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Martinez-Lopez MV, Coll E, Cruz-Quintana F, Dominguez-Gil B, Hannikainen IR, Lara Rosales R, Pérez-Blanco A, Perez-Marfil MN, Pérez-Villares JM, Uruñuela D, Rodríguez-Arias D. Family bereavement and organ donation in Spain: a mixed method, prospective cohort study protocol. BMJ Open 2023; 13:e066286. [PMID: 36609324 PMCID: PMC9827244 DOI: 10.1136/bmjopen-2022-066286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION There is a discrepancy in the literature as to whether authorising or refusing the recovery of organs for transplantation is of direct benefit to families in their subsequent grieving process. This study aims to explore the impact of the family interview to pose the option of posthumous donation and the decision to authorise or refuse organ recovery on the grieving process of potential donors' relatives. METHODS AND ANALYSIS A protocol for mixed methods, prospective cohort longitudinal study is proposed. Researchers do not randomly assign participants to groups. Instead, participants are considered to belong to one of three groups based on factors related to their experiences at the hospital. In this regard, families in G1, G2 and G3 would be those who authorised organ donation, declined organ donation or were not asked about organ donation, respectively. Their grieving process is monitored at three points in time: 1 month after the patient's death, when a semistructured interview focused on the lived experience during the donation process is carried out, 3 months and 9 months after the death. At the second and third time points, relatives' grieving process is assessed using six psychometric tests: State-Trait Anxiety Inventory, Beck Depression Inventory-II, Inventory of Complicated Grief, The Impact of Event Scale: Revised, Posttraumatic Growth Inventory and Connor-Davidson Resilience Scale. Descriptive statistics (means, SDs and frequencies) are computed for each group and time point. Through a series of regression models, differences between groups in the evolution of bereavement are estimated. Additionally, qualitative analyses of the semistructured interviews are conducted using the ATLAS.ti software. ETHICS AND DISSEMINATION This study involves human participants and was approved by Comité Coordinador de Ética de la Investigación Biomédica de Andalucía (CCEIBA) ID:1052-N-21. The results will be disseminated at congresses and ordinary academic forums. Participants gave informed consent to participate in the study before taking part.
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Affiliation(s)
| | | | - Francisco Cruz-Quintana
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | | | - Ivar R Hannikainen
- Department of Philosophy I, Faculty of Philosophy, University of Granada, Granada, Spain
| | | | | | - Maria Nieves Perez-Marfil
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | | | | | - David Rodríguez-Arias
- Department of Philosophy I, Faculty of Philosophy, University of Granada, Granada, Spain
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Pourhosein E, Bagherpour F, Latifi M, Pourhosein M, Pourmand G, Namdari F, Pourmand N, Ghaffari P, Dehghani S. The influence of socioeconomic factors on deceased organ donation in Iran. Korean J Transplant 2022; 36:54-60. [PMID: 35769431 PMCID: PMC9235528 DOI: 10.4285/kjt.21.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 11/08/2022] Open
Abstract
Background There is a large gap between the number of patients on organ waiting lists and the number of available organs for donation. This study investigated the socioeconomic factors in Iran that influenced decisions for organ donation among the families of brain-dead donors. Methods This retrospective cross-sectional study was performed among the families of 333 organ donors in Iran. Two trained researchers interviewed family members about the donor’s age, sex, cause of brain death, education level, marital status, number of children, history of addiction, the financial status of the donor’s family, and reasons for which they considered refusing organ donation. Results The mean age of the donors was 37.23±16.59 years. During 2017–2019, significant differences were found according to income (P<0.001), marital status (P<0.001), sex (P=0.04), and occupation (P=0.04). More than half of the organ donors were of low socioeconomic status, and nearly half were the sole income earners of large families. Trauma was the most common cause of death (44.6%). The most common reasons for which the families considered refusing organ donation were unfamiliarity with the concept of brain death, denial, and the expectation of a miracle. Conclusions The donor’s socioeconomic status and availability of social services, such as insurance coverage, psychological services, and mourning therapy courses, play an important role in organ donation. Adequate support for the deceased’s family after organ donation is imperative.
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Affiliation(s)
- Elahe Pourhosein
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Bagherpour
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Latifi
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourhosein
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farshad Namdari
- Department of Urology, AJA University of Medical Sciences, Tehran, Iran
| | - Naghmeh Pourmand
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Ghaffari
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Dehghani
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Leal de Moraes E, de Barros e Silva L, Pilan L, de Lima E, de Santana A, da Paixão N, La Maison C, Martins M, dos Santos M. My Loved One Was Not an Organ Donor: Ethical Dilemmas for Family Members of Deceased Potential Donors When Making the Decision on Donation. Transplant Proc 2019; 51:1540-4. [DOI: 10.1016/j.transproceed.2019.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kentish-Barnes N, Siminoff LA, Walker W, Urbanski M, Charpentier J, Thuong M, Sarti A, Shemie SD, Azoulay E. A narrative review of family members’ experience of organ donation request after brain death in the critical care setting. Intensive Care Med 2019; 45:331-342. [DOI: 10.1007/s00134-019-05575-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/19/2019] [Indexed: 11/27/2022]
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Özmert S, Sever F, Ayar G, Yazıcı MU, Öztaş DK. Brain Death and Organ Donation in Paediatric Intensive Care Unit. Turk J Anaesthesiol Reanim 2019; 47:55-61. [PMID: 31276112 DOI: 10.5152/tjar.2019.43726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/16/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose of the present study was to retrospectively analyse the brain death (BD) cases that were specified within the last 8 years in the paediatric intensive care unit of our hospital. Methods Archive files and computer records of 23 paediatric cases were analysed. Data on age, gender, conditions that caused BD, paediatric risk of mortality (PRISM III) scores, time between suspicion of BD and issuing of BD report, confirmatory tests used, complications that occurred following the diagnosis of BD and time to cardiac arrest development after diagnosis of BD were recorded. Results The average age of the patients was 6.8±5.5 years. The most frequent cause of BD was intracranial haemorrhage (30.4%). The mean time to diagnosis after BD suspicion was 5.9±6.2 days. Electroencephalography was performed in 61% of the patients in addition to the apnoea test. Radiological imaging methods were used in 39% of the patients (n=9). Of the cases, 34.7% developed hypothermia, and 4.3% developed diabetes insipidus (DI). Among them, 43.4% had both DI and hypothermia. The mean PRISM score was calculated as 22±9.2. The donation rate of the families was 17%. The mean time to cardiac arrest development after diagnosis of BD was 6.9±7.4 days in non-donor cases where medical support had been reduced. Conclusion Any patient with a neurologically poor prognosis in the intensive care unit should be considered to develop BD and diagnosed with BD without delay. The donation rate will increase if family interviews are done by an experienced and educated coordinator.
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Affiliation(s)
- Sengül Özmert
- Department of Anaesthesiolgy and Reanimation, University of Health Sciences Ankara Child Health and Diseases Haematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Feyza Sever
- Department of Anaesthesiolgy and Reanimation, University of Health Sciences Ankara Child Health and Diseases Haematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ganime Ayar
- Department of Paediatric Intensive Care Unit, University of Health Sciences Ankara Child Health and Diseases Haematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Mutlu Uysal Yazıcı
- Department of Paediatric Intensive Care Unit, Hacettepe University İhsan Dogramacı Children's Hospital, Ankara, Turkey
| | - Dilek Kahraman Öztaş
- Department of Public Health, Yıldırım Beyazıt University School of Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
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Steenaart E, Crutzen R, de Vries NK. Complexity of Organ Donation Registration: Determinants of Registration Behavior Among Lower-educated Adolescents. Transplant Proc 2018; 50:2911-23. [PMID: 30577148 DOI: 10.1016/j.transproceed.2018.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/19/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Registration rates are low for organ donation among lower educated adolescents in The Netherlands. This could be improved by preparing them for making a decision regarding donation when they become 18 years old. To do so, more insight is needed into their beliefs about organ donation and registration. METHODS A cross-sectional quantitative study was conducted among students in intermediate vocational education schools. Data were gathered my means of self-administrated questionnaires. The outcome measurements included current registration status, being an organ donor, intention to register, and intention to become a donor. Correlation coefficients were used to assess the strength of associations between beliefs and each of the 4 outcome measurements. RESULTS A total of 405 participants (mean age, 18.86 years) were included, of whom 26.6% had already registered a decision. Most beliefs showed a significant correlation with one or more of the outcomes. In general, the correlations were of small to medium size and participants scored around the middle of the scales on the beliefs. CONCLUSION Means and correlations need to be combined to gain insight into the importance of certain beliefs for future interventions. However, it is plausible that, in addition to these explicit beliefs, implicit factors play a role in registration behavior. This could be explored in future research. Results could support intervention development for increasing registration rates.
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López JS, Soria-Oliver M, Aramayona B, García-Sánchez R, Martínez JM, Martín MJ. An Integrated Psychosocial Model of Relatives' Decision About Deceased Organ Donation (IMROD): Joining Pieces of the Puzzle. Front Psychol 2018; 9:408. [PMID: 29692744 PMCID: PMC5902731 DOI: 10.3389/fpsyg.2018.00408] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 03/12/2018] [Indexed: 11/13/2022] Open
Abstract
Organ transplantation remains currently limited because the demand for organs far exceeds the supply. Though organ procurement is a complex process involving social, organizational, and clinical factors, one of the most relevant limitations of organ availability is family refusal to donate organs of a deceased relative. In the past decades, a remarkable corpus of evidence about the factors conditioning relatives' consent has been generated. However, research in the field has been carried out mainly by means of merely empirical approaches, and only partial attempts have been made to integrate the existing empirical evidence within conceptual and theoretically based frameworks. Accordingly, this work articulates the proposal of an Integrated Psychosocial Model of Relatives' Organ Donation (IMROD) which offers a systematic view of the factors and psychosocial processes involved in family decision and their interrelations. Relatives' experience is conceptualized as a decision process about the possibility of vicariously performing an altruistic behavior that takes place under one of the most stressful experiences of one's lifetime and in the context of interaction with different healthcare professionals. Drawing on this, in the proposed model, the influence of the implied factors and their interrelations/interactions are structured and interpreted according to their theoretically based relation with processes like rational/heuristic decision-making, uncertainty, stress, bereavement, emotional reactions, sense of reciprocity, sense of freedom to decide, and attitudes/intentions toward one's own and the deceased's organ donation. Our model also develops a processual perspective and suggests different decisional scenarios that may be reached as a result of the combinations of the considered factors. Each of these scenarios may imply different balances between factors that enhance or hinder donation, such as different levels of uncertainty and potential decisional conflict. Throughout our work, current controversial or inconsistent results are discussed and interpreted on the basis of the relationships that are posited in the proposed model. Finally, we suggest that the structure of the relationships and interactions contained in our model can be used by future research to guide the formulation of hypotheses and the interpretation of results. In this sense, specific guidelines and research questions are also proposed.
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Affiliation(s)
- Jorge S López
- Departamento de Psicología y Pedagogía, Universidad Pública de Navarra, Pamplona, Spain.,Departamento de Psicología Social y Metodología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Maria Soria-Oliver
- Facultad de Ciencias de la Salud, UNIR-Universidad Internacional de la Rioja, Logroño, Spain
| | - Begoña Aramayona
- Departamento de Psicología Social y Metodología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rubén García-Sánchez
- Departamento de Psicología Social y Metodología, Universidad Autónoma de Madrid, Madrid, Spain
| | - José M Martínez
- Departamento de Psicología Social y Metodología, Universidad Autónoma de Madrid, Madrid, Spain
| | - María J Martín
- Departamento de Psicología Social y Metodología, Universidad Autónoma de Madrid, Madrid, Spain
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Abstract
Background: The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. Objective: The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. Methods: This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. Findings: The main category of the data was “Decision to organ donation: a challenge from conflict to transcendence.” This main category consisted of 10 subcategories and 3 general categories. The general categories were “challenging outcomes,” “reassuring outcomes,” and “transcending outcomes.” Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Conclusion: Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from the tragedy of significant loss, healthcare professionals need to facilitate the process of achieving confidence and transcendence by them.
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Yazar MA, Açıkgöz MB. Knowledge Levels and Attitudes of People Living in the City Centre of Nevşehir on Organ Donation and Transplantation. Turk J Anaesthesiol Reanim 2016; 44:250-257. [PMID: 27909606 DOI: 10.5152/tjar.2016.87094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/06/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose of this descriptive study was to determine the knowledge levels and attitudes of people living in Nevşehir on organ donation (OD) and transplantation. METHODS Data were collected using a questionnaire administered to 414 people residing in Nevşehir between February and May 2016. The primary and secondary endpoints of the present study were to determine the attitudes and knowledge levels of participants on OD and transplantation, respectively. RESULTS Four hundred and fourteen people between the ages 20 and 65 years participated. In total, 8.9% of the participants correctly answered the question 'What is necessary for donating an organ?' and 31.4% of them correctly answered the question 'What is brain death?' Moreover, 53.1% of the participants stated that they wanted to receive reliable information on OD from OD centres. There was a close relationship between high education level and the willingness to donate organs (p<0.05). Further, 94.7% of the participants stated that they did not want to donate organs: 22.9% of them explained that their decision was because of their religious beliefs and 19.6% stated that their families did not allow it. It was observed that people who accepted organs from others were more willing to donate organs to their relatives (p<0.05). CONCLUSION People living in Nevşehir do not have sufficient knowledge on OD; they had various concerns on the issue and wanted to receive information from OD centres. Exemplification and internalisation methods can be used in educational schedules to increase the OD.
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Abstract
The initial moments of conversations, particularly discussions addressing difficult or unexpected health topics, establish the context and tone of the entire discussion. We examined how elements of relational and instrumental communication occurring within the first five minutes of the request impacted the length of the discussion. A sample of 16 U.S. tissue banking organizations and their staff (n = 226) making telephone requests for donation to families of tissue-donation eligible patients (n = 1,465) agreed to participate in the research. The first five minutes of 430 (29.4%) audiorecorded request conversations were qualitatively coded and analyzed. The primary outcome measure was whether the conversation continued beyond the first five minutes (yes/no). Aspects of both relational and instrumental communication were associated with discussion length. A logistic regression analysis found that the total number of distinct topics disclosed and requesters' vocal affect during the discussion as well as characteristics of the family member approached about donation predicted conversational maintenance. This research demonstrates that "thin slices" of effective relational and instrumental communication can have a significant, positive impact on conversation length.
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Affiliation(s)
- Heather M Traino
- a Department of Social and Behavioral Health , Virginia Commonwealth University
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Schulz PJ, van Ackere A, Hartung U, Dunkel A. Prior family communication and consent to organ donation: using intensive care physicians' perception to model decision processes. J Public Health Res 2012; 1:130-6. [PMID: 25170455 PMCID: PMC4140364 DOI: 10.4081/jphr.2012.e19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 03/15/2012] [Indexed: 11/30/2022] Open
Abstract
Generally, the Swiss hold favourable attitudes to organ donation, but only few carry a donor card. If no card is found on a potential donor, families have to be approached about donation. The aim of this paper is to model the role that some family communication factors play in the family decision to consent or not to organ donation by a brain dead relative. Information was gathered in face-to-face interviews, using a questionnaire and recording open answers and comments. Eight heads of intensive care units (ICU) of Swiss hospitals and one representative from Swisstransplant were interviewed. Questions asked respondents to estimate the prevalence and effect of communication factors in families facing a decision to consent to donation. Answers were averaged for modelling purposes. Modelling also relies on a previous representative population survey for cross-validation. The family of the deceased person is almost always approached about donation. Physicians perceive that prior thinking and favourable predisposition to donation are correlated and that the relatives’ predisposition is the most important factor for the consent to donation, up to the point that a negative predisposition may override an acknowledged wish of the deceased to donate. Donor cards may trigger family communication and ease the physicians’ approach to family about donation. Campaigns should encourage donate-willing people to talk to their families about it, make people think about organ donation and try to change unfavourable predispositions.
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Affiliation(s)
- Peter J Schulz
- Institute of Communication & Health, Faculty of Communication Sciences, University of Lugano , Switzerland
| | | | - Uwe Hartung
- Institute of Communication & Health, Faculty of Communication Sciences, University of Lugano , Switzerland
| | - Anke Dunkel
- Institute of Communication & Health, Faculty of Communication Sciences, University of Lugano , Switzerland
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Siminoff LA, Traino HM, Gordon NH. An exploratory study of relational, persuasive, and nonverbal communication in requests for tissue donation. J Health Commun 2011; 16:955-975. [PMID: 21512935 PMCID: PMC3183146 DOI: 10.1080/10810730.2011.561908] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study explores the effects of tissue requesters' relational, persuasive, and nonverbal communication on families' final donation decisions. One thousand sixteen (N = 1,016) requests for tissue donation were audiotaped and analyzed using the Siminoff Communication Content and Affect Program, a computer application specifically designed to code and assist with the quantitative analysis of communication data. This study supports the important role of communication strategies in health-related decision making. Families were more likely to consent to tissue donation when confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem were used during donation discussions. Consent was also more likely when family members exhibited nonverbal immediacy or disclosed private information about themselves or the patient. The results of a hierarchical log-linear regression revealed that the use of relational communication during requests directly predicted family consent. The results provide information about surrogate decision making in end-of-life situations and may be used to guide future practice in obtaining family consent to tissue donation.
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Affiliation(s)
- Laura A Siminoff
- Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, 23298, USA
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Santos MJD, Massarollo MCKB. Fatores que facilitam e dificultam a entrevista familiar no processo de doação de órgãos e tecidos para transplante. ACTA PAUL ENFERM 2011. [DOI: 10.1590/s0103-21002011000400005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Desvelar a percepção dos profissionais que atuam em Organizações de Procura de Órgãos sobre os fatores que facilitam e dificultam a entrevista familiar no processo de doação de órgãos e tecidos para transplante. MÉTODOS: Trata-se de pesquisa qualitativa, na vertente fenomenológica, modalidade "estrutura do fenômeno situado". Participaram do estudo 18 profissionais que atuavam em Organizações de Procura de Órgãos. RESULTADOS: Após a análise das entrevistas, foram revelados os fatores que facilitam e dificultam a entrevista familiar. CONCLUSÃO: As proposições que emergiram, revelaram que os fatores que facilitam e dificultam a entrevista familiar estão relacionados ao local da entrevista, à assistência prestada ao potencial doador e aos familiares, aos esclarecimentos fornecidos à família e a manifestação do potencial doador em vida sobre a decisão quanto à doação de órgãos.
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Coppen R, Friele RD, Gevers SKM, Van Der Zee J. Donor education campaigns since the introduction of the Dutch organ donation act: increased cohesion between campaigns has paid off. Transpl Int 2010; 23:1239-46. [DOI: 10.1111/j.1432-2277.2010.01139.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Family consent to tissue donation currently falls well below that for solid organ donation. Moreover, research suggests that Americans have limited understanding of tissue donation, an activity largely overshadowed by the more publicly visible organ donation. This research sought to identify determinants of families' consent to tissue donation. METHODS Data collection included a brief, self-administered survey completed by tissue bank staff and telephone interviews with family for a sample of tissue donor-eligible deaths reported to a national sample of 16 United States Tissue banks from 2003 to 2006. Family members (N = 1,418) and tissue bank staff (n = 226) involved in the tissue donation decision participated in the research. RESULTS The families of 1,015 (71.6%) tissue donor-eligible patients consented to tissue donation; 403 (26.8%) families refused. Results revealed a multitude of associations between study variables and the donation decision. A subsequent multivariable analysis identified determinants of family consent to tissue donation, including the discussion of key donation-related issues during the request (adjusted odds ratio [AOR], 17.22; 95% confidence interval [CI], 11.61-25.54), the quality of communication during the request (AOR, 12.39; CI, 7.76-20.02), families' tissue donation attitudes and knowledge (AOR, 10.01; CI, 6.47-15.50), families' initial reactions to the request (AOR, 7.86; CI, 5.13-12.05), families' advance notice of the request (AOR, 3.95; CI, 2.41-6.46), and patient and family sociodemographic characteristics (AOR, 3.32; CI, 2.01-5.48). CONCLUSIONS Family consent to tissue donation is affected by many of the same variables influencing consent to solid organ donation. Recommendations for practice are provided.
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Coppen R, Friele RD, Gevers SKM, van der Zee J. Imagining the impact of different consent systems on organ donation: the decisions of next of kin. Death Stud 2010; 34:835-847. [PMID: 24482852 DOI: 10.1080/07481181003765444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Next of kin play an important role in organ donation. The aim of this study was to assess the extent to which explicitness of consent to organ donation by the deceased impacts the likelihood that next of kin will agree to organ donation of the deceased by using hypothetical cases. Results indicate that that people say they are more willing to agree to donate organs of those who explicitly consented to donate than those whose permission to donate is presumed. The degree of explicitness for the consent to donate by the deceased appears to influence the next of kin's decision about whether to agree to donation. This variation might explain the absence of differences in efficiency between various types of consent systems.
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Affiliation(s)
- Remco Coppen
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
| | | | - Sjef K M Gevers
- Department of Social Medicine (Health Law Section), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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