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Improving attitude and knowledge of healthcare professionals towards organ donation in Israel: Results of 12 European Donor Hospital Education Programs
BLSEVIER
Improving Attitude and Knowledge of Healthcare Professionals Towards Organ Donation in Israel: Results of 12 European Donor Hospital Education Programs P. Singer and R. Rachmani
T
HE European Donor Hospital Education Program (EDHEP) has been implemented in Israel since 1993 to increase motivation and knowledge of health professionals. This 2-day seminar includes lectures on brain death, legal and religious aspects, protocols in Israel, and approach to the family. To evaluate the impact of EDHEP, the participants of 12 seminars were asked to answer a questionnaire assessing their knowledge on organ donation and sense of comfort and security in approaching bereaved relatives with the donation request.
MATERIALS AND METHOD Two hundred and four medical doctors, nurses, and social workers attended 12 seminars. These EDHEP seminars included a brain death workshop, a conference on the legal and religious aspects of organ donation, vignettes, a video dealing with sudden death, an interview of a family member after donation, and skill practices using professional actors. The 204 health professionals answered questions before and after the seminars evaluating knowledge (score 1, no knowledge, to score 5, knows everything). Fourteen questions screened their attitudes regarding the transplantation process (disagree: 1 to agree completely: 5). Student’s t-test and Pearson’s correlation test were used for statistical analysis.
RESULTS
One hundred thirty two nurses, 57 physicians, and 15 social workers attended the seminars. Fifty-two had more than 10 years of professional experience and only 9% had less than 2 years of experience. Forty percent had been previously involved in a donation request and 27.5% had been taking part in a meeting on transplantation. Mean knowledge score (see Table 1 for specific knowledge) increased significantly from 3.15 before to 4.36 after the seminar (P < .OOl). If only 25% of the participants knew that ,a donor can be older than 60, 57% of them knew it after. A positive attitude with regard to the donation process was high before (4.31) and improved slightly after EDHEP (4.44). A negative attitude decreased from 1.98 to 1.73
Table 1.
Brain death Legal aspects Religious aspects
Protocols Family approach
Before
Aft@
P Value
3.68 3.12 3.11 2.78 3.12
4.62 4.46 4.29 4.19 4.27
,001 ,001 ,001 ,001 ,001
(P < .OOl). Participants disagreed more after the workshop with the following attitudes: organ donation is not respectful of the body (from 1.98 to 1.73), organ donation hurts the family (from 2.14 to 1.72), or organ donation may endanger the life of the potential donor (1.72 to 1.31, P < .OOl). No difference in knowledge or attitude was found in gender, hospital origin, disciplines, or length of experienc.
DISCUSSION
The rate of organ donation in Israel is still low (below 9 per million population), with a family refusal rate of about 50% for the last 5 years. It has been suggested that there may be three to four as many potential donors than those actually reported. Health professionals are the “gatekeepers” for organ donations. The aim of EDHEP workshops was to increase the sense of comfort and security in doctors and nurses when approaching relatives with the donation request.’ The additional aim of the Israeli version was to increase knowledge in the brain death concept, legal and religious aspects as well as to increase motivation. Our study showed that a short education program significantly increases knowledge, mainly in brain death concept and in referral protocols. A significant decrease in negative attitudes was also observed. However, this program did not improve the rate of donation in our country, suggesting that
From the Education and Information Unit, Israel Transplant, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel. Address reprint requests to P. Singer, Education and Information Unit, Israel Transplant, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
0041-1345/97/$17.00 PII SO041 -1345(97)00892-O
0 1997 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010
3244
Transplantation
Proceedings,
29, 3244-3245
(1997)
3245
A-ITITUDE TOWARD ORGAN DONATION IN ISRAEL
this workshop has to be performed together with adequate strategies at the hospital level. CONCLUSION
The short-term effects of the Israeli version of the EDHEP resulted in a significant improvement in the knowledge of
health professionals. The implications tion process remain to be studied.
for the organ dona-
REFERENCES
1. Van Dalen J, Blok GA, Kranenburg J, et al: Transplant Proc 28:398, 1996
Improving Attitude and Knowledge of Healthcare Professionals Towards Organ Donation in Israel: Results of 12 European Donor Hospital Education Programs P. Singer and R. Rachmani
T
HE European Donor Hospital Education Program (EDHEP) has been implemented in Israel since 1993 to increase motivation and knowledge of health professionals. This 2-day seminar includes lectures on brain death, legal and religious aspects, protocols in Israel, and approach to the family. To evaluate the impact of EDHEP, the participants of 12 seminars were asked to answer a questionnaire assessing their knowledge on organ donation and sense of comfort and security in approaching bereaved relatives with the donation request.
MATERIALS AND METHOD Two hundred and four medical doctors, nurses, and social workers attended 12 seminars. These EDHEP seminars included a brain death workshop, a conference on the legal and religious aspects of organ donation, vignettes, a video dealing with sudden death, an interview of a family member after donation, and skill practices using professional actors. The 204 health professionals answered questions before and after the seminars evaluating knowledge (score 1, no knowledge, to score 5, knows everything). Fourteen questions screened their attitudes regarding the transplantation process (disagree: 1 to agree completely: 5). Student’s t-test and Pearson’s correlation test were used for statistical analysis.
RESULTS
One hundred thirty two nurses, 57 physicians, and 15 social workers attended the seminars. Fifty-two had more than 10 years of professional experience and only 9% had less than 2 years of experience. Forty percent had been previously involved in a donation request and 27.5% had been taking part in a meeting on transplantation. Mean knowledge score (see Table 1 for specific knowledge) increased significantly from 3.15 before to 4.36 after the seminar (P < .OOl). If only 25% of the participants knew that ,a donor can be older than 60, 57% of them knew it after. A positive attitude with regard to the donation process was high before (4.31) and improved slightly after EDHEP (4.44). A negative attitude decreased from 1.98 to 1.73
Table 1.
Brain death Legal aspects Religious aspects
Protocols Family approach
Before
Aft@
P Value
3.68 3.12 3.11 2.78 3.12
4.62 4.46 4.29 4.19 4.27
,001 ,001 ,001 ,001 ,001
(P < .OOl). Participants disagreed more after the workshop with the following attitudes: organ donation is not respectful of the body (from 1.98 to 1.73), organ donation hurts the family (from 2.14 to 1.72), or organ donation may endanger the life of the potential donor (1.72 to 1.31, P < .OOl). No difference in knowledge or attitude was found in gender, hospital origin, disciplines, or length of experienc.
DISCUSSION
The rate of organ donation in Israel is still low (below 9 per million population), with a family refusal rate of about 50% for the last 5 years. It has been suggested that there may be three to four as many potential donors than those actually reported. Health professionals are the “gatekeepers” for organ donations. The aim of EDHEP workshops was to increase the sense of comfort and security in doctors and nurses when approaching relatives with the donation request.’ The additional aim of the Israeli version was to increase knowledge in the brain death concept, legal and religious aspects as well as to increase motivation. Our study showed that a short education program significantly increases knowledge, mainly in brain death concept and in referral protocols. A significant decrease in negative attitudes was also observed. However, this program did not improve the rate of donation in our country, suggesting that
From the Education and Information Unit, Israel Transplant, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel. Address reprint requests to P. Singer, Education and Information Unit, Israel Transplant, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
0041-1345/97/$17.00 PII SO041 -1345(97)00892-O
0 1997 by Elsevier Science Inc. 655 Avenue of the Americas, New York, NY 10010
3244
Transplantation
Proceedings,
29, 3244-3245
(1997)
3245
A-ITITUDE TOWARD ORGAN DONATION IN ISRAEL
this workshop has to be performed together with adequate strategies at the hospital level. CONCLUSION
The short-term effects of the Israeli version of the EDHEP resulted in a significant improvement in the knowledge of
health professionals. The implications tion process remain to be studied.
for the organ dona-
REFERENCES
1. Van Dalen J, Blok GA, Kranenburg J, et al: Transplant Proc 28:398, 1996