Bidigare S A, Ellis A R
Department of Family Practice, St John Hospital and Medical Center, Detroit, Mich, USA.
Arch Fam Med. 2000 Jul;9(7):601-4; discussion 605. doi: 10.1001/archfami.9.7.601.
To determine if family physicians can increase the commitment of patients to organ donation.
Prospective, systematically randomized, cross-sectional study.
Family practice residency medical center associated with an urban, community-based teaching institution.
A total of 300 patients aged 18 years or older, able to give consent, and being seen for non-life-threatening visits; 247 patients returned valid second questionnaires.
Instruments included 2 self-administered questionnaires. All patients received questionnaire 1 to be completed in the examination room. They also received an informational brochure, a Michigan Secretary of State driver's license sticker (donor sticker) and questionnaire 2. Group 1 received the written materials only. Group 2 received written materials plus a brief verbal discussion by the investigators following a standard protocol. Questionnaire 2 was to be completed and returned after the interventions.
Self-reported completion of donor sticker was used to evaluate commitment to organ donation. Knowledge scores were summed for preintervention and postintervention means.
Thirty-three percent of patients had already committed to organ donation prior to the study. Of those not previously committed, 40% decided to do so after the interventions. There was no statistical difference in the recruitment of donors between the 2 intervention groups. Of new donors identified, 65% stated their decision was due to written materials provided, while 34% attributed this to discussion with a physician. Thirty-five percent of the family members made arrangements to donate their own organs after the discussion with the patient. There was a significant difference between mean pretest and posttest knowledge scores (10 questions; 7.9 vs 9.2; P<.01).
Family physicians can increase the commitment to organ donation through a relatively simple intervention.
确定家庭医生是否能够提高患者对器官捐赠的认同度。
前瞻性、系统随机、横断面研究。
与一所城市社区教学机构相关联的家庭医学住院医师培训医疗中心。
共有300名18岁及以上、能够给予同意且因非危及生命的就诊前来的患者;247名患者返回了有效的第二份问卷。
工具包括两份自填式问卷。所有患者在检查室收到问卷1并完成填写。他们还收到一份信息手册、一张密歇根州州务卿驾照贴纸(捐赠者贴纸)和问卷2。第1组仅收到书面材料。第2组除书面材料外,研究人员还按照标准方案进行了简短的口头讨论。问卷2在干预措施实施后完成并返回。
自我报告的捐赠者贴纸填写情况用于评估对器官捐赠的认同度。对干预前和干预后的知识得分进行汇总求均值。
33%的患者在研究前就已承诺进行器官捐赠。在那些之前未承诺的患者中,40%在干预措施实施后决定这样做。两个干预组在捐赠者招募方面没有统计学差异。在新确定的捐赠者中,65%表示他们的决定是由于提供的书面材料,而34%将其归因于与医生的讨论。35%的家庭成员在与患者讨论后安排捐赠自己的器官。干预前和干预后的知识得分均值之间存在显著差异(10个问题;7.9对9.2;P<0.01)。
家庭医生可以通过相对简单的干预措施提高对器官捐赠的认同度。