UBC Graduate Research

Nurses' intentions and behaviors regarding organ donation : a scoping review Butler, Heidi Elizabeth


BACKGROUND: Solid organ transplant can drastically improve quality of life and extend life expectancy. In Canada and around the world, the demand for organs well exceeds the available supply. Nurses in critical care areas play an important role in identifying and managing donors. Efforts have been made to improve donation rates in Canada, however, recent reviews of donor potential have revealed many missed opportunities linked to healthcare provider behaviours. AIMS: The Theory of Planned Behaviour (TPB) has been utilized to help explain and improve various health behaviours. A scoping review of the literature guided by the TPB was conducted exploring nurses’ attitudes, perceived behavioural control and social norms around donation. Applying the TPB model, I considered how these factors may influence nurses’ willingness to identify potential donors, speak with families and participate in donor management. SEARCH STRATEGY: Two databases CINAHL and PubMed were searched to identify 17 relevant articles included in the scoping review. Studies included were focused on nurses and organ donation, and at least one element of the TPB: attitudes, knowledge/perceived behavioural control and/or social norms in relation to organ donation. FINDINGS: The scoping review revealed nurses had mostly positive attitudes towards organ donation. However, the nurses in the studies reviewed felt they lacked knowledge around the concept of brain death, donor legality and the donor process. Nurses also lacked confidence and skills in initiating conversations regarding donation with families. They also recognized a need for more and continued education regarding organ donation. Nurses in one of the studies perceived there to be a lack of organizational structures and guidelines in place to help support donation. CONCLUSION: Applying the TPB model to the findings, one can infer that nurses’ attitudes, perceived behavioural control and social norms related to organ donation affect their intentions and behaviours of referring potential donors and approaching families. Addressing the barriers that exist for nurses participating in the donation process should be examined in order to maximize the capacity of nurses working in critical care areas. RELEVANCE TO NURSING PRACTICE: Nurses are seen as an essential link in organ procurement and play an important role in addressing the organ shortage in Canada by simply identifying potential donors and supporting families through the process. Incorporating more and frequent education and training in hospital and in classroom could help to improve nurses’ capacity to participate in the organ donor process, address negative attitudes and unpack ethically challenging or morally distressing cases.

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