Looking for New Alternatives: What Nursing Students of Lodz's Medical University in Poland Think About the Use of Organs Coming From Animals?

BACKGROUND: The shortage of organs has made it necessary to look for new alternatives as xenotransplantation. The objective of this study was to analyze the attitudes of Polish nursing students toward organ donation of nonhuman origin, and to determine the factors that affect them. METHODS: Year 2011-2012. Nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate of fulfillment of 80%. Validated questionnaire (PCID-XenoTx Rios) filled out anonymously and self-administered. RESULTS: The completion rate was 81% (325/402): 55% in favor (n = 179), 7% (n = 24) against, and 38% (n = 122) do not know. There were significant associations between: 1) the academic year, with 1st-year students presenting the more favorable attitude than those in the 3rd year (68% vs 41%; P = .039); 2) discuss the topic with friends (59% vs 41%; P = .043); 3) being in favor of cadaver organ donation (64% vs 41%; P < .001); and 4) consider the option of needing a transplant in the future (63%) compared with those who do not consider this option (40%; P = .040). In multivariate analysis, the relationship with being in favor of cadaver organ donation remained (odds ratio, 2.577; 95% confidence interval, 4.081-1.631; P < .001). CONCLUSIONS: Almost one-half of the nursing students had an unfavorable attitude toward xenotransplantation.

Organ Donation: What Are the Opinions of Nursing Students at the University of Bialystok in Poland?

BACKGROUND: Nursing students, as future professionals, have an enormous impact on the opinion of the rest of the population on topics of organ donation and transplantation (ODT). The objective of this study was to analyze the attitudes of nursing students at the University of Bialystok toward ODT, and to determine the factors that affect ithemt. METHODS: Academic year 2011-2012. STUDY POPULATION: nursing students at the University of Bialystok. Type of sampling: sampling points during 5 compulsory-attendance nursing courses with >80% fulfillment. Measuring instrument: validated questionnaire (PCID-ODT Rios) filled out anonymously and self-administered. RESULTS: Completion rate of 90% (331/367): 58% (n = 191) in favor, 35% (n = 118) undecided, and 7% (n = 22) against. The most important variables were: being in the 1st year (odds ratio [OR], 4.444; 95% confidence interval [CI], 11.627-1.700; P = .002); not knowing any donor (OR, 12.048; 95% CI, 55.555-2.57; P = .018); being in favor of organ donation by a relative (OR, 6.25; 95% CI, 14.705-2.666; P < .001); discussing the topic with friends (OR, 2,785; 95% CI, 5.347-1.447; P = .002); not worried about the possible mutilation of the body after donation (OR, 3.039; 95% CI, 5.882-1.569; P = .001); favorable attitude toward ODT of mother (OR, 3.676 (0.881-1.814; P < .001); accepting other treatment options, such as inhumation (OR, 3.436; 95% CI, 7.092-1.655; P = .001); accepting autopsy after death (OR, 2.141; 95% CI, 4.065-1.126; P = .020); and professing the Catholic religion (OR, 3.436; 95% CI, 8.333-1.410; P = .007). CONCLUSIONS: More than 42% of the nursing students were not in favor of organ donation, their attitudes influenced by various psychosocial factors.

Knowledge of the Concept of Encephalic Death: Is This an Obstacle in the Acceptance of Donation and Transplantation of Organs Among Students of Nursing at the Medical University of Warsaw in Poland?

BACKGROUND: The knowledge and acceptance of the concept of brain death among future health professionals is essential. The objective of this study was to analyze the knowledge of the concept of brain death among nursing students at the Medical University of Warsaw and determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate >80%. Validated questionnaire (PCID-DTO Rios), anonymous and self-administered. RESULTS: The completion rate was 96% (793/828); 71% (n = 561) knew the concept of brain death, 22% (n = 178) did not know it, and 7% (n = 54) did not know that it implies the death of the patient. Variables related to the correct knowledge: 1) to be studying in 4th year compared with 1st year (85% vs 60%; P ≤ .001); 2) discuss the subject with family (76% vs 61%; P ≤ .001); 3) discuss with friends (73% vs 63%; P = .009); and 4) having a favorable attitude toward organ donation (74% vs 65%; P = .011). In the multivariate analysis, the variables that remained independent were studying in 4th year (odds ratio [OR], 3.809; 95% confidence interval [CI], 2.006-5.823; P ≤ .001) and discussed with family concerning donation and transplantation (OR, 1.718; 95% CI, 1.241-2.381; P ≤ .001). CONCLUSIONS: One-third of the nursing students were unfamiliar with the concept of brain death.

Donate a Piece of Liver: Is This an Option Accepted by Future Nurses of Pomeranian Medical University in Poland?

BACKGROUND: Liver transplantation from living donors (LLD) has become a viable and important source of liver grafts. The objective of this study was to analyze the attitude of nursing students at the Pomeranian Medical University in Poland on donation of live liver, and to determine the factors that affect it. METHODS: Academic year 2011-2012, nursing students at a university in Poland, sampling points in 5 compulsory-attendance nursing courses with a completion rate of 80%, validated questionnaire (PCID-DVH Rios) filled out anonymously and self-administered. RESULTS: The completion rate was 89% (227/254). Of the 227 students surveyed, 92% (n = 209) were in favor, 6% (n = 14) undecided, and 2% (n = 4) against. When the LLD is not related, 44% (n = 100) of respondents would be in favor. With a positive attitude toward this type of donation, we associated the following variables: 1) age, with the youngest showing a more favorable attitude (P = .006); 2) attitude in favor of living kidney donation (98% vs 85%; odds ratio, 4.950; 95% confidence interval, 9.259-2.652; P = .002); 3) attitude in favor of accepting a family LLD (96% vs 81%; P = .003); 4) discussing donation and transplantation with family (95% vs 87%; P = .043). CONCLUSIONS: Ninety-two percent of nursing students at the Pomeranian Medical University in Poland were in favor of live organ donation, an attitude conditioned by various psychosocial factors.

Brain Death: Is It a Misunderstood Concept Among Nursing Students in the South of Poland?

BACKGROUND: The objective of the present study was to analyze the knowledge and acceptance of the brain death (BD) concept among nursing students. METHODS: The study was undertaken in the academic year of 2011 to 2012 in nursing students from the University of the South of Poland. The sample was carried out in compulsory sessions, in the 5 years of the nursing degree study, with a completion rate of 80%. The questionnaire was validated (PCID-DTO Ríos), self-administered, and completed anonymously. RESULTS: The completion rate was 93% (492 of 530). Of the students surveyed, 75% (n = 369) knew the concept of BD and considered it to mean a person's death. Of the rest, 19% (n = 93) did not know it, and the remaining 6% (n = 30) believed that it did not mean that a person was dead. The following variables were significantly related with the correct knowledge of the BD concept: 1) age (22 ± 2 years; P ≤ .001); 2) academic year (P ≤ .001); 3) discussion with friends about organ donation and transplantation (ODT) (P = .035); 4) partner's favorable attitude toward donation and transplantation (P = .009); and 5) being Catholic (P = .031). In the multivariate analysis, the following variables persisted as independent variables related to the BD concept: a) age [OR = 1.468 (1.247-1.697); P ≤ .001] and b) partner's opinion of ODT [OR = 2.248 (1.255-4.025); P = .006]. No association was found with attitude toward ODT. CONCLUSIONS: More than 25% of the students from the Jagiellonian University of Kraków did not know or accept the concept of brain death.

What Do Future Nursing Professionals Believe About Living Donor Kidney Transplantation? An Analysis of Attitudes of Nursing Students of the Medical University of Poznan in Western Poland.

BACKGROUND: Living donor kidney transplantation (LDKT) is the best treatment option in the late stage of chronic kidney disease. The objective of the study was to analyze the attitudes of nursing students at the Medical University of Poznan toward living donation of kidney. METHODS: Sampling points were compulsory attendance in the 5 nursing courses of the degree of fulfilment of 80%. The validated questionnaire (PCID-DVR Rios) was self-administered and anonymous. RESULTS: The completion rate was 92% (324 of 354). Among the students, 91% (n = 296) were in favor of LDKT, 5% (n = 15) were undecided, and 4% (n = 11) remained is against. When the living kidney donor is not related, 57% (n = 185) of respondents were in favor. The factors that are associated with a more favourable attitude are 1) the needs of organs for transplantation are covered (P = .012); 2) attitude in favor of organ donation and transplantation (P ≤ .001); 3) attitude toward living liver donation (P = .001); 4) attitude in favor of acceptance of LDKT for a relative (P ≤ .001); 5) discussing organ donation and transplantation with friends (P = .002); and 6) attitude in favor of organ donation from a family member (P = .011). In the multivariate analysis, highlights are acceptance of the donation of a living kidney donor from a family member [OR = 9.900 (35.714-2.770); P ≤ .001] and donating a piece of liver in life [OR = 50 (166.666-14.492); P ≤.001]. CONCLUSIONS: Among the nursing students, 91% are in favor of living kidney donation.

Factors Affecting Attitude Toward Organ Donation Among Nursing Students in Warsaw, Poland.

BACKGROUND: The opinion of future nursing professionals can influence the number of transplants. The objective of this study was to analyze the attitude of nursing students at the Medical University of Warsaw in the center of Poland toward organ donation and determine the factors that affect this attitude. METHODS: The study was conducted in the 2011 to 2012 academic year. The study population consisted of nursing students. Type of sampling consisted of sampling in points of compulsory attendance, in the 5 nursing courses with the higher degree of fulfillment of 80%. Measuring instrument used was the validated questionnaire (PCID-DTO Rios). The questionnaire was completed anonymously and was self-administered. RESULTS: The completion rate was 96% (793 of 828). Of the students surveyed (n = 793), 69% (n = 547) were in favor of organ donation and transplantation, 25% (n = 201) were undecided, and 6% (n = 45) were against. This attitude was related to being in favor of donating the organs of a relative (OR = 3.174; P < .001); discussion of the subject with the family (OR = 2.188; P < .001); positive attitude toward donation and transplantation of the father (OR = 3.039; P = .001); considered to having good information on the subject (OR = 8.695; P < .001); being a regular donor blood (OR = 3.597; P = .001); not worried by the possible mutilation of the body after donation (OR = 6.802; P < .001); and accepting other treatment options of the body such as the burial (OR = 1.683; P = .015). CONCLUSIONS: More than 30% of the nursing students are not in favor of organ donation, but this attitude is conditioned by several psychosocial factors.

Opinion of Nursing Students of the University of Bydgoszcz in Poland About the Transplantation of Living Liver Donors.

INTRODUCTION: Liver transplantation from living liver donation (LLD) has become an important source of liver grafts. MATERIAL AND METHOD: We studied the 2011-2012 academic year attitude of nursing students from a university in Poland. The sampling points were compulsory attendance in the 5 nursing courses. The validated questionnaire was Project Collaborative International Donor-Living Liver Donation Rios. The questionnaire was completed anonymously and was self-administered. RESULTS: The completion rate was 89% (440 of 495); 91% (n = 398) were in favor of the related LLD, 8% (n = 37) were undecided, and 1% (n = 5) were against. When the attitude toward LLD is not related, 40% (n = 177) of respondents were in favor. The favorable attitude was associated with the following: consideration of the needs of organs for transplantations are covered (P ≤ .001); attitude in favor toward organ donation and transplantation (ODT) (P = .001); attitude in favor toward LLD (P = .007); attitude in favor of the acceptance of a LLD by a family member (P = .001); discussion of ODT with the family (P ≤ .001); being in favor of donating organs of a relative (P ≤ .001); and being Catholic (P = .003). After multivariate analysis, we observed the following significant correlations: the thought that the needs of transplantation organs are covered (odds ratio [OR] = 4.608; P = .020); being ready to accept a liver from a LLD (OR = 3.125; P = .038); discussion with the family about the subject of donation and transplantation (OR = 3.215; P = .003); and not belonging to any doctrine or religious belief (OR = 11.363; P = .039). CONCLUSIONS: In this study 91% of nursing students were in favor of living organ donation.

Attitude of Nursing Students at the University of Lublin in Poland Toward Xenotransplantation of Organs.

OBJECTIVE: Because of the shortage of organs, it has become necessary to look for alternative sources of organs, such as xenotransplantation. The aim of this study was to analyze the attitude of nursing students at a university in the Eastern Poland toward xenotransplantation, to determine factors that affect their acceptance. MATERIAL AND METHOD: During the 2011-2012 academic year, nursing students at the University of the Eastern Poland enrolled the 5 nursing courses self-administered a validated questionnaire (the PCID-XenoTx Rios) anonymously. We undertook a descriptive statistical analysis using the Student t test, χ(2) test, and logistic regression analysis. RESULTS: The completion rate was 90% (608 of 672). When asked about the acceptability of organ donation from humans, 62% (n = 379) were in favor, 9% (n = 54) against, and 29% (n = 175) undecided. We found a significant association between the acceptability of transplantation and the university course and the respondents' religion (P ≤ .05). Fourth-year students have a more favorable attitude toward xenotransplantation than third-year students (75% vs 54%; P = .018). Catholics accept this type of donation more readily than those belonging to other faith traditions (63% vs 37%; P = .053). In the multivariate analysis, academic course is a significant influence on attitude toward xenotransplantation (odds ratio, 2.421; 95% CI, 4.347-1.345; P = .003). CONCLUSIONS: Nursing students have an unfavorable attitude toward xenotransplantation. This attitude is influenced by the religious beliefs and their academic year.

Organ donation and transplantation training for future professional nurses as a health and social awareness policy.

INTRODUCTION: Training and information for university nursing students about the organ donation and transplantation process is necessary because it will influence their attitudes toward the subject. We analyzed attitudes toward organ donation among nursing students in a donation and transplantation training course and any changes in opinions as a result of the course. MATERIALS AND METHODS: We questioned 48 students in the third year of nursing (University of Murcia, Spain) who were attending a 32-hour training course about donation and transplantation. We used a descriptive concurrent study, through the completion of a validated opinion survey with 27 items before and after the training course. RESULTS: Attitudes toward donation were favorable in 87% of respondents increasing to 94% after course completion. Before starting the course, 87% believed that there were not enough transplantable organs available to cover needs compared to 96% after the course. Before the course, 46% stated that they did not have complete information about the subject. Taking part in the course has encouraged family discussion about the subject (85% to 90%) and improved knowledge about family opinions (64% to 83%; P = .031). Attitudes toward living donation did not change after the course. However, there was an improvement in knowledge of the Spanish organ distribution system. CONCLUSIONS: Attitudes toward organ donation among third-year nursing students were favorable, and increased after undergoing a course about donation and transplantation. The most important part of the course was the increase in theoretical knowledge about the matter as well as the health education.

Intervención para la disminución de las estancias inapropiadas. Un estudio de tres años en un hospital universitario. Evaluación mediante el empleo del Appropriateness Evaluation Protocol (AEP) / Intervention for lowering inappropriate stays. A 3-years study at an university hospital. Evaluation by means of the employment of the Appropriateness Evaluation Protocol (AEP)

Objetivo: Evaluación de la intervención para disminuir las estancias inapropiadas, estudiando las características de los procesos de los servicios con mayor proporción de las mismas y analizando los resultados obtenidos. Métodos: Estudio concurrente de 569 estancias distribuidas entre los años 2000 a 2002, escogidas mediante muestreo de bloques durante un día único. Se estudia la proporción de estancias inadecuadas para un conjunto de servicios con mayor impacto en la inadecuación de las estancias. Se comparan las proporciones de inadecuación entre las diferentes unidades del hospital y entre los diferentes años. Se estudian los procesos de los dos servicios más desviados y se corrigen determinados defectos en la organización y estructura de éstos. Resultados: En los servicios quirúrgicos la inadecuación global fue del 71,4 por ciento y en los médicos el 70,7 por ciento. La proporción de adecuación global de la estancia varió desde el 70,07 por ciento del año 2000 al 73,06 por ciento del año 2002. La proporción de estancias inadecuadas en los servicios donde se realiza la intervención desciende un 30 por ciento y un 75 por ciento (desde el 47,6 al 33,3 por ciento y del 42,1 al 10,5 por ciento). La causa mas frecuente de inadecuación de la estancia es encontrarse pendiente de resultados y la posibilidad de realizar determinadas pruebas como paciente externo. Conclusiones: El análisis secuencial de la utilización de recursos mediante el AEP (Appropriateness Evaluation Protocol) permite evaluar y corregir defectos organizativos y de la distribución de los recursos. La selección de determinados servicios con niveles mas altos de inadecuación permite focalizar el problema y las soluciones. En nuestro medio la causa corregible más importante fue la mala distribución del horario de algunas pruebas que provocaba estancias inapropiadas y la estancia de pacientes para realizar pruebas que podrían realizarse de forma ambulatoria (AU)

[The evaluation of the quality of so-called "clinical protocols" in primary care developed in the Autonomous Community of Murcia. The Group for the Evaluation and Improvement of Clinical Protocols]. / Evaluación de la calidad de los denominados "protocolos clínicos" de atención primaria elaborados en la Comunidad Autónoma de Murcia. Grupo de Evaluación y Mejora de los Protocolos Clínicos.

OBJECTIVE: To evaluate the quality of the design (structural) of the clinical protocols worked out in the Murcia region. DESIGN: Descriptive evaluation. Retrospective, over 8 years. SETTING: Primary health care. PARTICIPANTS: The professionals from the 31 health centres in the Murcia Region with activities covered by protocols. MEASUREMENTS AND MAIN RESULTS: The 519 documents written between January 1985 and January 1994, of which 470 were obtained and classified, were the object of the study. 11 criteria for the design quality of the protocols were worked out, based on the bibliography and a previous experiment. The inter-observer reliability of these criteria were assessed and two of them were rejected. Then the quality of the protocols design was evaluated through rates of compliance with the 9 standard and previously validated explicit criteria. 55.1% (259) of the documents fitted the accepted definition of protocol. 42.3% (199) had a recording system. 20.2% (95) had foreseen their evaluation. 41.7% (196) had some algorithm. 38.1% (179) had an anamnesis and/or examination page. 88.9% (418) were under 20 pages. Only 11.9% (56) had an index. 57.7% (271) had no formal defects of hand-writing or legibility. Only 14.7% (69) had a bibliography. Only three of the nine criteria were satisfied in over 50% of cases; three more, in under 30%. Overall, the clinical protocols had 2488 defects, with an average per protocol of 5.29. CONCLUSIONS: The formal quality of the primary care clinical protocols worked out in the Autonomous Community of Murcia is very low. Corrective measures to improve this situation should be taken.