Perception par les médecins des conditions de prise en charge d’un Témoin de Jéhovah

Gouëzec, H.; Lerenard, Isabelle; Jan, S; Bajeux, Emma; Renaudier, P.; Mertès, P. M.; d’hémovigilance, Groupe des hémobiologistes et correspondants

doi:10.1016/j.tracli.2016.08.002

Cited by 3 publications

(2 citation statements)

References 2 publications

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“…Despite this, the results of our audit have shown that there is still low adherence to the policies. One reason behind the results of our study could indeed be that clinicians are simply not aware of the regulatory requirements, as has been demonstrated in healthcare systems across the world (7,8).…”

Section: Discussionmentioning

confidence: 86%

Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products

Melamed

2023

phy

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Blood components and products are life-saving therapeutics but with inherent, life-threatening risks. There are patients who do not accept blood products for different reasons, including fear of blood borne viruses, transfusion reactions and religious beliefs. It is important to determine the standard of care and outcomes for such patients, within any clinical setting. The aim of this audit was to evaluate adherence to the agreed standard of care for patients who do not accept blood transfusion. Methods All patients who refused transfusions between 2019 and 2021 were included. Scanned forms and Electronic Patient Records were used to gather data. Expected care standards were: (1) a multidisciplinary team (MDM) led alternative care plan, agreed at least 3 weeks prior to the intervention/ procedure, to prepare for blood loss, and (2) that the MDM should involve: either a surgeon or physician, anaesthetist (if the treatment is surgical or antenatal), haematologist or transfusion practitioner and the patient. Results There were 195 patients referred to MDMs, of which 105 were surgical (54%), 52 were interventional (27%) and 38 were antenatal (19%). Of these, 188 (96%) were sent before a procedure (or birth) with the remaining 7 (4%) referred for ongoing treatment of medical patients, i.e. with severe anaemia. In 72 patients (38%) the MDM did take place ≥3 weeks before the procedure (similar to the results from the first cycle of the audit, in 2017-18 = 40%). Almost 85% (165) of MDM included all relevant stakeholders. Discussion The delay in timely referral for MDM led alternative care plan was likely due to a lack of awareness of transfusion policies, and potentially could lead to cancellation of the procedure or unavailability of alternative protocols in an emergent scenario during surgery or intervention. Conclusion Improvement was required for safer procedures and outcomes, by investment in training, regular refreshers/ updates for staff and electronic protocols/ prompts.

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Section: Discussionmentioning

confidence: 86%

Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products

Melamed

2023

phy

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“…A study by Jakubowska et al [ 45 ] also showed that 50.02% of paediatric nurses in Lublin (eastern Poland) disagreed with JWs concerning blood treatment. Gouezec et al [ 46 ], on the other hand, demonstrated that, although French doctors do not oppose the medical care of JWs, the majority were somewhat lacking in their awareness of all the regulatory requirements, and remained committed to their primary focus: to save the patient, as long as it is not an end-of-life situation. Finally, a study by Rajtar [ 47 ] demonstrated that, while JWs in Germany claimed autonomy based on choice, German physicians often claimed autonomy based on reason.…”

Section: Discussionmentioning

confidence: 99%

Between Autonomy and Paternalism: Attitudes of Nursing Personnel Towards Jehovah’s Witnesses’ Refusal of Blood Transfusion

Domaradzki

Głodowska

Jabkowski³

2023

Int J Public Health

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Objectives: The study describes the attitudes of Polish nursing personnel towards Jehovah’s Witnesses’ (JWs’) refusal to receive blood and blood products.Methods: We developed an online survey assessing nurses’ knowledge and attitudes towards JWs’ refusal of blood transfusion in a life-threatening condition. It also examined nurses’ attitudes towards ethical and legal issues associated with JWs’ refusal of blood transfusions. These questions were explored using a sample of 202 Polish nurses.Results: Nurses’ knowledge of JWs’ stance towards blood transfusions is inadequate and they tended to be ill-disposed towards JWs’ refusal of blood transfusions. Although most nurses respected adult JW patients’ autonomy and supported their right to refuse blood, in the case of JW children they are guided by paternalism. Nurses’ attitudes were affected by whether they had children, whether they declared themselves religious, their level of education and prior experience with patients who had refused a blood transfusion.Conclusion: Since most nurses felt unprepared to care for JW patients, this study reveals an urgent need to train nurses in transcultural nursing and increase nurses’ cultural competencies, and that this should be incorporated into medical curricula.

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Cultural competences among future nurses and midwives: a case of attitudes toward Jehovah’s witnesses’ stance on blood transfusion

Domaradzki,

Głodowska,

Doron

et al. 2024

BMC Med Educ

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Background Transcultural nursing recognises the significance of cultural backgrounds in providing patients with quality care. This study investigates the opinions of master’s students in nursing and midwifery regarding the attitudes of Jehovah’s Witnesses towards refusing blood transfusions. Methods 349 master’s students in nursing and midwifery participated in a quantitative study and were surveyed via the Web to evaluate their awareness of the stance of Jehovah’s Witnesses on blood transfusions and the ethical and legal dilemmas associated with caring for Jehovah’s Witness (JW) patients. Results The study yielded three significant findings. It unequivocally demonstrates that nursing and midwifery students possess inadequate knowledge regarding Jehovah’s Witnesses’ stance on blood transfusions and their acceptance of specific blood products and medical procedures. Despite being cognisant of the ethical and legal dilemmas of caring for JW patients, students lack an understanding of patients’ autonomy to reject blood transfusions and their need for bloodless medicine. Students also articulated educational needs regarding cultural competencies regarding the Jehovah’s Witnesses’ beliefs on blood transfusions and non-blood management techniques. Conclusions Healthcare professionals need the knowledge and skills necessary to provide holistic, patient-centred and culturally sensitive care. This study emphasises the urgent need for university curricula and nursing postgraduate training to include modules on transcultural nursing and strategies for minimising blood loss.

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Perception par les médecins des conditions de prise en charge d’un Témoin de Jéhovah

Cited by 3 publications

References 2 publications

Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products

Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products

Between Autonomy and Paternalism: Attitudes of Nursing Personnel Towards Jehovah’s Witnesses’ Refusal of Blood Transfusion

Cultural competences among future nurses and midwives: a case of attitudes toward Jehovah’s witnesses’ stance on blood transfusion

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