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Table 3 Experiences of ICU healthcare professionals during the three stages of the process of the WLST process

From: Tensions between end-of-life care and organ donation in controlled donation after circulatory death: ICU healthcare professionals experiences

 

Physician n = 79

Nurses n = 127

OD(-)

n = 24

OD( +)

n = 55

OD(-)

n = 37

OD( +)

n = 90

Stage 1. WLST decision-making process

 Factors influencing the decision: from 0 to 10

  Bad prognosis and no treatment plan

10 (9–10)

10 (9–10)

9 (8–10)

10 (8–10)

  Patient’s wishes

6 (5–8)

7 (1–9)

8 (5–9)

5 (2–9)

  Wishes of relatives

6 (3–8)

7 (2–9)

7 (3–9)

8 (5–9)

  Possibility of organ donation

1 (0–2)

0 (0–5)

6 (2–9)

8 (3–9)

 Those who most influenced the decision

  The medical staff

9 (9–10)

8 (8–10)

9 (7–10)

9 (7–10)

  The nursing team

5 (5–8)

5 (3–8)

5 (3–7)

5 (2–7)

  The relatives

6 (3–8)

6 (5–8)

5 (3–9)

8 (3–9)

  The Organ Procurement Organization’s team

0 (0–1)

0 (0–1)

5 (1–8)

5 (0–7)

Stage 2. Period between the WLST decision and its actual implementation

 The length of this period was motivated by

  Psychological support for relatives

8 (6–9)

7 (1–8)

8 (2–10)

7 (5–10)

  Relatives’ availability and/or wishes

8 (6–9)

7 (1–9)

9 (5–10)

8 (5–10)

  Research for medical unsuitability

4 (1–7)

5 (1–7)

5 (0–9)

7 (2–10)

  Logistical issues

1 (0–5)

7 (3–9)*

1 (0–5)

4 (0–9)*

  Legal issues

1 (0–6)

1 (0–5)

0 (0–3)

1 (0–5)

  Purpose of this period: from end-of-life support (0) to organ donation (10)

1 (0–4)

5 (4–7)*

0 (0–1)

9 (5–10)*

Stage 3. Dying and death process

 I felt I changed my usual end-of-life care practices from No (0) to Yes (10)

-

2 (0–8)

-

0 (0–5)

 Purpose of the WLST implementation was: from end-of-life support (0) to organ donation (10)

-

5 (1–9)

-

9 (5–10)

  1. Numbers are median and IQR. All data range from 0 to 10
  2. WLST Withdrawal of Life Sustaining Therapies, OD Organ Donation, OD(-) WLST after OD had already been excluded, OD( +)WLST while OD is still under consideration
  3. *:p < 0.05