title: Attitudes of intensive care nurses towards brain death and organ transplantation: instrument development and testing.
abstract: OBJECTIVE
  This paper reports the development and testing of an instrument assessing attitudes of Korean intensive care unit nurses.
  
  
  BACKGROUND
  Reluctance by healthcare professionals to identify brain-dead patients as a potential donor is one reason for a shortfall in transplantable organs in all countries. Organ donation from brain-dead patients is a particularly contentious issue in Korea, following recent legal recognition of brain death within the cultural context of Confucian beliefs.
  
  
  METHODS
  A 38-item instrument was developed from the literature and key informant interviews, and validated by an expert panel and a pilot study. A survey was conducted with Korean intensive care unit nurses (n = 520) from October 2003 to January 2004. Principal component analysis with varimax rotation was used to determine construct validity. Item-to-total correlations and Cronbach's coefficient alpha were used to determine the scale's internal consistency and unidimensionality.
  
  
  RESULTS
  The scale demonstrated high internal consistency (alpha = 0.88). Principal component analysis yielded a four-component structure: Discomfort, Enhancing quality of life, Willingness to be a donor and Rewarding experience. Overall, Korean intensive care unit nurses showed positive attitudes towards organ transplantation, despite some mixed feelings.
  
  
  CONCLUSIONS
  The attitude scale was reliable and valid for this cohort. Areas were identified where professional development may enhance positive attitudes towards organ transplantation from brain-dead donors. Effective education for intensive care unit nurses is necessary to increase the organ donor pool in Korea. Further research could test the instrument with other populations.
authors.affiliation: Ansan College, Ansan City, Gyeonggi, South Korea. terripox@hanmail.net
authors.forename: Jung Ran
authors.initials: JR
authors.lastname: Kim
authors.forename: Murray John
authors.initials: MJ
authors.lastname: Fisher
authors.forename: Doug
authors.initials: D
authors.lastname: Elliott
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001926:Brain Death; D003422:Critical Care; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D006801:Humans; D007723:Korea; D009741:Nursing Staff, Hospital / Q000523:psychology*; D016377:Organ Transplantation / Q000523:psychology*; D025341:Principal Component Analysis / Q000379:methods; D011788:Quality of Life; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement