Requesting Organ Donation: The Case of Self-Efficacy ? Effects of the European Donor Hospital Education Programme (EDHEP)

Abstract

One of the major reasons for the shortage of donor organs is the high number of refusals by relatives. Studies have shown that the quality of communication with bereaved relatives influences whether to object or agree to organ and/or tissue donation. Breaking news of brain stem death, approaching relatives for permission to donate organs while also appropriately managing emotional reactions of relatives are complex tasks, which require knowledge of the domains as well as adequate skills to communicate information and understanding. In this study the effect of the European Donor Hospital Education Programme (EDHEP) on the self-efficacy of Intensive Care staff is evaluated. Self-efficacy scores significantly improved after attending EDHEP; an effect that was maintained at six month follow-up. EDHEP participants with high baseline scores on self-efficacy, maintained the increase at follow-up. EDHEP participants with low baseline scores on self-efficacy showed the greatest increase at the post-test. Increases in self-efficacy were significantly related to decreases in the perceived difficulty of requesting. Experience had a significant effect on both self-efficacy beliefs and perceived difficulty of requesting donation. As self-efficacy beliefs are perceived as better predictors for future behaviour than prior attainments, the results call for further research in this domain. The data indicate that training programmes should be tailored not only to working circumstances of participants, but should also take levels of experience and self-efficacy into account. Further study is necessary and the best way to proceed is to relate the outcomes of this study to behavioural outcomes.

Development and validation of a self-efficacy scale for clinical decision-making in general paediatrics

“…Due to the absence of literature on which to base the GPedsSE item generation, expert opinion was sought. This approach has been used previously in related studies to determine or validate the content of task-specific self-efficacy tools (15,17,18). The principal BaCkGRound: Success in a task is not only related to skill, but it is also related to 'self-efficacy', or belief in one's capability to perform that task.…”

Intensive care nurses’ perceptions of their professional competence in the organ donor process: a national survey

“…Health professionals trained in donor acquisition seemed to be more confident when the question of donation was approached (Morton et al 2000, Blok et al 2004, Dodd-McCue et al 2005 and knowledge in this area appeared to be beneficial for organ donation and transplan-tation (Sque et al 2000). Sque et al (2000) also found that nurses' participation in different aspects of organ donation and transplantation was associated with positive attitudes.…”

“…Health professionals trained in donor acquisition seemed to be more confident when the question of donation was approached (Morton et al. 2000, Blok et al. 2004, Dodd‐McCue et al.…”

The European experience

“…The European Donor Hospital Education Program (EDHEP), a Eurotransplant initiative launched in 1991, was designed to meet the training needs of medical and nursing Critical Care (CC) staff in breaking bad news, caring for the bereaved and requesting donation [33]. EDHEP aims at improving the communication with donor relatives regarding death and donation by providing insight in the grieving process and relatives’ emotional reactions related to the donation procedure [34]. The EDHEP Workshop “The grief response and donation request” has been organized hundreds of times and attended by several thousands of CC staff in Europe and beyond.…”