Attitudes towards organ donor advocacy among Swedish intensive care nurses

Abstract

Objectives: To explore the attitudes of Swedish intensive care nurses towards organ donor advocacy.

Background: The concept of organ donor advocacy is critical to nurses who care for potential donors in order to facilitate organ donation (OD).

Design: A retrospective cross-sectional study was employed.

Methods: Inclusion criteria in this survey were to be a registered nurse and to work in a Swedish intensive care unit (ICU). Participants were identified by the Swedish association of health professionals. A number of 502 Swedish ICU nurses answered the 32-item questionnaire Attitudes Towards Organ Donor Advocacy Scale (ATODAS), covering the five dimensions of organ donor advocacy: attitudes towards championing organ donation at a structural hospital level, or at a political and research level, attitudes towards actively and personally safeguarding the will and wishes of the potential organ donor, or by using a more professional approach and finally to safeguard the will and wishes of the relatives. Data were analysed with the SPSS version 18·0 and the results were assessed by using Student's t-test and post hoc test, analysis of variance (ANOVA), χ(2) , Pearson's correlation and regression analysis.

Results: The most favoured advocacy action was safeguarding the POD's will and wishes by a professional approach, closely followed by actively and personally safeguarding the POD's will and wishes. Nurses at local hospitals reported a more positive attitude towards organ donor advocacy overall compared with nurses at larger regional or university hospitals. Important factors leading to positive attitudes were seniority, working experience, participating in conversations with relatives, caring for brain-dead persons and private experiences from OD or organ transplantation.

Conclusions: Intensive and critical care nurses with short working experience in university hospitals showed the least positive attitude towards organ donor advocacy. This is problematic because many ODs and all transplantations are performed in university hospitals.

Relevance to clinical practice: This study emphasizes the importance of organizing the care of PODs and their relatives in a way that promotes advocacy.

Keywords: Advocacy; Brain death; Intensive and critical care nurses; Nursing developments; Organ donation.