TY - JOUR
T1 - Clinicians’ Perception and Experience of Organ Donation From Brain-Dead Patients
AU - Kentish-Barnes, Nancy
AU - Duranteau, Jacques
AU - Montlahuc, Claire
AU - Charpentier, Julien
AU - Martin-Lefevre, Laurent
AU - Joseph, Liliane
AU - Lefrant, Jean Yves
AU - Fieux, Fabienne
AU - Renault, Anne
AU - Thuong, Marie
AU - Chevret, Sylvie
AU - Azoulay, Elie
PY - 2017/9
Y1 - 2017/9
N2 - OBJECTIVE:: ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician’s perceptions and experience of organ donation. DESIGN AND SETTING:: Cross-sectional study among physicians and nurses (90 ICUs in France). We used factorial correspondence analysis to describe categories of clinicians regarding their perceptions and experience of organ donation. Factors associated with a positive (motivating) or negative (stressful) experiences were studied using multivariate logistic regression. PARTICIPANTS:: Physicians and nurses. MEASUREMENTS AND MAIN RESULTS:: Three thousand three hundred twenty-five clinicians working in 77 ICUs returned questionnaires. Professionals who experienced organ donation as motivating were younger (odds ratio, 0.41; 95% CI, 0.32–0.53; p < 0.001), more often potential organ donors (odds ratio, 1.92; 95% CI, 1.56–2.35; p < 0.001), less likely to describe inconsistency (odds ratio, 0.43; 95% CI, 0.23–0.8) or complexity (odds ratio, 0.55; 95% CI, 0.45–0.67) of their feelings versus their professional activity, less likely to report that organ donation was not a priority in their ICU (odds ratio, 0.68; 95% CI, 0.55–0.84), and more likely to have participated in meetings of transplant coordinators with relatives (odds ratio, 1.71; 95% CI, 1.37–2.14; p < 0.001). Professionals who felt organ donation was stressful were older (odds ratio, 1.84; 95% CI, 1.34–2.54; p < 0.001), less often physicians (odds ratio, 0.58; 95% CI, 0.44–0.77; p < 0.001), more likely to describe shift from curative care to organ donation as emotionally complex (odds ratio, 1.83; 95% CI, 1.52–2.21; p < 0.001), care of relatives of brain-dead patients as complex (odds ratio, 1.59; 95% CI, 1.32–1.93; p < 0.001), and inconsistency and complexity of personal feelings about organ donation versus professional activity (odds ratio, 3.25; 95% CI, 1.92–5.53; p < 0.001), and more likely to have little experience with caring for potential organ donors (odds ratio, 1.49; 95% CI, 1.09–2.04). CONCLUSIONS:: Significant differences exist among ICU clinician’s perceptions of organ donation. Whether these differences affect family experience and consent rates deserves investigation.
AB - OBJECTIVE:: ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician’s perceptions and experience of organ donation. DESIGN AND SETTING:: Cross-sectional study among physicians and nurses (90 ICUs in France). We used factorial correspondence analysis to describe categories of clinicians regarding their perceptions and experience of organ donation. Factors associated with a positive (motivating) or negative (stressful) experiences were studied using multivariate logistic regression. PARTICIPANTS:: Physicians and nurses. MEASUREMENTS AND MAIN RESULTS:: Three thousand three hundred twenty-five clinicians working in 77 ICUs returned questionnaires. Professionals who experienced organ donation as motivating were younger (odds ratio, 0.41; 95% CI, 0.32–0.53; p < 0.001), more often potential organ donors (odds ratio, 1.92; 95% CI, 1.56–2.35; p < 0.001), less likely to describe inconsistency (odds ratio, 0.43; 95% CI, 0.23–0.8) or complexity (odds ratio, 0.55; 95% CI, 0.45–0.67) of their feelings versus their professional activity, less likely to report that organ donation was not a priority in their ICU (odds ratio, 0.68; 95% CI, 0.55–0.84), and more likely to have participated in meetings of transplant coordinators with relatives (odds ratio, 1.71; 95% CI, 1.37–2.14; p < 0.001). Professionals who felt organ donation was stressful were older (odds ratio, 1.84; 95% CI, 1.34–2.54; p < 0.001), less often physicians (odds ratio, 0.58; 95% CI, 0.44–0.77; p < 0.001), more likely to describe shift from curative care to organ donation as emotionally complex (odds ratio, 1.83; 95% CI, 1.52–2.21; p < 0.001), care of relatives of brain-dead patients as complex (odds ratio, 1.59; 95% CI, 1.32–1.93; p < 0.001), and inconsistency and complexity of personal feelings about organ donation versus professional activity (odds ratio, 3.25; 95% CI, 1.92–5.53; p < 0.001), and more likely to have little experience with caring for potential organ donors (odds ratio, 1.49; 95% CI, 1.09–2.04). CONCLUSIONS:: Significant differences exist among ICU clinician’s perceptions of organ donation. Whether these differences affect family experience and consent rates deserves investigation.
UR - http://www.scopus.com/inward/record.url?scp=85021829287&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000002581
DO - 10.1097/CCM.0000000000002581
M3 - Article
AN - SCOPUS:85021829287
VL - 45
SP - 1489
EP - 1499
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 9
ER -