Moghaddam Hamideh Yazdi, Pouresmaeili Alireza, Manzari Zahra Sadat
Ph.D. in Nursing, Faculty of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Ph.D. in Private Law, Assistant Professor, Department of Law, Faculty of Theology and Islamic Sciences, Hakim Sabzevari University, Sabzevar, Iran.
Electron Physician. 2018 May 5;10(5):6868-6876. doi: 10.19082/6868. eCollection 2018 May.
Nurses in intensive care units (ICU) play a key role in taking care of brain dead patients and they are often in contact with such patients given the high rate of brain deaths. Consequently, they are in a challenging and stressful condition, which may be aggravated due to the need for increased organ donation, and this may also affect the quality of care provided for these patients.
This review analyzes the different studies on the concept of brain death from both medical and legal points of view. The aim of this study was to identify the challenges the nurses face with the perception of the concept of brain death and its effects on the care provided for the patients suffering from brain death, as well as organ donation.
This Narrative review study summarizes the information obtained from relevant literature through a targeted search of library texts and electronic resources including Science Direct, PubMed, Google Scholar, Scientific Information Database (SID), IranMedex, and Magiran databases during 2000-2017 in English and Persian, on the subject of interest by keywords such as brain death, organ donation, care, legal, regulations and nursing. Finally, a total of 44 relevant articles were reviewed.
Nurses play an important role in taking care of brain dead patients; therefore, recognizing challenges can be the first step in taking accurate care of these patients and subsequently maintaining the organs' health for transplants. Although there are clinical and legal uncertainties regarding the concept of brain death, nurses have an important effect on taking care of brain dead patients as well as the rate of organ donation.
Nurses in intensive care units should have a clear understanding of the concept of brain death in order to be able to take care of brain dead patients by avoiding psychological effects. In this regard, it is recommended that a comprehensive educational program be designed on the dimensions of brain death. Therefore, the nurses' awareness of brain death and their ability to clarify this concept to the patients' relatives would have a great effect on the decrease in the challenges and the stress imposed on the nurses. Also, there would be an increase in the quality of the care given to brain dead patients and even the rate of organ donation.
重症监护病房（ICU）的护士在照顾脑死亡患者方面发挥着关键作用，鉴于脑死亡发生率较高，他们经常接触此类患者。因此，他们处于具有挑战性和压力的状态，由于器官捐献需求增加，这种状态可能会加剧，这也可能影响为这些患者提供的护理质量。
本综述从医学和法律角度分析关于脑死亡概念的不同研究。本研究的目的是确定护士在脑死亡概念认知方面面临的挑战及其对为脑死亡患者提供的护理以及器官捐献的影响。
本叙述性综述研究通过在2000 - 2017年期间以英文和波斯文，在图书馆文本和电子资源（包括科学Direct、PubMed、谷歌学术、科学信息数据库（SID）、伊朗Medex和Magiran数据库）中进行有针对性的搜索，以脑死亡、器官捐献、护理、法律、法规和护理等关键词，总结从相关文献中获得的信息。最后，共审查了44篇相关文章。
护士在照顾脑死亡患者方面发挥着重要作用；因此，认识到挑战可能是准确护理这些患者并随后维持器官健康以进行移植的第一步。尽管关于脑死亡概念存在临床和法律上的不确定性，但护士对照顾脑死亡患者以及器官捐献率有重要影响。
重症监护病房的护士应清楚了解脑死亡概念，以便能够通过避免心理影响来照顾脑死亡患者。在这方面，建议在脑死亡层面设计一个全面的教育计划。因此，护士对脑死亡的认识以及他们向患者亲属阐明这一概念的能力将对减少护士面临的挑战和压力产生很大影响。此外，对脑死亡患者的护理质量甚至器官捐献率也会提高。
