{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:22Z","timestamp":1790060482455,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Organ donation in intensive care units (ICU) involves complex, emotional conversations with families during end\u2010of\u2010life care. While literature often examines consent rates, clinical protocols and family experiences, less is known about the factors that shape donation discussions from the perspective of ICU staff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To understand ICU staff experiences and perspectives of factors influencing organ donation discussions and family decision\u2010making in New Zealand ICUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>\n                      A qualitative descriptive study using reflexive thematic analysis of focus group data from 11\n                      <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                      staff (medical, nursing and health psychology) across three tertiary\n                      <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                      facilities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Three key themes were developed:\n                      <jats:italic>Having a \u2018Good\u2019 Conversation<\/jats:italic>\n                      ,\n                      <jats:italic>Acknowledging the Emotional and Mental Weight and Having the Will to Endure<\/jats:italic>\n                      and\n                      <jats:italic>Feeling Equipped to Care<\/jats:italic>\n                      . Participants emphasised the importance of trust\u2010based communication with families; culturally and emotionally responsive care tailored to families' individual needs; and regulating the emotional demands of donation work. Staff relied on regular collegial support to maintain emotional resilience and valued structured education, team preparation and access to resources that built their confidence in donation conversations. Participants identified practices and values that fostered a positive unit culture around organ donation, contributing to team resilience and meaningful family interactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study offers insight into the interpersonal, emotional and practical aspects of organ donation work in NZ ICUs from the perspective of staff. Findings show that supportive team culture, underpinned by quality communication, team preparation, emotional safety and adequate resources, enables more meaningful donation conversations with families. These insights highlight opportunities for strengthening practice, education and unit culture in donation work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Findings support the need for regular, multidisciplinary education; emotional support structures; and clear, standardised team processes to enhance donation conversations. Improving systemic infrastructure, such as robust donor identification pathways and public\u2010facing education, can further prepare staff and families to navigate donation as a normalised aspect of end\u2010of\u2010life care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70668","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:25:00Z","timestamp":1788852300000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Heart of the Matter: Staff Insights Into Organ Donation Conversations"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4022-3503","authenticated-orcid":false,"given":"Lydia","family":"Shim","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Te Toka Tumai Auckland, Grafton  Auckland New Zealand"},{"name":"School of Nursing The University of Auckland, Faculty of Medical and Health Sciences, Grafton  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6224-7514","authenticated-orcid":false,"given":"Cynthia J.","family":"Wensley","sequence":"additional","affiliation":[{"name":"School of Nursing The University of Auckland, Faculty of Medical and Health Sciences, Grafton  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4209-0334","authenticated-orcid":false,"given":"Rachael L.","family":"Parke","sequence":"additional","affiliation":[{"name":"School of Nursing The University of Auckland, Faculty of Medical and Health Sciences, Grafton  Auckland New Zealand"},{"name":"Cardiothoracic and Vascular Intensive Care Unit Te Toka Tumai Auckland, Grafton  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc2876"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-075433"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001694"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v13.i2.90274"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010019\u201005575\u20104"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-019-01332-9"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000000805"},{"issue":"4","key":"e_1_2_16_9_1","first-page":"638","article-title":"What Determinants Impact Deceased Organ Donation Consent in the Adult Intensive Care Unit? 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