Cohen Jonathan, Ami Sharona Ben, Ashkenazi Tamar, Singer Pierre
Department of General Intensive Care, Rabin Medical Center, Petah Tikva and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Clin Transplant. 2008 Mar-Apr;22(2):211-5. doi: 10.1111/j.1399-0012.2007.00776.x.
The acceptance and application of the concept that brain death is a valid determination of death is the central issue in organ donation. However, whether attitude to brain death of health care professionals influences the organ procurement process has not been systematically studied.
Questionnaires were distributed to health care professionals involved in the organ procurement process (intensive care, internal medicine, emergency room, anesthesia) in all hospitals in Israel. Attitude to brain death (defined as positive if the respondent accepted brain death as a valid determination of death, negative or do not know) and level of comfort in performing key donor-related tasks were analyzed.
A total of 2366 completed questionnaires were returned (629 doctors and 1737 nurses; response rate 60.3%). Overall, 78.9% of respondents had a positive attitude to brain death. This was significantly associated with increasing age, higher professional status and was most prevalent amongst intensive care unit staff (p < 0.001 for all variables). These respondents felt significantly more comfortable informing the transplant coordinator of a potential donor, explaining brain death to the family, raising the subject of organ donation, approaching the family about donation and providing support to the grieving family. In addition, they believed the transplant coordinator should be involved early in the donation process.
The understanding and acceptance of brain death as a valid determination of death was associated with a positive effect on the level of comfort of health care professionals in performing key donor-related tasks. Reinforcing a positive attitude to brain death among health care professionals may facilitate the procurement process.
脑死亡是判定死亡的有效标准这一概念的接受与应用是器官捐献中的核心问题。然而，医护人员对脑死亡的态度是否会影响器官获取过程尚未得到系统研究。
向以色列所有医院参与器官获取过程的医护人员（重症监护、内科、急诊室、麻醉科）发放问卷。分析对脑死亡的态度（如果受访者接受脑死亡作为判定死亡的有效标准则定义为积极态度，消极态度或不知道）以及执行关键供体相关任务时的舒适程度。
共回收2366份完整问卷（629名医生和1737名护士；回复率60.3%）。总体而言，78.9%的受访者对脑死亡持积极态度。这与年龄增长、职业地位提高显著相关，且在重症监护病房工作人员中最为普遍（所有变量p<0.001）。这些受访者在告知移植协调员潜在供体、向家属解释脑死亡、提出器官捐献话题、与家属商讨捐献以及为悲痛的家属提供支持时明显感觉更自在。此外，他们认为移植协调员应在捐献过程早期介入。
将脑死亡理解并接受为判定死亡的有效标准对医护人员执行关键供体相关任务时的舒适程度有积极影响。加强医护人员对脑死亡的积极态度可能会促进器官获取过程。
