The Impact of Educational Intervention on Attitude Toward Organ Donation Among Health Care Workers in Malaysia.

BACKGROUND: The attitudes of the health care workers (HCWs) are essential in influencing organ donation rate. The aim of this study was to assess the effects of an educational intervention on attitudes toward organ donation among HCWs. METHODS: A questionnaire-based interventional study was conducted with 458 HCW from 5 hospitals in Malaysia. A 26-item self-administered questionnaire was distributed online as a preintervention test. Respondents then went through website-based educational materials followed by a post-intervention questionnaire. RESULTS: A total of 345 (75.3%) respondents completed the tests. Their attitude toward organ donation was positive preintervention. After the intervention, respondents expressed an increase willingness to donate their own organs (P = .008) and their relatives' organs (P < .001) after death; were more willing to adopt organ donation as part of end-of-life care (P =.002); were more comfortable talking to relatives about organ donation (P =.001); and expressed an increase consideration to execute the action at any time (P =.001). There was increased willingness to admit to the intensive care unit for facilitating organ donation (P =.007); to employ the same resources to maintain a potential brain-dead donor (P < .001); and to support organ donation in case they or their relatives were diagnosed with end-stage organ failure (P =.008). However, there was an increase in negative attitudes regarding the association between organ donation with health care failure (P =.004) and with pain (P =.003). Positive attitude scores were higher after the intervention (P < .001). CONCLUSION: An educational website-based intervention was able to improve the attitudes of HCWs toward organ donation.

Knowledge and Perceptions on End-of-life Care among End-stage Renal Disease Patients on Hemodialysis.

The role of end-of-life care is fundamental for end-stage renal disease (ESRD) patients, who are known to have a high morbidity and mortality rate despite being on dialysis. This requires effective communication and shared decision-making. Thus, exploring patients' knowledge and perceptions is essential to improve the gaps in delivering end-of-life care. This study aimed to describe the knowledge and perceptions of end-of-life care among ESRD patients on hemodialysis (HD). This was a cross-sectional study involving 14 outpatient HD centers in Kuantan, Malaysia. Patients were recruited from March to June 2019. A validated questionnaire was delivered via interview-based surveys by the researcher or trained interviewers. The majority of the respondents had poor knowledge of the disease and end-of-life care. However, more than 70% of the respondents felt that it was important for them to be actively involved in medical decision-making, as well as being prepared and planning for death. End-of-life needs, which included management of symptoms and psychological, social, and spiritual support, were important to most respondents. Additionally, patients with higher educational backgrounds were observed to have higher scores for both knowledge and perceptions (P <0.05). The study found poor knowledge but acceptable perceptions among patients. This highlights the gaps in the current local approach in clinical practice to end-of-life care in ESRD.

Encapsulating peritoneal sclerosis associated with Burkholderia pseudomallei peritonitis.

Burkholderia pseudomallei is a known motile organism in soil. Its infection is usually described in immunocompromised patients. It inflicts serious infection with high mortality and morbidity rate. We report a rare case of an end-stage renal disease patient on regular continuous ambulatory peritoneal dialysis (PD) who developed melioidosis PD peritonitis. Within a short period of time, she developed encapsulating peritoneal sclerosis evidenced by the intraoperative findings of intraabdominal cocooning. Choice and duration of antibiotic are important for proper eradication of the organism. Early diagnosis and treatment of both conditions also may improve the prognoses.