The Effect of Psychological Support for the Relatives of Intensive Care Unit Patients on Cadaveric Organ Donation Rate.
Adanir T, Erdogan I, et al.Transplantation Proceedings 2014; 46(10): 3249-3252.
Aims
To determine whether psychological support for relatives of brain-dead patients in the intensive care unit (ICU) helps them decide to consent to organ donation.
Interventions
The interview group attended interviews every 2 days with a psychologist if they wanted to. Interviews were therapeutic in nature and were conducted according to the relatives’ psychosocial needs determining the subject of the interview. Topics discussed were the problems of daily life and changes to quality-of-life. The diverse psychological problems of the relatives of the patients included feelings of worry, grief, helplessness, and disorders of sleep and concentration. The effects of the relatives’ present circumstances were discussed in an effort to strengthen their coping strategies.
Participants
First degree relatives of 200 general ICU patients.
Outcomes
Consent rate of organ donation.
Follow-up
Not reported.
CET Conclusions
This paper reports the results of a pseudorandomised trial of psychological support for relatives in intensive-care patients, in an attempt to assess the impact of psychological support on willingness for organ donation. Participants were assigned to unstructured interviews by a psychologist for general support during their relative’s stay or not by bed number. They were then asked, either at the point of discharge or death of their relative, whether they would have accepted organ donation if possible. Psychological interview appeared to have a significant impact on those relatives supporting organ donation, whether their relative was discharged or died. Aside from the poor allocation concealment due to the method of randomisation, there are a number of methodological issues. Psychological interviews were unstructured and no formal psychological testing was performed pre- or post- interview, which means that the components of the interview that had the positive impact are hard to determine and the intervention would be difficult to replicate in another setting. Agreement to donate was only theoretical, rather than actual donation rates, and many of the patients may have been unsuitable as organ donors. The lack of baseline psychological assessment makes it difficult to determine whether the groups were comparable.
Data analysis
Per protocol analysis
Trial registration
Not reported.