Knowledge of the Brain Death Concept by Personnel in Spanish and Latin-American Healthcare Centers

Abstract

Background The knowledge and acceptance of the concept of brain death (BD) among health care personnel is fundamental. Objective To analyze the level of understanding of the BD concept among personnel in Spanish and Latin American healthcare centers and to determine the factors affecting this attitude. Material and methods Data from 12 hospitals and 32 primary care centers in 4 countries within the International Collaborative Donor Project were selected (Spain, Mexico, Cuba and Costa Rica (n = 4378)). Results 62% of the personnel (n = 2714) understood BD and believed that this was the death of an individual. Of the rest, 30% (n = 1 333) did not understand it and the remaining 8% (n = 331) believed it did not mean the death of a patient. 83% (n = 931) of physicians understood BD, compared to 75% (n = 895) of nurses, 55% (n = 299) of healthcare assistants, 53% (n = 108) of non-healthcare university-educated personnel and 36% (n = 481) of those without a university education (p<0.001). 68% (n = 1084) of Mexicans understood BD compared to 66% (n = 134) of Cubans, 58% (n = 1411) of Spaniards, and 52% (n = 85) (p<0.001) of Costa Ricans. There were significant relationships between knowledge of the concept and the following: type of healthcare center (p<0.001), clinical service (p<0.001), having spoken about organ donation within the family (p<0.001) and one's partner's attitude to the subject (p<0.001). A direct relationship has been found between understanding the concept and attitude toward deceased donation (p<0.001). Conclusions The understanding of BD by personnel from healthcare centers was not as good as expected. There were marked differences depending on job category.