patients with care. There is limited guidance for nurses on the care of these patients. The present study aimed to report the experiences of nurses regarding the care of patients diagnosed with brain death.

Semi-structured interviews were conducted with 31 nurses and other stakeholders, and the observations and field notes were analyzed using continuous and comparative analysis based on grounded theory.

The qualitative analysis of the data resulted in extraction of six final categories, including 'facing increased tensions and conflicts', 'organ donation: a distinct care element', 'inconsistency of care management', 'effective care requirements', 'challenges, rights and duty requirements', and 'moral obligation to provide holistic care until the last minute'. Data analysis identified 'Challenges, rights and duty requirements' as the main issue and showed that the nurses managed this issue using the strategy of 'moral obligation to provide holistic care until the last minute' as the core variable.

According to the results, it is recommended that the healthcare system (especially hospital management) take supportive action for nurses in various fields of care of brain-dead patients to resolve educational, moral and legal challenges.

Attitudes towards multi-organ donation among intensive care unit nurses in transplant hospitals

AIM

To evaluate the attitudes towards deceased multi-organ donation and transplantation among nurses within the critical care units of the six public tertiary transplant hospitals in Madrid, Spain.

BACKGROUND

Spain has a rate of 49 donations per million population, whereas Madrid has a lower donation rate of 34.2 per million population. Nurses generate social opinion, and their attitude can be one of the barriers against organ donation.

METHOD

An observational descriptive study was conducted among critical care units' nurses. The measuring instrument was the Collaborative International Donor Project in Organ Donation and Transplantation. Data were collected from January to October 2019, and a statistical analysis was performed.

RESULTS

A total of n = 313 questionnaires achieved a response rate of 51%. Of the intensive care unit nurses surveyed, 85% had a favourable opinion towards the donation of their organs being affected by psychosocial variables related to social variables with respect to family, religion and attitude towards the body.

CONCLUSION

The intensive care unit nurses of the Madrid transplant hospitals maintain a favourable attitude towards organ donation and transplantation. It is necessary to implement specialized training and periodically evaluate training in this sector. To maintain and improve the attitude towards organ donation, family discussion among health personnel should be encouraged. Religion influences the attitude of nurses and donation rates.

IMPLICATION FOR NURSING AND HEALTH POLICY

Intensive care nurses' attitude towards organ donation is influenced by social variables. This study shows that the attitude is positive but improvable. These findings contribute to promote awareness of the lack of organs and the benefits of organ donation.

Knowledge, Attitude, and Performance of ICU, CCU, and Emergency Wards Nurses in Kermanshah, Iran, regarding Organ Donation

Background

Providing an organ for donation is a major problem worldwide and nurses play an important role in facilitating the process of organ donation. This study is aimed at investigating the knowledge, attitude, and performance of nurses working in the ICU, CCU, and emergency wards regarding organ donation.

Methods

In this descriptive-analytical study, 185 nurses working in ICU, CCU, and emergency wards were studied through systematic random sampling. The data collection was done by a self-administered questionnaire.

Results

The mean knowledge of nurses was 8.9 ± 1.4 out of 10. There was a significant relationship between knowledge of nurses regarding donation and religion and having organ donation card (P < 0.001). The mean attitude of nurses was 7.8 ± 2.2 out of 8. The variables, including “having a donation card and marriage,” were associated with attitude of nurses toward organ donation. The mean performance of nurses was 0.4 ± 0.7 out of 3. There was a significant relationship between performance of nurses and having a donation card (P < 0.001). Knowledge was the strongest predictor of nurses' performance (P < 0.01).

Conclusion

The studied nurses showed sufficient knowledge and favorable attitude toward organ donation; however, they had poor performance. It is suggested to hold training courses to improve performance of nurses. The revision of the nursing students' curriculum as future nurses should also be considered.

MANAGEMENT OF NURSE CARE IN THE ORGAN AND TISSUE DONATION PROCESS

ABSTRACT Objective: to identify the activities developed by nurses in care management in the organ and tissue donation process. Method: this is a quantitative, retrospective, exploratory and descriptive study, carried out in two hospital institutions in southern Brazil, between June 2013 and June 2016. The sample consisted of 104 records of patients notified to the State Transplant Center. For data analysis, descriptive statistics were used. Results: at Institution A, 70.2% (73) of medical records were analyzed and at Institution B, 29.8% (31). As for activities developed by nurses, it is noteworthy that in the first, they carried out 1,299 management activities (93.7%) and in the second, 317 (53.9%). As for assistance activities, in the first, 507 (83.1%) and in the second, 217 (63.1%) activities. With regard to nursing care, care should be taken to maintain temperature, water balance and glycemic control. Conclusion: it was possible to identify that nurses develop a greater number of actions aimed at management issues in the donation process. As for assistance, there was a greater concern with maintaining the temperature.

Lived experiences of international operating room nurses in organ procurement surgery: A phenomenological study

International operating room nurses come from different regions of the world with diverse social and cultural backgrounds, religions, personal beliefs, and education. They are likely to form unique attitudes toward multi-organ procurement that potentially might affect their opinions and clinical practices. The aim of this phenomenological study was to explore the lived experiences of international operating room nurses participating in deceased organ procurement procedures in Australia. Semistructured interviews were conducted with 18 international operating room nurses. van Manen's phenomenological data analysis method was adopted to uncover and interpret meanings from these nurses' descriptions. Four essential themes emerged and evolved to signify the meanings of participants' experiences in organ procurement procedures: the surreality of death, personal and professional challenges, becoming stronger, and personal beliefs and wishes. The present study highlights the importance of cultural awareness in dealing with death, organ procurement, and interprofessional collaboration in the multi-cultural perioperative context. It is essential to provide clinical education and support around culture and practice transition for international operating room nurses to increase and maintain their professional confidence, career satisfaction, health, and well-being during organ procurement surgery.

Organ and tissue donation: use of quality tool for process optimization

Abstract Objective: Identify by means of a management tool causes of losses of possible and potential organs and tissues donation as opportunities of improvements in the organs and tissues donation system. Method: Descriptive and quantitative study developed in three hospitals in the south of the country, which used an instrument of the National Transplant Organization of Spain to trace opportunities of improvements in the scenario of the organs and tissues donation. Tha data collect was carried out in patients´medical records from July and October 2017. The data were analyzed through the descriptive statistics. Results: Of the 321 deaths occurred, 73% were heart arrested and 27% were brain death. In all hospitals the percentage of brain death was higher than 25%. The causes of losses involve hemodynamic alterations 78.3% and medical contraindications 21,7%, with respect to hemodynamic instability 33% related to the hypotension, polyuria 28% , sodium more than 155mEq/l 22% and temperature below 35.5ºC in 17%. Conclusion and Implications for practice: The main causes of loss involve the hemodynamic instability and the contraindication, with respect to opportunities of improvements it was possible to measure the causes of the non-validation of the potential organs donor. The management tool used in the study allows the healthcare team to develop strategies directed towards actual problems incurred at the stages of the donation and transplantation process.