Abstract
Background. Organ donation in Iran faces a persistent shortage, with nearly 25,000 patients awaiting transplantation and an estimated 6,000 viable organs lost annually. Despite Iran’s leading position in Asia for organ donation in 2020, critical gaps remain. One under examined factor is the role of Healthcare Professionals (HCPs), whose interactions strongly shape family consent decisions. Prior studies have focused mainly on HCPs’ knowledge or attitudes, while real-world touchpoints, communication processes, and behavioral factors have received limited attention. The absence of an integrated framework capturing educational, psychological, communicative, and institutional components restricts the development of effective national strategies. This study aimed to address this gap by identifying key components and touchpoints of HCPs within a social marketing perspective through a scoping review.
Methods. This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR guidelines. The primary question guiding this review was: “What roles, components, and touchpoints of healthcare professionals involved in the organ donation process have been reported in the literature, and how do these factors contribute to family decision-making and the advancement of organ donation?” The eligibility criteria were developed using the Population–Concept–Context (PCC) framework and included studies involving healthcare professionals, their roles, and clinical touchpoints in deceased organ donation. Studies focusing on families or the general public, living donation, purely technical or clinical aspects of transplantation, articles without full-text access, and studies published before 2020 were excluded. A systematic search was conducted in PubMed, Scopus, Web of Science, ProQuest, Emerald, and SID for studies published between 2020 and 2024. Title, abstract, and full-text screening were performed independently by two reviewers using Rayyan software. Consistent with JBI guidance for scoping reviews, no formal quality appraisal was undertaken; however, studies were assessed for methodological relevance and clarity. Data were analyzed using thematic analysis in MAXQDA and Excel, and themes were refined through reviewer consensus and confirmed by the research supervisors.
Results. Out of 1,670 identified studies, 108 were included in the final analysis. The thematic synthesis revealed four main domains and 19 components influencing the role of healthcare professionals in organ donation: 1) Educational and Awareness-Raising Role: Knowledge development, attitude change, providing information to families, communication skills enhancement, legal awareness, ethical education, and updating specialized knowledge; 2) Communication Role: Effective communication, trust-building, interpersonal and team communication, and managing families' emotions; 3) Psychological and Emotional Dynamics: Burnout management, job fatigue, stress, and emotional resilience; 4) Institutional Policies and Supports: professional support, legal support, transparent policies, and encouraging staff participation.
Conclusion. Given the multidimensional nature of the organ donation process, developing this system requires a perspective that extends beyond purely clinical and technical aspects. Based on the analysis of available evidence, healthcare policymakers and managers should view healthcare professionals as key agents of behavioral change in organ donation. Accordingly, educational, communicative, supportive, and managerial programs should be designed and implemented in an integrated manner. Furthermore, establishing standardized communication protocols for interacting with families, strengthening psychological and professional support for staff, and utilizing social marketing-based approaches can improve the performance of the organ donation system. Addressing these requirements at the levels of policymaking, education, and health services management can facilitate increased family consent, improved decision-making processes, and the sustainable development of organ donation in the country.
Research Insight
· Healthcare professionals serve as the most influential touchpoints in the organ donation process; their role transcends the mere dissemination of clinical data.
· Specialized training, legal literacy, and refined interpersonal skills are essential for optimizing family interactions and significantly increasing the probability of obtaining consent for donation.
· Trust-building, empathetic engagement, and the sensitive management of family bereavement are the primary communicative drivers in the organ donation decision-making process.
· Occupational burnout, stress, and emotional fatigue may reduce the effectiveness of healthcare professionals in supporting the organ donation process.
· Legal protections, transparent policies, and integrated organizational frameworks can facilitate healthcare professionals’ engagement in organ donation programs.
· Within a social marketing context, healthcare professionals play a central role in the “People”, “Promotion”, and “Process” components of the marketing mix.
· Integrating organ donation education into healthcare curricula, implementing standardized family communication protocols, and strengthening psychological and organizational support systems may contribute to higher organ donation rates.