title: Attitudes to organ donation among Swedish ICU nurses.
abstract: OBJECTIVE
  To present data on Swedish ICU nurses' attitudes to brain death and organ donation and to test a questionnaire designed to explore these issues in terms of validity and reliability.
  
  
  BACKGROUND
  Previous studies have identified various barriers to organ donation. The single most important factor was the attitude of ICU staff.
  
  
  METHODS
  A 34-item instrument was developed to explore attitudes and experiences of organ donation.
  
  
  METHODS
  The questionnaire was sent to 50% of ICU nurses in Sweden (n = 1013) and the response rate was 69% (n = 702). The expected scale dimensionality was examined both by explorative principal component analysis and confirmatory multi-trait analysis. Scale reliability was further estimated using Cronbach's alpha. Chi-squared test was used to compare proportions between ICU specialities and Pearson correlations were calculated to investigate relationships between each of the factors verified and the single items.
  
  
  RESULTS
  The main findings were that less than half of the ICU nurses trusted clinical diagnosis of brain death without a confirmatory cerebral angiography. Twenty-five percent of the respondents indicated that mechanical ventilation was withdrawn to reduce the possible suffering of a person assumed to be clinically dead, without the issue of organ donation being raised. A total of 39% had experienced occasions when the question about organ donation was never raised with the relatives. Four factors were verified and labelled: personal attitudes to organ donation as a situation; Organisational attitudes to organ donation as a phenomenon; Environmental resources; and Personal wish to donate, which accounted for 70% of the variance.
  
  
  CONCLUSIONS
  Swedish ICU nurses reported several barriers to organ donation. An action plan including education in brain death diagnostics, interpersonal relationships and interaction with relatives as well as regular follow-up regarding donation issues in various ICU settings would be useful.
  
  
  CONCLUSIONS
  All nurses working in ICUs are obliged to participate in organ donation and are therefore included in these results.
authors.affiliation: The Unit for Organ and Tissue Donation, Sahlgrenska University Hospital, Gothenburg, Sweden. anne.floden@vgregion.se
authors.forename: Anne
authors.initials: A
authors.lastname: Flodén
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Persson
authors.forename: Magnus
authors.initials: M
authors.lastname: Rizell
authors.forename: Margareta
authors.initials: M
authors.lastname: Sanner
authors.forename: Anna
authors.initials: A
authors.lastname: Forsberg
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007362:Intensive Care Units; D009741:Nursing Staff, Hospital / Q000523:psychology*; D013548:Sweden; D014019:Tissue Donors / Q000523:psychology*; D000078329:Workforce