Article

Primary care physicians' attitudes and practices regarding discussing organ donation with their patients.

Center for Reducing Health Disparities, Division of Pulmonary and Critical Care, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio 44109, USA.
Journal of the National Medical Association (Impact Factor: 0.91). 01/2010; 102(1):52-8.
Source: PubMed

ABSTRACT Among the general population, discussing organ donation with a primary care provider may be associated with increased willingness to donate. However, the frequency with which primary care providers hold these discussions with their patients has not been reported.
Cross-sectional mail and an Internet survey of validated questions regarding organ donation were done.
A national sample of 831 primary care physicians. black, and Hispanic physicians were oversampled.
Few physicians reported receiving formal training in donation (17%). Only 5% of physicians have donor cards available in their practice, and only 11% have donation information available in their practice. While 30% of physicians reported discussing end-of-life care with their patients, fewer than 4% reported discussing donation with their patients. However, only 36% felt that discussing donation was outside of their scope of practice. In a multivariate regression model, predictors of discussing donation with patients included having received formal education about organ donation (odds ratio [OR], 2.6; p < .05) and discussing end-of-life care with patients (OR, 12.8; p < .001).
Very few primary care physicians reported discussing organ donation with their patients despite the majority agreeing that it was within their scope of practice. Primary care physicians who had received education on the subject or who regularly discuss end-of-life care with their patients were more likely to discuss donation. Efforts to improve donation in the general population should include a focus on understanding and improving communication about organ donation between providers and their patients.

1 Bookmark
 · 
374 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the identification and timely referral of potential donors by hospital healthcare providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital-OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation-related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed.
    American Journal of Transplantation 08/2012; · 6.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Only a minority of hospice patients eligible to donate tissue and organs choose to do so. Hospice care staff play a key role in discussions about donation, but their willingness to engage in these discussions and their understanding of issues around tissue and organ donation is poorly understood. To (i) identify factors associated with the wish of hospice doctors, nurses and healthcare assistants to donate their own organs after death; (ii) survey the experience of discussing the subject with patients; (iii) determine staff members' knowledge of organ and tissue donation and (iv) identify factors associated with knowledge of organ and tissue donation. Cross-sectional questionnaire survey of hospice care staff. 76 of the 94 care staff of one large UK hospice completed and returned the questionnaire. Staff wishing to donate their organs after death (43/76 56.6%) were more likely to be doctors or nurses than healthcare assistants (p=0.011) and more likely to have discussed organ or tissue donation with their family (p<0.001). Staff reporting ever having discussed donation with patients had more years' experience (p=0.045) and had similarly discussed donation with their own family (p=0.039). Those with greater knowledge were more likely to have discussed organ or tissue donation with a patient (p=0.042). A reluctance to instigate discussions about organ and tissue donation may prevent palliative patients and their families being allowed the opportunity to donate. Suboptimal knowledge among hospice staff suggests the need for greater liaison between hospice staff, and the organ and tissue donation teams.
    Supportive and Palliative Care 03/2014; 4(1):98-103.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Health care professionals who work at Critical Care Units (CCU) constitute a key group in the process of obtaining organs for transplantation. For this reason, and with the purpose of understanding the set of variables associated to the process involved in identifying potential organ donors, a survey was conducted among professionals from CCU in three important hospitals in Lisbon. A multivariate model has been elaborated using logistic regression analysis. According to the model, variables associated to the process of identifying a potential organ donor are: perception of the level of information about organ donation and transplantation; when information about this topic was received in the year prior to the present research; perception about own capability to assess a patient as a potential organ donor; perception about the amount of work when an organ donor is identified; perception about the attitude of next-of-kin toward organ removal; and perception about the reversibility of the brain death.
    Escritos de Psicología (Internet). 08/2010; 3(3):8-14.

Full-text (2 Sources)

View
116 Downloads
Available from
May 22, 2014