A study on knowledge towards brain death among residents in Indonesia

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Criteria in diagnosing death have continued to evolve from century to century, and it helped humans in diagnosing death. Somatic criteria, such as state of decomposition and rigor mortis, are the oldest criteria in diagnosing death in human history. Brain death is a condition in which the brain irreversibly loses its function. Brain death is characterized by loss of brainstem reflexes, loss of motor response, loss of respiratory function in normothermic conditions, and coma in patients with irreversible brain lesions and without metabolic disturbances or drug effects.

In diagnosing brain death, there are different criteria in various countries around the world. These criteria are not all universally accepted; thus, it is crucial to have brain-dead knowledge. A doctor’s knowledge of brain death is essential because the diagnosis has to be accurate. However, there has been no research on the knowledge of brain death in doctors in Indonesia.

An observational analytic study conducted by Asra Al Fauzi et al., (2020) Universitas Airlangga – Dr. Soetomo Academic Medical Center Hospital Surabaya, a study published in Folia Medica Indonesiana (The Center for Medical Science Community, Faculty Medicine, Universitas Airlangga) aims to evaluate brain death knowledge among resident in Indonesia.

This study used an observational analytic study with a cross-sectional study design using a questionnaire. The research subjects consisted of 132 level 2 (after two years of residency) and level 3 (after 4 years of residency) residents, the total sampling for which was taken from the departments of Neurosurgery, Anesthesiology, and Neurology at Dr. Soetomo Academic Medical Center Hospital, Surabaya, Indonesia. Researchers chose the research subjects from the three departments because in Indonesia, neurologists, anesthesiologists, and one other doctor, who is usually a neuro pediatrician or neurosurgeon, are responsible for diagnosing brain death. Researchers also chose levels 2 and 3 residents because the researchers considered they had gained a lot of experience in dealing with brain death in the intensive care unit (ICU). This study uses a self-created questionnaire based on the Local Regulation No. 37/2014 and previous research.

After all the survey data were collected, the data were analyzed using IBM SPSS Statistics 25. Data analysis includes descriptive statistics, validation tests using the Pearson Product-Moment Correlation method, the Mann-Whitney test, and the Kruskal-Wallis test. The ethics committee approved this study of Dr. Soetomo Academic Medical Center Hospital Surabaya.

A total of 132 residents of Neurosurgery, Neurology, and Anesthesiology participated in this study. From the series of studies, residents’ knowledge of the concept of brain death was in the sufficient category (41.7%), residents’ knowledge of the technical diagnosis of brain death was in a good category (40.2%), residents’ knowledge of brain death examination was in the less category (43.2%), and finally, it was found that the resident’s knowledge of brain death was in a good category (35.6%). There were also significant differences in knowledge of brain death between Neurosurgery, Neurology, and Anesthesiologist Resident.

In general, the Indonesian resident doctors’ knowledge of brain death is adequate, but knowledge of the clinical examination of brain death is still lacking. Further research must be carried out to promote knowledge of brain death in residents as well as professional doctors/specialists, so that the number of organ transplants, especially in Indonesia, will increase.

Author: Asra Al Fauzi

Link: https://www.e-journal.unair.ac.id/FMI/article/view/21235 / http://dx.doi.org/ 10.20473 / fmi.v56i2.21235

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