European Donor Hospital Education Programme Research Articles

Training for Doctors and Nurses to Deal With Bereaved Relatives After a Sudden Death: Evaluation of the European Donor Hospital Education Programme (EDHEP) in Germany

The sudden death of a person is one of the most extreme and painful experiences for the relatives, and doctors require special communication skills to deal adequately with the bereaved. The Dutch European Donor Hospital Education Programme was developed to train doctors and nurses in talking to the bereaved relatives and to make the donation request. In Germany, the one-day workshop has been adapted to the German language, law, and clinical practice. The evaluation data of 75 workshops and experiences of 760 participants (doctors, nurses, and psychologists) are reported. The framework of, methods used, and issues dealt with in the workshop were clearly appreciated by the great majority of the participants. Criticisms and suggestions were directed mainly at the duration of the workshop. One third of the participants pleaded for a 2-day workshop, two thirds for a refresher course half a year later. The main effects reported were that two thirds of the participants rated that relatives could be helped, talked with, and cared for in a better way. The workshop participants also reported that they themselves were better able to cope with the situation and were more inclined to take on the task following the workshop. Finally, the necessities and limits of psychosocial training for doctors and their staff are discussed.

Dealing with grief and requesting donation. An international challenge. Effects of the European Donor Hospital Education Programme

Dealing with grief and requesting donation. An international challenge. Effects of the European Donor Hospital Education Programme

Staff training to deal with bereaved relatives in intensive care - conclusion of 11 years and 874 workshops of the European Donor Hospital Education Programme in Germany

Staff training to deal with bereaved relatives in intensive care - conclusion of 11 years and 874 workshops of the European Donor Hospital Education Programme in Germany

Requesting organ donation: The case of self-efficacy

One of the major reasons for the shortage of donor organs is the high number of refusals by relatives. Studies have shown that the quality of communication with bereaved relatives influences whether to object or agree to organ and/or tissue donation. Breaking news of brain stem death, approaching relatives for permission to donate organs while also appropriately managing emotional reactions of relatives are complex tasks, which require knowledge of the domains as well as adequate skills to communicate information and understanding. In this study the effect of the European Donor Hospital Education Programme (EDHEP) on the self-efficacy of Intensive Care staff is evaluated. Self-efficacy scores significantly improved after attending EDHEP; an effect that was maintained at six month follow-up. EDHEP participants with high baseline scores on self-efficacy, maintained the increase at follow-up. EDHEP participants with low baseline scores on self-efficacy showed the greatest increase at the post-test. Increases in self-efficacy were significantly related to decreases in the perceived difficulty of requesting. Experience had a significant effect on both self-efficacy beliefs and perceived difficulty of requesting donation. As self-efficacy beliefs are perceived as better predictors for future behaviour than prior attainments, the results call for further research in this domain. The data indicate that training programmes should be tailored not only to working circumstances of participants, but should also take levels of experience and self-efficacy into account. Further study is necessary and the best way to proceed is to relate the outcomes of this study to behavioural outcomes.

Requesting Organ Donation: The Case of Self-Efficacy ? Effects of the European Donor Hospital Education Programme (EDHEP)

One of the major reasons for the shortage of donor organs is the high number of refusals by relatives. Studies have shown that the quality of communication with bereaved relatives influences whether to object or agree to organ and/or tissue donation. Breaking news of brain stem death, approaching relatives for permission to donate organs while also appropriately managing emotional reactions of relatives are complex tasks, which require knowledge of the domains as well as adequate skills to communicate information and understanding. In this study the effect of the European Donor Hospital Education Programme (EDHEP) on the self-efficacy of Intensive Care staff is evaluated. Self-efficacy scores significantly improved after attending EDHEP; an effect that was maintained at six month follow-up. EDHEP participants with high baseline scores on self-efficacy, maintained the increase at follow-up. EDHEP participants with low baseline scores on self-efficacy showed the greatest increase at the post-test. Increases in self-efficacy were significantly related to decreases in the perceived difficulty of requesting. Experience had a significant effect on both self-efficacy beliefs and perceived difficulty of requesting donation. As self-efficacy beliefs are perceived as better predictors for future behaviour than prior attainments, the results call for further research in this domain. The data indicate that training programmes should be tailored not only to working circumstances of participants, but should also take levels of experience and self-efficacy into account. Further study is necessary and the best way to proceed is to relate the outcomes of this study to behavioural outcomes.

The European Donor Hospital Education Programme (EDHEP): enhancing communication skills with bereaved relatives.

Intensive care medical and nursing staff self-rate their communication skills as improved following attendance at the European Donor Hospital Education Programme (EDHEP) workshop. A prospective study was conducted to determine what impact EDHEP has on communication skills. Doctor-nurse pairs from 10 experimental and 10 control Intensive Care Units undertook two standardized simulated relative encounters (Breaking Bad News and Donation Request) at three measurement points (pre, post and follow-up). Nurses showed no change in communication skills. Experimental group doctors showed significant improvement in breaking bad news and requesting donation; most of these improvements were not maintained. Control group doctors showed some improvement in breaking bad news, indicating that participating in measurement by itself initiates some transient change in communication skills. Attendance at EDHEP does lead to significant improvement in some, but not all, communication skills essential in breaking bad news and requesting donation. Further research is necessary to determine what factors additional to EDHEP will contribute to enduring change in these particular skills.

A European perspective on organ procurement: breaking down the barriers to organ donation.

A worldwide shortage of donor organs has led to the development of national and international systems for organ procurement and allocation. Such systems promote organ donation and ensure fair distribution of available donor organs through a combination of legislation, organ exchange organizations (OEOs), transplant coordinators, publicity campaigns, donor cards, and professional training programs. The development of national and international OEOs is central to this process because they maintain waiting lists and allocate organs in the most appropriate way. Most countries also employ transplant coordinators whose role involves promoting links between transplant centers and intensive care units, establishing protocols for organ donation, and helping hospital staff deal with the sensitive issues involved in organ donation. Educational initiatives, such as the European Donor Hospital Education Programme developed by Eurotransplant is now used in over 30 countries worldwide. The program aims to improve professionals' understanding of the legal and ethical issues involved in transplantation, to help them communicate effectively and sympathetically with bereaved families, and to increase organ donation rates. Other initiatives include programs such as the Donor Action Programme, which was set up by professional organizations in the US and Europe aiming to help hospitals establish tailor-made organ procurement policies to ensure that all potential donors can be identified and reported and the needs of unfortunate families can be met in a caring and sensitive manner.

Participants' judgements of the European Donor Hospital Education Programme (EDHEP): an international comparison.

The European Donor Hospital Education Programme (EDHEP) is a one-day workshop, aimed at providing guidelines for breaking the news of the death of a relative and for raising the issue of organ donation with bereaved relatives. Participants' judgements of the workshop in the Netherlands and in the United Kingdom were compared to determine whether EDHEP meets doctors' and nurses' training needs in breaking bad news and requesting organ donation. In both countries EDHEP appears to be greatly appreciated by intensive care medical and nursing staff; the judgements are more positive in the United Kingdom than in the Netherlands. It seems that, irrespective of their professional experience, intensive care staff consider EDHEP a valuable teaching programme that increases confidence in communicating with bereaved relatives about death and organ donation.

The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation.

The competence of critical care staff when it comes to death and organ donation can make the difference between a family's agreeing to or refusing the latter. Doctors and nurses often feel uncomfortable approaching relatives about donation and attribute this to a lack of training. Bereaved relatives express dissatisfaction with inappropriate communication and support when brain death is announced and thereafter when a request for donation is made. The European Donor Hospital Education Programme (EDHEP) was designed to meet the training needs of critical care staff in breaking bad news, caring for the bereaved, and requesting donation. EDHEP is a two-part educational package consisting of a presentation about the donor shortage followed by a one-day workshop. The implementation of EDHEP throughout the world has been facilitated through effective national working groups and standardised "train the trainer" courses. Several countries anecdotally report increases in donation following implementation. Controlled evaluation of the effect(s) of EDHEP, which started at the end of 1995, focuses on the satisfaction of the participants with EDHEP, on the competence of the participants in breaking bad news and requesting donation, on the teamwork regarding death and donation, on the satisfaction of bereaved relatives, and on organ donation rates.

The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation

The competence of critical care staff when it comes to death and organ donation can make the difference between a family's agreeing to or refusing the latter. Doctors and nurses often feel uncomfortable approaching relatives about donation and attribute this to a lack of training. Bereaved relatives express dissatisfaction with inappropriate communication and support when brain death is announced and thereafter when a request for donation is made. The European Donor Hospital Education Programme (EDHEP) was designed to meet the training needs of critical care staff in breaking bad news, caring for the bereaved, and requesting donation. EDHEP is a two-part educational package consisting of a presentation about the donor shortage followed by a one-day workshop. The implementation of EDHEP throughout the world has been facilitated through effective national working groups and standardised “train the trainer” courses. Several countries anecdotally report increases in donation following implementation. Controlled evaluation of the effects) of EDHEP, which started at the end of 1995, focuses on the satisfaction of the participants with EDHEP, on the competence of the participants in breaking bad news and requesting donation, on the teamwork regarding death and donation, on the satisfaction of bereaved relatives, and on organ donation rates.

Participants' judgements of the European Donor Hospital Education Programme (EDHEP): an international comparison

Participants' judgements of the European Donor Hospital Education Programme (EDHEP): an international comparison

Supporting the bereaved relative: reflections on the actor's experience.

For several months 1 and a team of fellow performers were involved, as simulated bereaved relatives, with a research project based in hospitals in the north-west of England. The project, the European Donor Hospital Education Programme, EDHEP (UK), was set up in order to provide a research input into the already established EDHEP in Europe. The programme is designed to develop communication and interpersonal skills among health care workers in Intensive Care/Therapy Units, especially in the breaking of bad news of death to near relatives and in asking consent for the removal of tissues and/or organs for transplantation. The associated research was initiated by an international grouping of clinical psychologists with the purpose of assessing the efficacy of the training schedule Results are expected soon from the main body of research, some aspects of which provide analytical data drawn from encounters between health care professionals and actors as simulated relatives. Here, however, the experiences and feelings of the 'relatives' themselves are described, discussed and reflected upon.

European Donor Hospital Education Programme (EDHW)—Effects on the competence of intensive care doctors and nurses

The health of women involves their emotional, social, cultural, spiritual and physical well-being and is influenced by social, political and economic factors, as well as by a woman's biology. This definition of women's health provides the conceptual framework for a relevant and effective approach to patient education, health promotion and disease prevention activities in women. Such activities must focus not only on diseases that are more common, more prevalent or more serious in women, but also on priority health issues identified by women themselves, the diversity of women, the determinants of health and above all, the impact of gender on health. These programs must also be based on knowledge resulting from gender sensitive, bias-free health research. The traditional oppression and disempowerment of women must also be addressed at both personal and societal levels, thus broadening our approach so that we become social as well as health activists.