scholarly journals Comparing organ donation decisions for next-of-kin versus the self: Results of a national survey

Author(s):  
Christopher WY Liu ◽  
Lynn N Chen ◽  
Amalina Anwar ◽  
Boyu Lu Zhao ◽  
Clin KY Lai ◽  
...  

Objectives: Intensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker's mindset. This focused on: (1) how decisions compare when made on behalf of a relative (versus the self); and (2) confidence in decisions made for family members. Design: Cross-sectional survey in Singapore. Setting: Participants were recruited from community settings via door-to-door sampling and community eateries. Participants: 973 adults who qualified as organ donors in Singapore. Results: Although 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative's. Using machine learning, we found that consistency was predicted by: (i) religion, and (ii) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative's were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives' wishes upon death. Conclusions: These findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker's mindset (e.g., overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051273
Author(s):  
Christopher Weiyang Liu ◽  
Lynn N Chen ◽  
Amalina Anwar ◽  
Boyu Lu Zhao ◽  
Clin K Y Lai ◽  
...  

ObjectivesIntensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker’s mindset. This focused on: (1) how decisions compare when made on behalf of a relative (vs the self); and (2) confidence in decisions made for family members.DesignCross-sectional survey in Singapore.SettingParticipants were recruited from community settings via door-to-door sampling and community eateries.Participants973 adults who qualified as organ donors in Singapore.ResultsAlthough 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative’s organs. Using machine learning, we found that consistency was predicted by: (1) religion, and (2) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative’s were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives’ wishes on death.ConclusionsThese findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker’s mindset (eg, overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.


Author(s):  
Wan Nor Aliza Wan Abdul Rahman ◽  
Abdul Karim Othman ◽  
Yuzana Mohd Yusop ◽  
Asyraf Afthanorhan ◽  
Hasnah Zani ◽  
...  

In admissions to the intensive care unit (ICU), there is a high possibility of a life-threatening condition and possible emotional distress for family members. When the family is distressed and hospitalized, a significant level of stress and anxiety will be generated among family members, thereby decreasing their ability to make responsible decisions. As a result, the family members need full and up-to-date details, helping them to retain hope, and this contributes to lower stress levels. While there is growing evidence of the effectiveness of shared decision-making for family members who are directly involved in decisions, particularly regarding shared decision-making in the Malaysian context, there is less evidence that supported decisions help overall outcome. This study aims to developing the family satisfaction with decision making in the Intensive Care Unit (FS-ICU)-33 Malay language version of family member’s satisfaction with care and decision making during their stay at the intensive care units. A quantitative, cross-sectional validation study and purposive sampling was conducted from 1st November 2017 and 10 October 2018 to January 2020 among 208 of family members.  The family members of the ICU patients involved in this study had an excellent satisfaction level with service care. Higher satisfaction in ICU care resulting in higher decision-making satisfaction and vice versa.


2020 ◽  
Vol 29 (5) ◽  
pp. 358-368
Author(s):  
María Soria-Oliver ◽  
Begoña Aramayona ◽  
Jorge S. López ◽  
María J. Martín ◽  
José M. Martínez ◽  
...  

Background Most family members of potential organ donors experience the death of their relative in an intensive care unit. While under an emotional burden, bereaved relatives must make a decision that will affect the life of other patients. A better understanding of grief within the context of organ donation will help intensive care unit staff better support families during this process. Objectives To empirically describe the emotional reactions of potential organ donors’ family members facing a loved one’s death and analyze the relationship of these reactions to factors that occur in the process of illness and death. Methods A prospective observational study was conducted in 16 Spanish hospitals for 36 months. Data of 421 relatives of potential organ donors, collected through a previously validated instrument, included relatives’ emotional responses, deceased’s and relatives’ characteristics, circumstances of death, and behavior of health care staff. Results Unexpected deaths were linked to more intense emotional reactions and less acceptance of death than were anticipated deaths. Additional stressors, such as perception of poor treatment by hospital staff, perception of deficient medical care, and poor relationships among family members, were associated with stronger reactions. Conclusions Observation and analysis of the factors studied may help hospital staff members anticipate bereaved relatives’ emotional reactions and provide better support during the grieving process, increasing family members’ well-being and facilitating a better-informed organ donation decision.


Author(s):  
Jumana Alibrahim ◽  
Abdelmoneim Awad

Vaccine hesitancy (uncertainty or unwillingness to receive vaccinations) is a major barrier to manage the COVID-19 pandemic in the long term. This study aimed to explore the prevalence of COVID-19 vaccine hesitancy among the public in Kuwait, to understand their attitudes towards vaccines in general, and to identify predictors of COVID-19 vaccine hesitancy. A cross-sectional study was conducted among 4147 adults aged ≥ 18 years. The snowball sampling strategy was used for data collection through social media and e-mails. A total of 3061 (73.8%) respondents indicated that they were vaccinated or intending to be vaccinated against the COVID-19 infection, while 1086 (26.2%) expressed their vaccine hesitancy. The most common reasons for vaccine hesitancy were the concerns about the vaccine’s possible side effects, its rushed development, and its efficacy in preventing the infection. Over half (57.2%) of respondents expressed intermediate to high levels of negative attitude towards vaccines in general. On the multivariable logistic regression analysis, the findings revealed that vaccine hesitancy was significantly more prevalent among respondents aged 30–64 years; females; married or divorced; residents of Hawalli, Al-Farwaniyah, Al-Jahra, and Mubarak Al-Kabeer; had intermediate monthly average income; non-smokers; not feeling worried about catching the infection; do not know whether any of their family members have been infected or died because of COVID-19 infection; do not have a large extent of confidence in the Kuwait health system’s ability to handle the pandemic; did not receive influenza vaccine during the last year; refused or elected to forego a doctor-recommended vaccine; did not receive adequate information from the public health authorities/healthcare providers about the COVID-19 vaccines; none of their first-degree family members received or were intending to receive the vaccine; and expressed intermediate to high levels of negative attitudes towards vaccines in general. The present findings provide a steer as to the groups that most need to be reached to increase the rates of vaccine uptake.


2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Mohammedjud Hassen Ahmed ◽  
Gebiso Roba Debele ◽  
Berhanu Fikadie Endehabtu

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data


Author(s):  
Silvia Faccioli ◽  
Francesco Lombardi ◽  
Pierantonio Bellini ◽  
Stefania Costi ◽  
Silvia Sassi ◽  
...  

The COVID-19 emergency has imposed distanced education and has interrupted most rehabilitation services. Adolescents with disabilities have been isolated, and the burden on their families has been exacerbated. A cross-sectional survey was administered to adolescents with disability and to parents of disabled children to describe their experience during lockdown and their concerns or expectations about rehabilitation. A sample of 53 adolescents and 239 parents completed the survey. Adolescents were ages 13–18 years old (45.3% female). Most parents were between 35 and 55 years old (84.9% female). While 53.6% of the parents reported no positive effects of the lockdown, 92.5% of the adolescents expressed favorable consequences. The increased time spent with family members was judged positively by 27.2% of parents and by 64.2% of adolescents. Concern for their child’s disability was expressed by 47.3% of parents, while 73.6% of adolescents expressed concerns regarding the ban on meeting friends. In both groups, anxiety symptoms were correlated with the fear of contracting COVID-19 and with financial problems. Parents would have liked even more remote support from school and healthcare professionals, which was available for most participants. Thus, socioeconomic support, assistive technology and telerehabilitation strategies might help families with disabilities during a lockdown.


2021 ◽  
pp. bmjspcare-2020-002619
Author(s):  
Marcus Sellars ◽  
Julien Tran ◽  
Linda Nolte ◽  
Ben White ◽  
Craig Sinclair ◽  
...  

ObjectiveTo describe the Australian adult public’s knowledge and experiences regarding substitute decision-making for medical decisions and their preferences for obtaining information about the substitute decision-maker (SDM) role.MethodsThis is a national cross-sectional online survey of the Australian adult public. The survey examined participants’ advance care planning (ACP) awareness and experience, SDM experiences and preferences for obtaining more information about SDM, and participant knowledge about SDM.ResultsOf 1586 people who opened the survey, 1120 (70.6%) were included in the final sample. 13% (n=142) of participants indicated they had acted as an SDM. A median score of two correct responses out of five showed low to moderate knowledge about the SDM role among all participants, with only 33% reporting awareness of SDM laws existing in Australia. While most (59%) participants ranked a health professional as their preferred source of obtaining information about supporting SDMs, few participants who had been an SDM (n=64, 45%) reported obtaining any support in making medical decisions. The median SDM knowledge scores for people who had discussed ACP (3.0 vs 2.0, U=1 45 222, z=6.910, p<0.001), documented their ACP preferences (3.0 vs 2.0, U=71 984, z=4.087, p<0.001) or acted in the SDM role (3.0 vs 2.0, U=56 353, z=−3.694, p<0.001) were significantly higher compared with those who had not.ConclusionsThe Australian public may have low to moderate knowledge about the SDM role and access only minimal support when making challenging medical decisions.


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