Study On Clinical Staffs’ Attitudes Towards Organ Donation And Countermeasures In A Tertiary Hospital

BackgroundOrgan transplantation is known as "the pearl of the medicine crown". It is one of the most effective ways to treat various types of end-stage organ failure and it brings hopes of cure for many patients. The number of organ transplants and technology in China have reached the level of developed countries, but the ratio of supply and demand of organ transplants is 1:30, with the ratio of US is 1:4, which formed disparity gap between our country and US, making the cause of organ transplant in our country faced with severe challenge. Before 2010, the main organs of our country were mainly from the body of the death penalty and living organs, and the former source has been controversial and criticized in the world, while the living organ donation was a serious violation of the principle of medical ethics of "non nocere prium". With a full cessation of the so-called "use organs from executed prisoners" at the beginning of 2015, and with reference to advanced experience of organ donation in many other countries, we are fully aware of that the citizen body organ donation after death is the key driving power and only way to solve the shortage of organs and guarantee the organ transplantation to develop sustainably. As the primary contact persons of the body and organ donors,, As the primary contacts of potential organ donors, clinical staffs’ cognition, attitude and behavior play the key role in the affection of organ donation work.ObjectivesCollect data about related knowledge, attitudes and behavior of hospital clinicians, nursing staff in a first-class teaching hospital of three classes about organ transplantation and potential organ donors, and analyze he main influence factors on hospital clinicians, nursing staffs finding, referrals, coordination of potential organ donors. Analyze the reason why the relatives of potential organ donors refuse to donate organs and affective elements. Finally, provide data support and advice strategy in order to improve the active participation of the medical personnel in the work of organ donation, play their professional expertise, and make the organ donation a routine and normalization in the clinical medical work.MethodsWe totally distributed 857 copies of self-made questionnaires among 482 doctors and 375 registered nurses form different sections in a tertiary first-class hospital.812 valid questionnaires were collected, and the effective rate was 94.7%. Sorting the materials and using Epidata 3.0 software for data entry. SPSS 17.0 was used for data analysis and processing. Descriptive statistics was adopted to analyze each index, case number and percentage were used to show enumeration data, which were compared with chi-square test. P< 0.05 was considered significant.Results80.5% of nurses and 55.6% of clinicians did not understand the time limit of organ donation.90.4% of nurses and 71.7% of physicians did not understand the process of organ donation,93.8% of nurses and 81.3% of the physicians did not understand compensation mechanism after organ donation. Doctors knew more about the donation than the nurses, and the young middle-aged and senior medical personnel of the medical staff knew better, the difference was statistically significant.93.2% of physicians and 90.1% of nurses in public hospitals considered that it was feasible to coordinate organ donation. But 64.1% of physicians and 59.5% of nurses believed that the public did not identify the majority of organ donation,65.4% of doctors and 57.5% nurses represented that the majority relatives of potential organ donors would refuse to donate, no difference between doctors and nurses. For individuals to sign the volunteer contract of organ donation, physicians were more positive than the nurses, the nurses with senior professional titles were more positive than those with junior titles. The difference was statistically significant.Only 38.8% of physicians and 39.4% of the nurses said they would take the initiative to prompt the families of potential organ donors to donate, other health care workers (48.6% and 31.1%, relatively) did not express their opinions,12.6% of doctors and 29.5% nurses clearly expressed their unwillingness.51.2% of physicians and 44.8% of nurses were willing to act as medical coordinator and there were statistically significant between each other.82.2% of nurses and 90.0% of physicians were in favor of the signing of "organ donation informed book", and the coordination initiative has significantly improved.68.6% of nurses and 79.5% of physicians were willing to actively coordinate potential organ donors and there were statistically significant between each other.By summing up 97 cases of potential organ donors, we found that 76.3% of families said that "the concept can not be accepted’was the main reason why they rejected to donate organs while 70.1% of families members showed higher pressure from the public.ConclusionOrgan donation work in our country has just started, the potential organ donors is also a new concept for medical staff. Through the survey we found that physicians and nurses had a higher degree of recognition for the conduct of organ donation in clinical works but their enthusiasm would be affected by public’s attitude to organ donation and current health care environment. Therefore, strengthening publicity, developing a reasonable work system and procedures would be helpful to enhance staffs’awareness, eliminate certain concerns and actively participate in coordinating work. Through the analysis we also found that traditional values and public pressure were the main reason why relatives of potential organ donors rejected donation. Therefore, in the future we should put more attention on the teaching concept design for primary pupils and students in high schools and universities, and change the attitudes of people fundamentally so as to lay a solid foundation for the development of organ donation. We should promote the legislation of brain death, optimize double-blind principle and establish a sound rescue system for vulnerable people. We also need to improve humane care and psychological support, reduce the rate of donation refuse and strengthen coordination team building to promote the progress of organ donation.