Volume 24, Issue 6 (Feb - Mar 2021)                   2021, 24(6): 544-555 | Back to browse issues page

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Taherkhani M, Yekefallah L, Dehghankar L, Namdar P, Ranjbaran M. Critical Care Nurses’ Attitudes Towards Organ Donation and its Relationship With Empathy. Journal of Inflammatory Diseases. 2021; 24 (6) :544-555
URL: http://journal.qums.ac.ir/article-1-3142-en.html
1- Department of Nursing, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
2- Department of Nursing, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
3- Department of Surgery, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. , drpeymannamdar@gmail.com
4- Department of Food Safety and Hygiene, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.
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1. Introduction
ne of the great achievements of modern medicine is the transplantation of body organs and tissues [1], and is one of the most important sources of organ supply for patients with advanced organ failure or patients with brain death [4, 5]. In Iran, 1% -4% of hospital deaths and 10% of deaths in Intensive Care Units (ICUs) are related to brain deaths, while in the United States, less than 1% of all deaths are due to brain death [6]. Due to the shortage of donor organs, the number of organ transplants in Iran is much lower than in European and American countries [7]. Attitude towards the organ transplantation is the most important and effective factor to explain organ donation [9]. Improving the attitudes towards organ donation can increase the desire of individuals to donate and ultimately increase the number of organ donors [3, 11, 12]. Similarly, the attitudes of the treatment team can affect people’s willingness to donate organs for transplantation [10]. Physicians and nurses working in ICUs who have the most contact with brain dead patients [14] are a key member in the process of organ donation and solving the problem of donor organ shortage by identifying donors and supporting their families [15]. On the other hand, attitudes toward organ donation and the degree of willingness to register as an organ donor are directly related to various variables, including humanitarian and benevolent feelings, religious beliefs, altruism, and empathy [16]. Empathy is an important predictor of various helpful behaviors [17]. People who have a higher level of empathy can create more positive thoughts about organ donation than people with a low level of empathy [16]. Several studies that have conducted in Iran and other countries to assess the knowledge, attitude and practice of nurses about brain death and organ donation process have indicated that the nurses’ knowledge, attitude and practice of the organ donation process are poor [28, 29]. The aim of this study was to determine the attitude of nurses in critical care units towards organ donation and its relationship with empathy.
2. Materials and Methods
The present study is a descriptive cross-sectional study. The statistical population consists of all nurses working in critical care units of Bu Ali Sina and Velayat hospitals, including ICU-General, ICU-Internal, ICU-Trauma, ICU-Open heart surgery, Dialysis Unit (DU), Emergency Department (ED)-General, ED-Internal, and ED-Trauma. The sample size was calculated 208 with 95% confidence level, maximum estimation error of d = 0.8 and maximum standard deviation of nurses’ empathy score (SD= 5.88) in the study of Milanik et al. [16]. Considering the possibility of sample drop, the sample size was set at 229. Samples were selected by stratified random sampling method. To do sampling, the wards of each hospital were first considered as a strata. Then, from each ward that included different critical care units, samples were randomly (using random number table) selected based on the ratio of nurses in those units to the total population. Exclusion criteria were having less than one year of experience in special wards, unwillingness to participate in the study, having a history of organ donation or transplantation in family and relatives, a need for a donated organ, and withdrawal from the study. Data collection tools were a demographic form [30], Chakradhar’s Organ Donation Questionnaire (ODQ) and Davis’s Interpersonal Reactivity Index (IRI). After collecting data, they were analyzed in SPSS V. 22 software using descriptive statistics (frequency, percentage, standard deviation) and statistical tests.
3. Results
The mean score of ODQ was higher in females compared to males (P = 0.006), in married subjects compared to single ones (P = 0.02), and in head nurses compared to nurses (p=0.41). The mean ODQ score was higher in DU nurses followed by ICU nurses compared to ED nurses (P = 0.23), where the nurses of ICU-General had the highest score (51±6.07) and the nurses of ED-Trauma had the lowest score (44.48±8.52) (Table 1). 

Among ICUs, the highest and lowest ODQ scores were related to ICU-General and ICU-Open heart surgery, respectively. Among EDs, the highest and lowest ODQ scores were related to ED-internal and ED-trauma, respectively (Table 1). The highest and lowest IRI scores were related to DU (62.85±7.63) and ICU-General nurses (55.56±8.97), respectively. Among ICUs, the highest and lowest IRI scores were related to ICU-Open heart surgery and ICU-General, respectively. Among EDs, the highest and lowest IRI scores were related to ED-internal and ED-trauma, respectively. The total IRI score (r=0.13, P=0.04) and its dimensions of perspective taking (r=0.152, P=0.02) and fantasy (r=0.14, P=0.03) had a positive correlation with the ODQ score (Table 2). 

4. Discussion and Conclusion
In the present study, nurses obtained more than three quarters of the ODQ score and the most positive attitude towards organ donation belonged to the ICU-General and DU nurses. The high score of attitude among nurses in DU can be due to the contact of nurses in this ward with patients whose lives depend on organ donation and somehow deal with the issue of organ donation. Empathy and its two aspects of perspective taking and fantasy had a significant positive relationship with attitudes of nurses towards organ donation. In order to encourage the community to donate organs, it is necessary to increase the attitude of nurses as the first treatment group in interaction with the patients’ families [2]. In order to moderate behavioral and emotional beliefs and increase the positive attitude towards organ donation, it is possible to hold special training courses and presenting motivational issues to the nurses. In conclusion, critical care nurses’ empathy with patients has a significant effect on increasing the nurses’ attitudes towards accepting organ donation. Although empathy is an inherent quality, it is essential to pay attention to the nurses’ relationships with patients and increase empathy, which is important in communication.

Ethical Considerations
Compliance with ethical guidelines

This study was approved by Ethics Committee of Qazvin University of Medical Sciences (Code: IR.QUMS.REC.1397.179). The participants were informed about the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them.

This research was extracted from the MSc. thesis of the first author at the Department of Nursing, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin. 

Authors' contributions
Conceptualization, methodology, validation and research: Mahnaz Taherkhani, Leila Dehghankar, Peyman Namdar; Drafting and editing: Mahnaz Taherkhani; Final approval: Mahnaz Taherkhani, Peyman Namdar, Lily Yekehfalah; Date analysis: Mahdi Ranjbaran; Supervision and Management: Lily Yekhfalah, Leila Dehghankar.

Conflict of interest
The authors declare no conflict of interest.

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Type of Study: Research | Subject: Emergency Medicine

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