Grief Reactions of Potential Organ Donors’ Bereaved Relatives: An Observational Study

2020 ◽  
Vol 29 (5) ◽  
pp. 358-368
Author(s):  
María Soria-Oliver ◽  
Begoña Aramayona ◽  
Jorge S. López ◽  
María J. Martín ◽  
José M. Martínez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Organ Donation ◽  
Family Members ◽  
Hospital Staff ◽  
Emotional Reactions ◽  
Care Staff ◽  
Health Care Staff ◽  
Organ Donors

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.

Nursing Interventions to Reduce Stress in Families of Critical Care Patients: An Integrative Review

2021 ◽  
Vol 41 (1) ◽  
pp. 32-44
Author(s):  
Valérie Lebel ◽  
Sylvie Charette
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Psychological Symptoms ◽  
Family Members ◽  
Care Staff ◽  
Health Care Staff ◽  
Accurate Information ◽  
Nursing Interventions ◽  
And Behavior

Background Having a family member admitted to an intensive care unit is a stressful experience that may lead to psychological symptoms including depression, anxiety, and posttraumatic stress disorder. Objective To better understand the phenomenon of stress experienced by families of intensive care unit patients and identify nursing interventions that may help reduce it. Methods An integrative literature review was performed to identify principal stressors for families of patients receiving care in neonatal, pediatric, and adult intensive care units and recommended nursing interventions. Results The principal stressors in the 3 types of intensive care units were change in parental role or family dynamics, appearance and behavior of the patient, the care setting, and communication with the health care staff. Nursing interventions should focus on valuing the role of family members in patient care, improving communication, and providing accurate information. Clinical Relevance Family members of intensive care patients will benefit from nursing interventions that adequately acknowledge and address the stress they experience. Conclusion Nurses play a crucial role in helping to reduce the stress experienced by family members of intensive care unit patients.

scholarly journals Barriers to reporting clinical errors in operating theatres and intensive care units of a university hospital: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sedighe Ghobadian ◽  
Mansour Zahiri ◽  
Behnaz Dindamal ◽  
Hossein Dargahi ◽  
Farzad Faraji-Khiavi
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Qualitative Study ◽  
Qualitative Content Analysis ◽  
Operating Theatre ◽  
University Hospital ◽  
Care Staff ◽  
Health Care Staff ◽  
Organizational Problems

Abstract Background Clinical errors are one of the challenges of health care in different countries, and obtaining accurate statistics regarding clinical errors in most countries is a difficult process which varies from one study to another. The current study was conducted to identify barriers to reporting clinical errors in the operating theatre and the intensive care unit of a university hospital. Methods This qualitative study was conducted in the operating theatre and intensive care unit of a university hospital. Data collection was conducted through semi-structured interviews with health care staff, senior doctors, and surgical assistants. Data analysis was carried out through listening to the recorded interviews and developing transcripts of the interviews. Meaning units were identified and codified based on the type of discussion. Then, codes which had a common concept were grouped under one category. Finally, the codes and designated categories were analysed, discussed and confirmed by a panel of four experts of qualitative content analysis, and the main existing problems were identified and derived. Results Barriers to reporting clinical errors were extracted in two themes: individual problems and organizational problems. Individual problems included 4 categories and 12 codes and organizational problems included 6 categories and 17 codes. The results showed that in the majority of cases, nurses expressed their desire to change the current prevailing attitudes in the workplace while doctors expected the officials to implement reform policies regarding clinical errors in university hospitals. Conclusion In order to alleviate the barriers to reporting clinical errors, both individual and organizational problems should be addressed and resolved. At an individual level, training nursing and medical teams on error recognition is recommended. In order to solve organizational problems, on the other hand, the process of reporting clinical errors should be improved as far as the nursing team is concerned, but when it comes to the medical team, addressing legal loopholes should be given full consideration.

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

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 ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Organ Donation ◽  
Family Members ◽  
The Self ◽  
Organ Donors ◽  
Next Of Kin ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier

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.

Potential Heart, Liver, and Kidney Donation after Circulatory Determination of Death in a Neonatal Intensive Care Unit

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Alexandra Trottier ◽  
Guillaume Maitre ◽  
Audrey Hébert ◽  
Matthew J. Weiss
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Organ Donation ◽  
Neonatal Intensive Care ◽  
Organ Donors ◽  
Determination Of Death ◽  
Eligibility Criteria ◽  
Number Of Patients

<b><i>Background:</i></b> Pediatric organ donation after circulatory determination of death (DCD) has increased in recent years; however, there are few data reporting the number of neonatal potential DCD organ donors and no Canadian-specific reports. <b><i>Objective:</i></b> The main objective of this study was to estimate the number of patients who may have become actual DCD organ donors from a single, tertiary neonatal intensive care unit (NICU) over 5 years. <b><i>Methods:</i></b> We reviewed all medical charts of newborns ≥2.5 kg, who died in our center’s NICU from January 2013 to December 2017. We determined how many could have become actual organ donors after brain death (DBD) or DCD based on 3 sets of organ-specific eligibility criteria defined as conservative, standard, and liberal. <b><i>Results:</i></b> Of the 39 deceased patients, none met the criteria for DBD. Twenty-nine (75%) died after the withdrawal of life-sustaining therapies. According to the conservative criteria, 1 patient would have been eligible for kidneys and liver donation. Three patients met standard criteria for kidneys and 1 for liver. Eight patients would have been eligible donors for kidneys, 7 for liver, and 2 for heart according to liberal criteria. Only 2 patients were evaluated for DCD, and no organ donation was performed. <b><i>Conclusions:</i></b> While uncommon, we identified potential DCD organ donors in the NICU population for kidney, heart, and liver transplants. The substantial variability in the number of potential donors depending on the selected eligibility criteria emphasizes the need for a standardized definition adapted to local capacities.

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

2021 ◽  
Author(s):  
Christopher WY Liu ◽  
Lynn N Chen ◽  
Amalina Anwar ◽  
Boyu Lu Zhao ◽  
Clin KY Lai ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Organ Donation ◽  
Family Members ◽  
The Self ◽  
Organ Donors ◽  
Next Of Kin ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier

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.

scholarly journals Family Needs of Patients Admitted to the Intensive Care Units

2018 ◽  
Vol 5 (4) ◽  
pp. 128-132
Author(s):  
Fateme Hasandoost ◽  
Maryam Momeni ◽  
Leila Dehghankar ◽  
Nastaran Norouzi Parashkouh ◽  
Haydeh Rezaei Looyeh ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Organizational Support ◽  
Family Members ◽  
Educational Status ◽  
Care Staff ◽  
Teaching Hospitals ◽  
Health Care Staff ◽  
Family Needs ◽  
Cross Sectional

Background and aims: Organizational support of family members of the patients admitted to intensive care units (ICUs) potentially reduces mental stresses and enables them to better comply with and support the patients. The current study aimed at evaluating the needs of families of the patients admitted to ICUs in teaching hospitals of Iran. Methods: This cross-sectional study was conducted in 2015 using convenience sampling method. The Critical Care Family Needs Inventory (CCFNI) in 5 factors was used as a main data collection tool. The study population included 235 family members of the patients. Results: Total score of CCFNI was 132.32±18.46. Needs of family members of ICU patients decreased 0.428 times following the increase of length of stay in ICU (P<0.001). Moreover, the need for supportive cares was significantly 9.273 times lower among illiterate families, compared with the ones with higher education level (P<0.018). Conclusion: Considering that the highest need was in the area of support and the predictors of the family needs of the patients were the duration of hospitalization and the educational status of their families, the main focus of nurses should be on the support of family members of the patients admitted to the ICU and supporting and paying attention to their needs, who experience stressful conditions, to satisfy them and even to encourage them to give better care to the patient and help health care staff.

scholarly journals Gradually Disengaging: Parent–Health care Provider Relationships After a Child’s Death in the Pediatric Intensive Care Unit

2018 ◽  
Vol 24 (3) ◽  
pp. 470-492 ◽  
Author(s):  
Ashleigh E. Butler ◽  
Helen Hall ◽  
Beverley Copnell
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Study Data ◽  
Care Staff ◽  
Constructivist Grounded Theory ◽  
Health Care Staff ◽  
Bereaved Parents ◽  
Child's Death

When a child dies in the intensive care unit, many bereaved parents want relationships with their child’s health care staff to continue in the form of follow-up care. However, the nature of these relationships and how they change across the parents’ bereavement journey is currently unknown. This article explores early and ongoing relationships between parents and health care staff when a child dies in intensive care. Constructivist grounded theory methods were used to recruit 26 bereaved parents from four Australian pediatric intensive care units into the study. Data were collected via audio-recorded, semistructured interviews and analyzed using the constant comparative methods and theoretical memoing. Findings show that these relationships focus on Gradually disengaging, commonly moving through three phases after the child dies: Saying goodbye, Going home, and Seeking supports. These findings provide guidance to health care staff on what families need as they leave the intensive care unit and move through bereavement.

Organ donation rates in a neurosurgical intensive care unit

2002 ◽  
Vol 97 (4) ◽  
pp. 811-814 ◽  
Author(s):  
John Dickerson ◽  
Alex B. Valadka ◽  
Tina LeVert ◽  
Kimberly Davis ◽  
Mary Kurian ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Donation ◽  
Organ Procurement ◽  
Organ Donors ◽  
Content Type ◽  
Number Of Patients ◽  
Neurosurgical Intensive Care ◽  
Neurosurgical Intensive Care Unit ◽  
Fine Print

Object. The number of patients waiting for organ transplantation continues to grow, while organs are donated by very few of the thousands of potential donors who die every year. The authors' neurosurgical intensive care unit (NICU) has worked closely with coordinators from the local organ procurement organization (OPO) for many years. In this study, the authors analyze donation rates in the NICU and discuss factors that may be important in maximizing these rates. Methods. All referrals from the NICU to the OPO from 1996 to 1999 were analyzed. Of the 180 referrals, 98 patients were found to be medically suitable as potential donors. Another 15 patients died of hemodynamic collapse shortly after admission to the NICU. If one assumes that all 15 patients would have been suitable donors, the unsuccessful resuscitation rate becomes 15 (13.3%) of 113. Of the 98 eligible donors, consent was obtained and organs or tissue were recovered in 72, yielding a successful organ procurement rate of 73.5%. Conclusions. Close working relationships among physicians, nurses, and OPO coordinators can result in higher donation rates than have been reported previously. Aggressive resuscitation and stabilization of all patients, early identification of potential organ donors, prompt declaration of brain death, and attempts by the OPO coordinator to build rapport with families are all important factors that may increase donation rates. Because most organ donors have sustained catastrophic intracranial events, neurosurgeons are uniquely positioned to influence organ donation policies at their hospitals and thus to salvage some benefit from tragic cases of overwhelming brain injury.

scholarly journals Comfort of the patient's family in an Intensive Care Unit related to welcoming

2013 ◽  
Vol 47 (5) ◽  
pp. 1114-1121 ◽  
Author(s):  
Mariana de Almeida Moraes Gibaut ◽  
Luisa Mayumi Rocha Hori ◽  
Katia Santana Freitas ◽  
Fernanda Carneiro Mussi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Members ◽  
Hospital Staff ◽  
Likert Scale ◽  
Health Condition ◽  
The State ◽  
Comfort Level ◽  
The Family ◽  
Scale Data

This study aimed to identify the level of comfort of families of patients in a critical health condition related to the welcoming practices performed by the hospital staff. Interviews were conducted with 250 relatives in hospitals of the state Bahia, using a Likert scale. Data were analyzed as percentages and quartiles. For nine of the 12 statements of the scale, most relatives scored their comfort level between very and totally comfortable, median of 4,revealing kindness, tranquility and friendly communication with family members. More than half of the sample scored its level as not at all to more or less comfortable, median of 3, for statements about demonstration of interest towards the relative by the staff and flexible visiting of the patient. The necessity of greater interest of the team in the condition and needs of the family was observed. Promoting comfort from the dimension of welcoming demands interdisciplinary actions grounded in humanistic philosophy, in which the nurse has an important role to play.

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