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Poursaadati M, Maarefvand M, Niyasar M, Khubchandani J. Organ donation-related psychosocial interventions: Towards a research-based guideline - A prospective observational study. INDIAN JOURNAL OF TRANSPLANTATION 2022. [DOI: 10.4103/ijot.ijot_125_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Darlington AS, Long-Sutehall T, Randall D, Wakefield C, Robinson V, Brierley J. Parents' experiences of requests for organ and tissue donation: the value of asking. Arch Dis Child 2019; 104:837-843. [PMID: 31079074 DOI: 10.1136/archdischild-2018-316382] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/13/2019] [Accepted: 03/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE A proportion of children die, making them potentially eligible to be organ/tissue donors. Not all are approached for donation, and experiences of those parents are not well understood. The objective was to investigate to what extent organ and tissue donation (OTD) is discussed as part of end-of-life care and to explore parents' and healthcare professionals' (HCPs) experiences. DESIGN A retrospective qualitative study. SETTING Multicentre study with participants recruited through two neonatal intensive care units (ICUs), two paediatric ICUs, a cardiac ICU and a children's hospice. PATIENTS Bereaved parents, parents of a child with a long-term condition (LTC) and HCPs. INTERVENTIONS None. MAIN OUTCOMES AND MEASURES Parents' and HCPs' views and experiences of discussions about OTD. RESULTS 24 parents of 20 children were interviewed: 21 bereaved parents and 3 parents of a child with a LTC. Seven parents were asked about donation (13 not asked), four agreed and two donated. 41 HCPs were interviewed. Themes: complexity of donation process, OTD as a coping strategy, the importance of asking, difficulty of raising the topic,\ and parents' assumptions about health of organs (when donation is not discussed). CONCLUSIONS The findings add new knowledge about parents' assumptions about the value of their child's organs when discussions about OTD are not raised, and that HCPs do not routinely ask, are sometimes hesitant to ask in fear of damaging relationships, and the reality of the complexity of the donation process. Given the current levels of awareness around OTD, the topic should be raised.
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Affiliation(s)
| | | | - Duncan Randall
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Claire Wakefield
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Kids Cancer Centre, Syndey Children's Hospital, Sydney, NSW, Australia
| | - Victoria Robinson
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Joe Brierley
- Department of Critical Care & Paediatric Bioethics Centre, Great Ormond Street Hospital for Children, London, UK
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Abstract
THEORETICAL PRINCIPLES Pragmatic Children's Nursing Theory draws on the theory principles of North American Pragmatist including the work of William James, Richard Rorty, and John Dewy and incorporates Margaret Urban Walkers' work on expressive collaborative feminism. PHENOMENA ADDRESSED In this discussion paper I explore how the role of parents is framed in Pragmatic Children's Nursing Theory. In setting out Pragmatic Children's Nursing Theory I detailed a rebuttal of Family Centred care. However, working with the theory I have come to realise how the arguments against Family Centred care do not exclude involving parents in children's care. Indeed, Pragmatic Children's Nursing recognises the vital role parents and other carers play in children's access and experience of childhood. Using Walkers expressive collaborative feminism who accepts and who rejects the parenting role for children living with illness is discussed. RESEARCH LINKAGES This is an emergent theoretical approach to children's nursing with challenging research evidence. However, I draw on existing children's nursing studies to explore the potential of Pragmatic Children's Nursing Theory to assist children, parents and nurses in negotiating care. Concluding that as childhoods and parenting are continually evolving, in time, in certain physical, cultural and political contexts, that pragmatic theory will evolve to meet these intergenerational contextual challenges.
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Luberda K, Cleaver K. How modifiable factors influence parental decision-making about organ donation. Nurs Child Young People 2018; 29:29-36. [PMID: 29115763 DOI: 10.7748/ncyp.2017.e810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/09/2022]
Abstract
A global shortage of organs from children and adults available for transplantation is compounded by the failure of next of kin to consent for organs to be donated after death. Non-modifiable and modifiable factors influence decision-making in this area. Modifiable factors are of interest when examining families' decision-making about the donation of organs from their deceased child. A scoping review was undertaken to determine how modifiable factors influence parental decision-making about organ donation. Thematic analysis identified two themes: interactions with healthcare professionals and pre-disposition to organ donation. Satisfaction with experiences of hospital care, the information provided and the way it was communicated, as well as interactions pertaining to emotional support were all found to be modifiable factors that influenced decision making. Likewise, a predisposition to organ donation and knowing the deceased's wishes were associated with the consent decision. Nurses working in critical care environments need to be able to support parents during this difficult time. This article aims to raise awareness of modifiable factors that influence parental decision-making, highlighting their relevance for children's nursing practice.
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Dicks SG, Ranse K, Northam H, van Haren FMP, Boer DP. A novel approach to studying co-evolution of understanding and research: Family bereavement and the potential for organ donation as a case study. Health Psychol Open 2018; 5:2055102917753706. [PMID: 29399367 PMCID: PMC5788101 DOI: 10.1177/2055102917753706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
A novel approach to data extraction and synthesis was used to explore the connections between research priorities, understanding and practice improvement associated with family bereavement in the context of the potential for organ donation. Conducting the review as a qualitative longitudinal study highlighted changes over time, and extraction of citation-related data facilitated an analysis of the interaction in this field. It was found that lack of 'communication' between researchers contributes to information being 'lost' and then later 'rediscovered'. It is recommended that researchers should plan early for dissemination and practice improvement to ensure that research contributes to change.
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Affiliation(s)
| | | | | | - Frank MP van Haren
- University of Canberra, Australia
- Australian National University, Australia
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Dicks SG, Ranse K, Northam H, Boer DP, van Haren FM. The development of a narrative describing the bereavement of families of potential organ donors: A systematic review. Health Psychol Open 2017; 4:2055102917742918. [PMID: 29379629 PMCID: PMC5779939 DOI: 10.1177/2055102917742918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Families of potential post-mortem organ donors face various challenges in the unfamiliar hospital context and after returning home. This review of sources published between 1968 and 2017 seeks to understand their journey as a bereavement experience with a number of unique features. Grief theory was used to identify ways that staff can assist family members to tolerate ambiguities and vulnerabilities while contributing to an environment characterised by compassion and social inclusion. Staff can guide families and create opportunities for meaningful participation, building resilience and developing bereavement-related skills that could assist them in the months that follow.
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Affiliation(s)
| | | | | | | | - Frank Mp van Haren
- University of Canberra, Australia.,Australian National University, Australia
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"Effective" Requesting: A Scoping Review of the Literature on Asking Families to Consent to Organ and Tissue Donation. Transplantation 2017; 101:S1-S16. [PMID: 28437367 DOI: 10.1097/tp.0000000000001695] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Families are often asked to consent to the donation of their deceased relative's organs or tissues. These end-of-life conversations are important because they affect consent rates as well as the psychological impact of the decision for families. This scoping review of the literature on requesting family consent was prepared to support of the development of leading practice recommendations for end-of-life conversations with families of potential donors. A scoping review maps research activity in a field across a range of commentary and empirical study designs but does not attempt meta-synthesis of empirical data or quality assessment. METHODS We performed a scoping review of the peer-reviewed literature from January 2000 to February 2015 on the questions of what constitutes an "effective" request and the factors that affect consent rates and family satisfaction with their decision and the process. This review includes a final set of 168 articles addressing (a) whether, when, and how to ask families for consent to donation or (b) characteristics of families or decedents that affect families' decisions or family satisfaction with their decisions. RESULTS Six main themes were identified: (1) the objectives of requesting and encouraging family consent to donation, (2) the effect of the donation decision on family well-being, (3) the process of requesting family consent, (4) the impact of the quality of the care for the deceased and for the family, (5) the content and manner of the request for family consent, and (6) the characteristics of the family and deceased that affect the request for family consent. CONCLUSION This scoping review found that there is a large literature on how to modify the process and manner of the request to increase family consent rates. Another important line of inquiry focuses on the psychological impact of the decision on the family. Although a scoping review does not attempt to synthesize results or draw evidence-based conclusions, the literature generally supports the intuitive expectations that compassionate and respectful care for the deceased and family, listening for and addressing family concerns, and an attitude to donation that is positive (but not solely procurement-focused) and is best for both consent rates and family well-being. Although the presumption is often that the primary objective of asking for family consent is to secure consent and donation, some ethical commentary on requesting consent emphasizes that this objective must be balanced with the parallel obligation to protect the psychological well-being of families. This places some constraints on the approaches used in family consent discussions.
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Krupic F, Sayed-Noor AS, Fatahi N. The impact of knowledge and religion on organ donation as seen by immigrants in Sweden. Scand J Caring Sci 2016; 31:687-694. [DOI: 10.1111/scs.12379] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ferid Krupic
- Department of Orthopaedics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Arkan S. Sayed-Noor
- Department of Surgical and Perioperative Sciences; Umeå University; Umeå Sweden
| | - Nabi Fatahi
- University of Gothenburg; Institute of Health and Caring Sciences; Gothenburg Sweden
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Ashkenazi T, Cohen J. Interactions between health care personnel and parents approached for organ and/or tissue donation: influences on parents' adjustment to loss. Prog Transplant 2015; 25:124-30. [PMID: 26107272 DOI: 10.7182/pit2015145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT The effect of loss on those approached for organ and/or tissue donation, particularly in the years thereafter, has received little attention. OBJECTIVE To assess whether adjustment of a parent to loss of a child is influenced by interactions with health care personnel. METHODS A self-administered questionnaire was completed by the parents of 216 decedents. Interactions in the hospital were assessed by examining the experience in the hospital, physical separation from the child, and the relationship with health care professionals. Adjustment to loss was defined by 4 components: grief, personal growth after loss, meaning of life after loss, and the meaning of organ donation. RESULTS A positive experience in the hospital was significantly associated with the meaning of donation. Increased satisfaction with the separation process was associated with better adjustment on all components. Finally, a better relationship with health care professionals was associated with less grief and with greater personal growth. These results were characterized after adjustment for time since loss, which was from 6 months to 27 years. CONCLUSIONS Interactions in the hospital appear to influence adjustment to loss significantly. Appropriate interventions may aid parents in their adjustment to life.
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Affiliation(s)
- Tamar Ashkenazi
- Israel Transplant, Ministry of Health (TA, JC) and Tel Aviv University (JC), Tel Aviv, Israel, Rabin Medical Hospital, Petah Tikva, Israel (JC)
| | - Jonathan Cohen
- Israel Transplant, Ministry of Health (TA, JC) and Tel Aviv University (JC), Tel Aviv, Israel, Rabin Medical Hospital, Petah Tikva, Israel (JC)
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Siminoff LA, Molisani AJ, Traino HM. A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation. Pediatrics 2015; 136:e108-14. [PMID: 26034251 PMCID: PMC4485007 DOI: 10.1542/peds.2014-3652] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although existing studies suggest that factors affecting families' decisions regarding pediatric organ donation mirror those for adult patients, health professionals working in this area maintain that pediatric and adult decision-makers differ in significant ways. This study compared the request process, experiences, and authorization decisions between family decision-makers (FDMs) of adult and pediatric donors and nondonors. METHODS Perceptions of the donation request were collected via telephone interviews with 1601 FDMs approached by staff from 9 US organ procurement organizations (OPOs). Authorization regarding donation (ie, authorized/refused) was obtained from FDM reports and verified by using OPO records. Tests of association were used to estimate differences between FDMs of adult and pediatric patients. A logistic regression analysis was conducted to identify variables predicting FDM authorization. RESULTS FDMs of children were significantly more likely to authorize donation than were FDMs of adults (89.7% vs 83.2%; χ(2) = 6.2, P = .01). Differences were found between pediatric and adult families' initial feelings toward donation, donation-related topics discussed, communication behaviors and techniques used, perceptions of the request, and receipt and preference of grief information. The likelihood of FDM authorization increased with the number of topics discussed and communication skills employed during requests. Authorization was not predicted by patient age (ie, adult versus pediatric). CONCLUSIONS FDMs of children are willing to donate and experience no more psychological distress from the request for donation than do FDMs of adults. Communication emerged as a critical factor of family authorization, reinforcing its importance in requests for donation.
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Affiliation(s)
- Laura A. Siminoff
- Department of Public Health, Temple University, Philadelphia, Pennsylvania; and
| | - Anthony J. Molisani
- Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, Virginia
| | - Heather M. Traino
- Department of Public Health, Temple University, Philadelphia, Pennsylvania; and
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Garstang J, Griffiths F, Sidebotham P. What do bereaved parents want from professionals after the sudden death of their child: a systematic review of the literature. BMC Pediatr 2014; 14:269. [PMID: 25319926 PMCID: PMC4287432 DOI: 10.1186/1471-2431-14-269] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/03/2014] [Indexed: 12/02/2022] Open
Abstract
Background The death of a child is a devastating event for parents. In many high income countries, following an unexpected death, there are formal investigations to find the cause of death as part of wider integrated child death review processes. These processes have a clear aim of establishing the cause of death but it is less clear how bereaved families are supported. In order to inform better practice, a literature review was undertaken to identify what is known about what bereaved parents want from professionals following an unexpected child death. Methods This was a mixed studies systematic review with a thematic analysis to synthesize findings. The review included papers from Europe, North America or Australasia; papers had to detail parents’ experiences rather than professional practices. Results The review includes data from 52 papers, concerning 4000 bereaved parents. After a child has died, parents wish to be able to say goodbye to them at the hospital or Emergency Department, they would like time and privacy to see and hold their child; parents may bitterly regret not being able to do so. Parents need to know the full details about their child’s death and may feel that they are being deliberately evaded when not given this information. Parents often struggle to obtain and understand the autopsy results even in the cases where they consented for the procedure. Parents would like follow-up appointments from health care professionals after the death; this is to enable them to obtain further information as they may have been too distraught at the time of the death to ask appropriate questions or comprehend the answers. Parents also value the emotional support provided by continuing contact with health-care professionals. Conclusion All professionals involved with child deaths should ensure that procedures are in place to support parents; to allow them to say goodbye to their child, to be able to understand why their child died and to offer the parents follow-up appointments with appropriate health-care professionals. Electronic supplementary material The online version of this article (doi:10.1186/1471-2431-14-269) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joanna Garstang
- Division of Mental Health and Wellbeing, Warwick Medical School, Coventry CV4 7AL, UK.
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Ashkenazi T, Klein M. A Practical Israeli Strategy for Appealing for Organ Donation. Prog Transplant 2013; 23:173-9. [DOI: 10.7182/pit2013393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Context Most reports on organ donation have been related to the importance of support for families, explanations of brain death, and the appeal for organ donation. In contrast, no reports have addressed organ donation from the perspective of intervention in cases of “sudden mourning” and the practical aspects of how to facilitate donation in such cases. Objective To develop a specific strategy for professional intervention in cases of imminent death to bring the family to a state of cognitive and emotional preparedness that will enable them to accept the tragic news, donate organs, and then take leave of the deceased. Method The strategy presented here was developed on the basis of the records of donor coordinators who documented their interaction with families; consultations with professionals in the fields of marketing, persuasion, and negotiating; research conducted on families who did or did not donate organs; and statements made by family members of donors in focus and support groups in more than 10 years. Results The strategic approach includes early-stage rules such as staff self-awareness, and then later, critical stages of the process that take place before and at the time of determination of brain death: preparation for and the notification of death itself and the request for organ donation, including persuasion skills, coping with resistance and expressions of anger, and physical leave-taking from the decease. Conclusions The flexible, strategic approach set out here is designed to maximize the chances of procuring organ donation while protecting the family's rights and welfare.
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Affiliation(s)
- Tamar Ashkenazi
- Israeli Transplant Center, Ministry of Health, Tel Aviv, Israel (TA), Soroka Medical Center, Be'er-Sheva, Israel (MK)
| | - Moti Klein
- Israeli Transplant Center, Ministry of Health, Tel Aviv, Israel (TA), Soroka Medical Center, Be'er-Sheva, Israel (MK)
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Hogan NS, Coolican M, Schmidt LA. Making Meaning in the Legacy of Tissue Donation for Donor Families. Prog Transplant 2013; 23:180-7. [DOI: 10.7182/pit2013862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Context Individuals needing lifesaving (heart valves, skin grafts for repair of critical burn injuries) and life-enhancing (corneas, bone and tendon grafts, skin, and veins) tissue donations outnumber the tissues available for transplant. Objective To describe the grief family members experienced 6 months after donation and to learn how family decision makers gained meaning from the decision to donate a loved one's tissues. This is phase 1 of a longitudinal study in which family decision makers will be surveyed again at 13 and 25 months after donation. Design Qualitative descriptive. Participants One hundred seven family decision makers whose family member died a traumatic sudden death and who authorized donating tissues for transplant. Data Collection and Analysis Data were written responses to the questions, “If you could ask or tell your dead family member something, what would it be” and “What meaning does donating tissue to others have for you” Data were analyzed by using content analysis procedures. Results Concepts derived from the first question represent the context of family members grieving the sudden death of a loved one. Concepts were (1) feeling empty, (2) missing and loving, (3) being grateful, and (4) having regrets. The concepts derived from the second question were (1) fulfilling their family member's wish, (2) doing the right thing, (3) believing something good came from the death, (4) helping others, and (5) living on. Reasons for donating were based, in part, on honoring the legacy of their loved ones who had given of themselves to others in life and now continued to give to others after death. Conclusion The results of this study provide a basis for health professionals and donation staffs to better understand the context within which families grieve and give meaning to tissue donation.
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Affiliation(s)
- Nancy S. Hogan
- Loyola University Chicago, Illinois (NSH, LAS), Musculoskeletal Transplant Foundation, East Hampton, Connecticut (MC)
| | - Maggie Coolican
- Loyola University Chicago, Illinois (NSH, LAS), Musculoskeletal Transplant Foundation, East Hampton, Connecticut (MC)
| | - Lee A. Schmidt
- Loyola University Chicago, Illinois (NSH, LAS), Musculoskeletal Transplant Foundation, East Hampton, Connecticut (MC)
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Ashkenazi T, Klein M. Predicting Willingness to Donate Organs According to the Demographic Characteristics of the Deceased's Family. Prog Transplant 2012; 22:304-10; quiz 311. [DOI: 10.7182/pit2012955] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Transplant professionals need to gain a better understanding of the factors that facilitate willingness to donate a family member's organs, in order to increase the rate of organ donation. Objective To conduct an integrated analysis of demographic data relating to key family members, so as to help transplant professionals predict the likelihood that family members would be willing to donate organs. Method Demographic variables were collected on 753 brain-dead patients and 995 first-degree relatives in 20 Israeli hospitals from 2004 to 2009. The data were recorded by transplant coordinators who used a uniform format to document meetings with next of kin. The data were analyzed by using the Chaid Statistical Test from the SPSS statistical package. Results In this total study population, the most significant factor affecting the decision to donate was religion. With increasing religiousness, the likelihood of consent decreased. A large disparity was apparent among Moslems, Christians, and Jews. Within the religious groups, education (Jews), familial proximity to the deceased (Christians and Moslems), and the quality of relationships with the medical staff (Moslems) were the main predictors of consent. Summary Most countries have Christian, Moslem, and Jewish residents, so the conclusions of this study and its implications for practice should be relevant for transplant coordinators anywhere. The recommendations, which stem from the results of this study, relate to activities of transplant coordinators before and during their interaction with families, before the request for organ donation.
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Affiliation(s)
- Tamar Ashkenazi
- Israel Transplant Center, Ministry of Health, Jerusalem, Israel (TA), Soroka Medical Center, Be'er-Sheva, Israel (MK)
| | - Moti Klein
- Israel Transplant Center, Ministry of Health, Jerusalem, Israel (TA), Soroka Medical Center, Be'er-Sheva, Israel (MK)
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Families' reflections on the process of brain donation following coronial autopsy. Cell Tissue Bank 2010; 13:89-101. [PMID: 21140229 DOI: 10.1007/s10561-010-9233-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
Abstract
This study aims to explore families' reflections on their decision to donate brain tissue to the NSW Tissue Resource Centre (NSW TRC), Australia. Specifically, the study aims to investigate respondents' initial reactions to the request for donation, primary reasons for their decision, and subsequent satisfaction levels. Participants were next-of-kin (NOK) contacted between May 2002 and May 2008, on the day of their relative's autopsy, who agreed to donate brain tissue to the NSW TRC for medical research. All 111 NOK were invited to participate, and those who agreed completed an anonymous questionnaire. Fifty completed questionnaires were received. Results showed that 74% of respondents were not upset by the donation call and 98% were satisfied with their decision to donate. Of the 22% who reported having been upset, many indicated that their distress was partly related to their circumstances. When asked the main reason for their donation, 66% had wanted to help others, or help research, while 24% stated their primary reason as a belief that they were respecting the wishes of their deceased relative. These findings show that NOK are not further distressed by being asked to donate brain tissue, give altruistic reasons for consent and are satisfied with the decision they made. In both this study and previous literature, the importance of discussion about organ donation amongst relatives is a recurring theme. Knowledge about a relative's wishes is likely to help facilitate decision-making, overcoming at least one crucial barrier to lifting rates of organ donation for transplantation and research.
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Jacoby L, Jaccard J. Perceived support among families deciding about organ donation for their loved ones: donor vs nondonor next of kin. Am J Crit Care 2010; 19:e52-61. [PMID: 20810408 DOI: 10.4037/ajcc2010396] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Families' experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families' support needs during this traumatic time is an obligation and a challenge for critical care staff. OBJECTIVES (1) To elicit family members' accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families' donation decision. METHODS Retrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care. RESULTS One hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent. CONCLUSIONS Specific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.
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Affiliation(s)
- Liva Jacoby
- Liva Jacoby is an associate professor in the Department of Medical Education and the Alden March Bioethics Institute at Albany Medical College in Albany, New York. Jim Jaccard is a professor in the Department of Psychology at Florida International University in Miami
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