The willingness to give: the public and the supply of transplantable organs.

We report the results of a representative random-sample telephone survey of the public's willingness to donate organs. Our goal was to identify differences within the public and target groups who might be receptive to educational efforts to increase donation. We distinguish differences in attitude and demographic characteristics in three groups: those committed to donation, those opposed, and those who might change their opinions with more specific information. While approval of donation is nearly universal, only about half of the public would donate a relative's organs when they do not know the relative's preference. Whites, higher-income individuals, and those with higher educational levels were more favorable. Those who might change their minds fall midway between those committed and those opposed, both demographically and by attitude. They include more nonwhites and more individuals with incomes less than $25,000 than members of the group committed to donation. Targeting public education messages to this group is likely to have the most success in reducing the gap between supply and demand for human organs.

Implementation issues in addictions day treatment.

Innovative treatment programs can be implemented successfully in hospitals only if key actors take on leadership responsibility for the new programs. Implementation of an innovative Addictions Day Treatment Program (ADT) for alcohol and substance abusers in a 156-bed community hospital is reported. Implementation issues for staff psychiatrists, psychologists, psychiatric nurses, and hospital administrators are the primary subject of this article. Participation of these professional groups depended on their treatment ideology, the threat they perceived the program to be to patients, the time demanded of them, whether they would be reimbursed for providing care by the program, and the changes the program introduced in provider-patient interaction. The way shared responsibility among key hospital and unit leaders made it possible to overcome resistance to the program and to develop a positive consensus about day treatment is shown.

Health professionals and hospital administrators in organ procurement: attitudes, reservations, and their resolutions.

The responses of hospital administrators, directors of nursing, intensive care unit nurses, and neurosurgeons are reported to a range of inquiries designed to measure their commitment to organ procurement and thereby identify impediments limiting their cooperation with organ procurement efforts. Descriptive and multivariate statistical techniques are used to analyze data collected from each group. We find general approval for organ procurement but serious hesitation about dealing with donor families, particularly among physicians. Physician support for donation, moreover, is the strongest predictor of other professionals, attitudes toward donation. Neurosurgeons and intensive care unit nurses who believe organ procurement is a professional responsibility have the fewest reservations about facilitating organ donation.