Blanca Miranda

Analysis of the attitudes and motivations of the Spanish population towards organ donation after death

Starting with the relevance of the Spanish experience, this study analyses the population’s disposition towards organ donation after death by means of a representative survey of the adult Spanish population (N = 1206, estimated error ±2.87%, P < 0.05). Of the participants, 8.1% were declared donors, 59.3% were likely to donate, 14.5% were against donating and 18.1% did not know or did not respond; 87.3% would donate relative’s organs if the deceased favoured donation, 50.2% if the deceased’s wishes were unknown and 13.1% even if the deceased opposed donation. Among people who were favourable towards donation, the main motives expressed were the will to save other people’s lives, solidarity and knowing they might someday need a donation. The most important motives for not donating among participants who were against it were the fear of premature organ extraction, of premature pronouncement of death and of mutilation. Reticence to donate is associated with low socio‐economic and cultural level, advanced age and high religious commitment; it is also associated with a low perception of transplant efficacy, not directly knowing any transplanted people and the lack of qualified information. The results support diverse potentially effective strategies for promoting donation in the general population.

Donantes de órganos en España: evolución de las tasas de donación por comunidades autónomas y factores determinantes

Fundamento y objetivo El proposito del estudio ha sido analizar la evolucion de las tasas de donacion en las diferentes comunidades autonomas durante los ultimos anos y describir los factores con un mayor peso especifico en relacion con el numero de donantes. Material y metodo Se ha realizado un estudio descriptivo y retrospectivo, con datos de donacion y poblacion general, poblacion en individuos de 70 anos o mas, siniestralidad vial, numero de entrevistas para la donacion y porcentaje de respuestas negativas, en las diferentes comunidades autonomas entre 2001 y 2006. Tambien se analizo la correlacion entre los factores estudiados estratificando por ano. Para evaluar la evolucion temporal se realizo un analisis de regresion lineal para medidas repetidas. Resultados El numero de habitantes, la poblacion de 70 anos o mas y el numero de victimas mortales por accidente de trafico se correlacionaron con el numero de donantes general, de ese grupo de edad y fallecidos por esa causa, respectivamente. Estas relaciones no se cumplieron en todas las comunidades autonomas. El porcentaje de negativas no guardo relacion con el numero de entrevistas realizadas, si bien su disminucion se relaciono con un aumento de la tasa de donantes. Aunque de forma no tan constante, el aumento del porcentaje de donantes de 70 anos o mas y la disminucion del de fallecidos por accidentes de trafico se relacionaron con mayores tasas de donantes. Conclusiones La evolucion del numero de donantes sigue el crecimiento de la poblacion y el descenso del porcentaje de negativas, si bien se explica de forma diferente segun la comunidad autonoma.

Hospital attitudes: preliminary findings from donor action pilot projects

Abstract Purpose: As part of the Donor Action collaboration (Euro‐transplant Foundation, The Netherlands; Organización National de Trasplantes, Spain; and The Partnership for Organ Donation, USA), a hospital survey was administered to gather baseline data on staff attitudes about organ donation and level of self‐reported skills/confidence in performing a range of organ donation roles. Methods: A standard survey instrument was administered in two hospitals in Spain, two in The Netherlands and one in the UK. In four hospitals the survey was administered to all ICU staff; in one hospital it was administered to a random sample of hospital staff. The instrument was created in English, and translated into Spanish and Dutch for the hospitals in each country. Results: Data were analysed by country and showed consistently strong perceptions that organ donation saves lives (97%). Support for donation (95%) and willingness to donate ones own organs (82%) were high in all three country samples. Significant differences in belief were observed when respondents were asked whether they agreed that organ donation helps families with their grief. The UK respondents were more likely to agree (57%), with lower levels of agreement in Spain (47%) and The Netherlands (14%) (P < 0.0001). Average ratings of skills/confidence were highest for notifying the transplant coordinator (49%) and comforting the family (48%) with lower confidence reported regarding explaining brain death (34%), introducing organ donation (32%), and requesting organ donation (26%). Ratings varied widely across countries with UK respondents expressing the highest level of self‐reported confidence, and Spanish respondents the lowest level. For example, 77% of UK respondents reported themselves skilled/confident explaining brain death, versus 47% of Dutch respondents and 11% of Spanish respondents (P < 0.0001). Similar results were seen regarding requesting organ donation: UK 53%; The Netherlands 30%; Spain 13% (P < 0.0001). Conclusions: There has been a lack of data about hospital staff attitudes and skills to allow for comparison across national systems, and to support the targeting of specific strategies to the needs within different countries. These results show the feasibility of collecting and comparing data across national systems. These pilot findings also suggest that there may be important differences in attitudes and self‐perceived skills/confidence across countries. Work remains to correlate attitudes and self‐perceived skills to actual performance. It is noteworthy that the sense of staff preparedness was lowest in Spain which has the highest donation rates. This may reflect the degree to which role specialization in donation has been successfully integrated into hospital practice. Expansion of the survey to additional hospitals will help to answer such questions.