A comparison of organ transplant patient and professional staff attitudes

Although most health care professionals acknowledge the importance of collaboration and team work between patients and staff in organ transplantation (TX), there is a scarcity of research exploring the nature of staff-patient relationships. We surveyed 204 TX-patients and professional staff (n=83 patients,n=121 staff) and compared their attitudes with regard to (a) psychosocial selection criteria of patients being assessed for organ TX, (b) patient and staff role expectations, and (c) communication styles in relation to organ TX. Our findings indicate overall agreement between patients and staff with regard to the importance of (a) family and social support, (b) current alcohol and drug abuse, and (c) patient noncompliance as factors to consider in the selection of candidates for TX. Attitudes and beliefs did not relate to demographic factors, years of experience (staff), or type of TX (patients and staff). Patients had higher expectations of nursing care and of shared patient-nurse roles than did staff (p<0.001). Assessment of communication style found that collaboration was the least used style, while avoidance of communication and accommodation were the most common. Nurses, social workers, and chaplains were more willing to compromise than were patients and physicians (p<0.001). We conclude that for TX patients and staff (a) there is general agreement with regard to the psychosocial criteria that are important in the selection of patients for organ TX; (b) post-TX misunderstandings may occur due to conflicting opinions about role responsibility, with patients (and physicians) having significantly stronger beliefs in the “equality” of role relationships than did other staff; and (c) resolution of problems is not collaborative in nature, or is unlikely to result in compromise, but instead is either a passive avoidance or an accommodation to satisfy others. These aspects of patient-staff relationships require further attention if TX programs are to obtain optimal results.