pISSN 3022-6783
eISSN 3022-7712

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Korean J Transplant 2023; 37(4): 241-249

Published online December 31, 2023

https://doi.org/10.4285/kjt.23.0049

© The Korean Society for Transplantation

Facilitators and barriers in the donor family interview process from the perspective of hospital staff: a cross-sectional study

Seyed Mohammad Reza Nejatollahi1 , Yazdan Abdolmohammadi2 , Sepideh Ahmadi2 , Arman Hasanzade3 , Fatemeh Hosseini2 , Arshia Mohseni3 , Shadi Shafaghi2 , Mojtaba Mokhber Dezfuli2 , Fariba Ghorbani3

1Department of Hepato-Pancreato-Biliary and Transplant Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence to: Fariba Ghorbani
Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Shahid Bahonar Ave, Darabad, Tehran 19569, Iran
E-mail: dr.f.ghorbani@gmail.com

Received: September 4, 2023; Revised: September 28, 2023; Accepted: October 15, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Obtaining consent from potential donor families is a challenging step in the donation process and is influenced by various factors.
Methods: In this cross-sectional study, we utilized a questionnaire containing 14 questions about facilitators and barriers in the family interview process. The questionnaire was distributed in March 2023 to intensive care unit (ICU) nurses who had experience with donor family interviews. We collected the opinions of these respondents on hospital performance and drew comparisons between the studied hospitals.
Results: A total of 60 participating ICU nurses provided mean scores for hospital performance in family interviews of 2.60±0.84 for type I hospitals (those providing neurosurgery and trauma care) and 2.035±0.890 for type II hospitals (those without neurosurgery and trauma services; P=0.04). The mean scores for public and private hospitals were 1.86±0.86 and 2.59±0.85, respectively (P=0.008). Based on the findings, the most important facilitators were the availability of organ donation staff and access to a professional team for family discussions. Conversely, poor physician communication skills and limited communication capabilities among medical staff were identified as significant barriers. Implementation of a professional team for family interviews was found to be more critical for type II hospitals. Poor physician communication skills were a significant concern in public hospitals, while families’ lack of awareness of patient prognosis emerged as a key barrier in private hospitals.
Conclusions: This study highlights numerous facilitators and barriers that vary across hospitals. Addressing these issues individually and developing tailored plans to enhance hospital performance in interviewing donor families is essential.

Keywords: Organ donation, Brain death, Organ procurement system, Organ donor

HIGHLIGHTS
  • The present study reveals that inadequate physician communication skills constitute a significant barrier to obtaining consent from donor families.

  • The presence of a professional team during family interviews is a crucial factor.

  • Family acceptance of the patient’s prognosis during the interview, along with acknowledgment of the inevitability of death, was found to be important.

  • The entire donation team, especially physicians, and hospital staff need training to enhance their communication skills with potential donor families.