Is there an association between consent rates in Swiss hospitals and critical care staffs' attitudes towards organ donation, their knowledge and confidence in the donation process?

This study investigated the critical care staff’s attitude, knowledge and involvement with donation, skills and confidence with donation-related tasks and their association with consent rates at the hospital level. In 2015, we conducted a cross-sectional survey among critical care staff of hospitals involved in organ donation using an anonymous online questionnaire with a response rate of 56.4% (n = 2799). The hospital level consent rate was obtained from the Swiss Monitoring of Potential Donors database (2013–2015). For each hospital, we calculated a mean score for each predictor of interest of the Hospital Attitude Survey and investigated the association with hospital consent rates with generalized linear mixed-effect models. In univariable analysis, one score point increase in doctors' confidence resulted in a 66% (95% CI: 45%–80%) reduction in the odds to consent, and one score point increase in nurses' attitudes resulted in a 223% (95% CI: 84%–472%) increase in the odds to consent. After simultaneously adjusting for all major predictors found in the crude models, only levels of education of medical and nursing staff remained as significant predictors for hospital consent rates. In Switzerland, efforts are needed to increase consent rates for organ donation and should concentrate on continuous support as well as specific training of the hospital staff involved in the donation process.

本研究旨在探讨重症监护医护人员对器官捐献的态度、认知与参与度，以及其完成捐献相关任务的技能与信心，并分析上述因素与医院层面器官捐献同意率的关联。2015年，我们针对参与器官捐献工作的医院重症监护医护人员开展了一项横断面调查，采用匿名在线问卷形式，最终应答率为56.4%（n=2799）。医院层面的捐献同意率数据取自2013-2015年的瑞士潜在捐献者监测数据库（Swiss Monitoring of Potential Donors）。我们针对医院态度调查问卷（Hospital Attitude Survey）中各关注预测因子，为每家医院计算了平均得分，并采用广义线性混合效应模型（generalized linear mixed-effect models）分析其与医院捐献同意率的关联。单变量分析结果显示，医师信心每提升1个得分点，捐献同意比值比降低66%（95%置信区间：45%~80%）；而护士态度每提升1个得分点，捐献同意比值比升高223%（95%置信区间：84%~472%）。在对粗模型中检出的所有主要预测因子进行同时校正后，仅医护人员的学历水平仍为医院捐献同意率的显著预测因子。在瑞士，仍需采取措施提升器官捐献同意率，相关工作应聚焦于为参与捐献流程的医院医护人员提供持续支持与针对性培训。