Knowledge of the brain death concept by personnel in Spanish and Latin-American healthcare centers.

BACKGROUND: The knowledge and acceptance of the concept of brain death (BD) among health care personnel is fundamental. OBJECTIVE: To analyze the level of understanding of the BD concept among personnel in Spanish and Latin American healthcare centers and to determine the factors affecting this attitude. MATERIAL AND METHODS: Data from 12 hospitals and 32 primary care centers in 4 countries within the International Collaborative Donor Project were selected (Spain, Mexico, Cuba and Costa Rica (n=4378)). RESULTS: 62% of the personnel (n=2714) understood BD and believed that this was the death of an individual. Of the rest, 30% (n=1333) did not understand it and the remaining 8% (n=331) believed it did not mean the death of a patient. 83% (n=931) of physicians understood BD, compared to 75% (n=895) of nurses, 55% (n=299) of healthcare assistants, 53% (n=108) of non-healthcare university-educated personnel and 36% (n=481) of those without a university education (p<0.001). 68% (n=1084) of Mexicans understood BD compared to 66% (n=134) of Cubans, 58% (n=1411) of Spaniards, and 52% (n=85) (p<0.001) of Costa Ricans. There were significant relationships between knowledge of the concept and the following: type of healthcare center (p<0.001), clinical service (p<0.001), having spoken about organ donation within the family (p<0.001) and one's partner's attitude to the subject (p<0.001). A direct relationship has been found between understanding the concept and attitude toward deceased donation (p<0.001). CONCLUSIONS: The understanding of BD by personnel from healthcare centers was not as good as expected. There were marked differences depending on job category.

Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers.

INTRODUCTION: Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation. OBJECTIVE: To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude. MATERIAL AND METHOD: Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered. STATISTICAL ANALYSIS: Student's t-test, the χ2 test and logistic regression analysis. RESULTS: Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n=2,191) were in favor of deceased organ donation. According to country, 94% (n=189) of Cubans were in favor, compared to 82% (n=1,313) of the Mexicans, 73% (n=121) of the Costa Ricans and 69% (n=568) of the Spanish (P<.001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P<.001); 2) being a physician (OR= 2.544; P<.001); 3) performing a job related to transplantation (OR = 1.610; P=.005); 4) having discussed the subject of donation and transplantation within the family (OR= 3.690; P<.001); 5) having a partner with a favorable attitude toward donation and transplantation (OR= 3.289; P<.001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR= 3.021; P=.001); 7) not being concerned about the possible mutilation of the body after donation (OR= 2.994; P<.001); 8) the preference for other options apart from burial for treating the body after death (OR= 2.770; P<.001); and 9) acceptance of carrying out an autopsy if one were needed (OR= 2.808; P<.001). CONCLUSIONS: Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors.

Level of awareness of personnel in hospital services related to the donation process: A Spanish and Latin American multicenter study.

BACKGROUND: Services related to the donation and transplantation process are fundamental for developing solid organ transplantation and procuring organs from deceased donors. This study was conducted to analyze the attitude toward deceased organ donation among hospital personnel working in donation- and transplantation-related services in hospitals in Spain and Latin America. METHODS: Nine hospital centers within the "International Donor Collaborative Project" were selected (Spain, Mexico, Cuba, and Costa Rica). A random employee sample was taken and stratified according to the type of service and job category in transplant-related hospital services. RESULTS: Of the 925 employees surveyed, 78% were in favor of donation. By job category, attitude was more favorable among physicians (89%; p < 0.001). By type of service, attitude was more positive among personnel in transplant patient follow-up units (87%; p = 0.018). By country, the Cubans were most in favor (91%), followed by the Mexicans (81%), the Costa Ricans (77%), and the Spanish (70%; p < 0.001). Other factors were age (p < 0.001), sex (p = 0.005), considering the possibility of needing a transplant (p = 0.002), understanding the concept of brain death (p < 0.001), being in favor of living donation (p < 0.001), having discussed the subject of donation and transplantation within the family and the partner (p < 0.001), carrying out pro-social activities (p = 0.002), and concern about mutilation after donation (p = 0.002). CONCLUSIONS: Transplant-related personnel had a favorable attitude toward deceased donation, although it was not as positive as we would expect, especially among non-physicians. This attitude needs to be improved because of the negative effect that can result in organ donation. There were pronounced differences between countries, and the discordance between attitude and actual deceased donation rates in each country is notable.