Introduction: The Japanese guidelines for end-of-life care in emergency and intensive care emphasize the importance of respecting patients’ last wishes. Organ donation is one of the wishes of end-of-life patients. However, the rate of confirmation of organ donation wishes in Japan is only 14%. Physicians’ stress is one of the factors contributing to this situation. Previous studies have reported that several physicians feel the burden of transplant medicine. Generally, self-efficacy is considered a stress management skill to overcome stress. To the best of our knowledge, only a few studies have reported on self-efficacy in overcoming the stress related to confirming organ donation wishes. Therefore, we investigated relationship between stress and self-efficacy to decrease the burden on physicians confirming organ donation wishes.
Method: Thirty physicians who oversaw end-of-life patients in the emergency and intensive care units at Showa Medical University Fujigaoka Hospital in Japan between June 2022 and October 2023 were included. We explained to them while obtaining their consent, that organ donation is part of end-of-life care and that confirming patients’ wishes as the last choice is the responsibility of healthcare providers. We administered a web-based questionnaire before and after the physicians explained, “Do Not Attempt Resuscitation.”
Results: No relationship was observed between stress and self-efficacy among all physicians. In the group with previous experience in confirming wishes, no relationship was noted between stress (p = 1.000) and self-efficacy (p = 0.537) among physicians who confirmed patients’ wishes and those who did not. However, in the group without previous experience in confirming wishes, physicians who confirmed patients’ wishes reported significantly less stress increase (p = 0.004) and significantly higher self-efficacy (p = 0.048).
Conclusion: The recognition that confirming patients’ wishes for organ donation is part of patient-centered end-of-life care affected physicians who confirmed such wishes for the first time. We concluded that "Feeling Comfortable" in confirming organ donation wishes leads to self-efficay enabling coexistence with stress.