Psychological impact on nurses facilitating end-of-life care decisions, including organ donation, in emergency and intensive care settings
Mayumi Kumazawa1,2, Satoko Abe2, Eiichi Geshi3.
1Showa Medical University Fujigaoka Hospital, Yokohama, Kanagawa, Japan; 2Graduate School of Health Sciences, Showa Medical University, Yokohama, Kanagawa, Japan; 3Office of Institutional Research, Showa Medical University, Tokyo, Japan
Introduction: Several patients admitted to emergency departments experience life-threatening conditions, and their families experience critical situations. They were required to make decisions regarding end-of-life care, including resuscitation and organ donation, further exacerbating confusion. Previous studies have reported that nurses supporting proxy decision-making also encounter difficulties. Additionally, several nurses experience the burden of transplant medicine and require additional support. However, facilitating proxy decision-making, particularly regarding end-of-life care, including organ donation, is a distinctive and potentially rewarding aspect of emergency nursing care. Therefore, we elucidated the relationship between nurses’ conflicting experiences, including both challenges and rewarding aspects.
Method: A web-based questionnaire was conducted on 29 nurses employed in the emergency department of a university hospital. The survey assessed basic characteristics (age, gender, and nursing experience), whether they have received grief care education and participation in informed consent regarding resuscitation procedures, standardized response scales, and self-efficacy scales. We performed statistical analyses, including descriptive statistics for each variable. Spearman’s rank correlation coefficient and independent t-tests were used, depending on data characteristics.
Results: Twenty-eight nurses completed the questionnaire (response rate: 96.6%). Experience with grief care education was significantly associated with reduced stress responses (p < 0.001), while participation in informed consent showed a significant association with higher self-efficacy (p = 0.002). However, no significant correlation was observed between stress response and self-efficacy (p = 0.467).
Conclusion: We concluded that grief care education may reduce stress levels among emergency nurses, and that participation in informed consent processes could enhance self-efficacy by facilitating shared decision-making with families in crisis.