ATTITUDES TOWARDS ORGAN DONOR ADVOCACY AMONG SWEDISH INTENSIVE AND CRITICAL CARE NURSES: A SUMMARY OF A DOCTORAL DISSERTATION

• Published in: Transplantation Vol. 99; p. S57
• Main Authors: Floden, Anne, sberg, Anna
• Format: Journal Article
• Language: English
• Published: 01-10-2015
• ISSN: 0041-1337

End-of-Life Care in the intensive care unit (ICU) Involves caring for brain dead (BD) persons who by their death become potential organ donors (POD). In this situation, the concept of organ donor advocacy is critical. Aim: To investigate attitudes and actions of ICU nurses in the context of organ donation (OD) based on their experiences. Methods: Four studies were performed consisted of Swedish ICU nurses. Study I n=9; II n=702; III n=15; IV n=502. The Interviews (I,III) were analyzed by Phenomenography. The questionnaires (II,IV) were analyzed by Principal component analysis, Multi-trait analysis, Cronbach's Alpha and Descriptive statistics. The Instrument Attitudes towards organ donor advocacy scale (ATODAS) was developed for study IV. Results: Less than half of the ICU nurses (48%) trusted clinical neurological examination to establish BD without a confirmatory cerebral angiography. The participants perceived BD and the diagnostics of BD In four qualitatively different ways. The participants said that the nurses' perceptions could affect the family's attitude to CD. In total, 39% had experienced that the question about CD was never raised with the relatives, 25% Indicated that mechanical ventilation was withdrawn in order to reduce suffering for a presumably dead person. Almost half considered that caring for a mechanically ventilated POD was a great burden Involving emotional strain. There was an overall perception of a lack of organization regarding CD in the ICU and that identification of PODs did not take place due to the lack of structure and guidelines. Conclusions: The lack of organization, ambiguity and various perceptions of the BD diagnosis seem to be a crucial aspect when caring for a POD. These aspects are essential for the ICU nurse's possibility to fulfill their professional responsibility towards the deceased, next of kin, colleagues and organ recipients.