Shih F J, Lai M K, Lin M H, Lin H Y, Tsao C I, Chou L L, Chu S H
School of Nursing, College of Medicine, National Taiwan University, Taipei.
Psychosom Med. 2001 Jan-Feb;63(1):69-78. doi: 10.1097/00006842-200101000-00009.
Organ donation is a complex decision for family members of Asian donors. The impact of cadaveric organ donation on both Chinese and Western donor families has not been well investigated within a cultural framework. The purposes of this study were to follow Chinese family members' appraisal of their decision to donate organs, to explore the possible negative and positive impacts of organ donation on their family life, and to determine what help they expected from healthcare providers during the first 6 months after donation.
Twenty-two family members (10 men and 12 women) of cadaveric organ donors who signed consent forms at an organ transplant medical center in Taiwan participated in this project and completed in-depth interviews during the sixth month after donation.
Participants were 25 to 56 years old (mean = 48.15 +/- 8.31 years). The type of kinship of the participants included the donor's parents, older sister, and spouse. Subjects reported several negative impacts: worry about the donor's afterlife (86%), stress due to controversy among family members over the decision to donate (77%), and stress due to others' devaluation of the donation (45%). Positive impacts reported by the subjects included having a sense of reward for helping others (36%), having an increased appreciation of life (32%), having closer family relationships (23%), and planning to shift life goals to the study of medicine (9%). Subjects expected the transplant team to provide information about organ recipients (73%), to submit the necessary documents so that family members could receive healthcare payments from the insurance company (68%), to help resolve legal proceedings and settlements associated with accidents (64%), and to not overly publicize their decision to donate (64%).
Although all of the subjects reported that organ donation was the right decision, the decision to donate did not protect Taiwanese donor families from negative psychocognitive bereavement. The impacts of organ donation were affected by the subject's social cultural, spiritual, and legal context and the nature of their bereavement.
对于亚洲捐赠者的家庭成员而言,器官捐赠是一个复杂的决定。在文化框架内,尸体器官捐赠对中国和西方捐赠者家庭的影响尚未得到充分研究。本研究的目的是跟踪中国家庭成员对其器官捐赠决定的评估,探讨器官捐赠对其家庭生活可能产生的消极和积极影响,并确定在捐赠后的头6个月里他们期望从医疗服务提供者那里得到哪些帮助。
在台湾一家器官移植医疗中心签署同意书的22名尸体器官捐赠者的家庭成员(10名男性和12名女性)参与了本项目,并在捐赠后第六个月完成了深入访谈。
参与者年龄在25至56岁之间(平均年龄=48.15±8.31岁)。参与者的亲属类型包括捐赠者的父母、姐姐和配偶。受试者报告了几个负面影响:担心捐赠者的来世(86%)、家庭成员之间因捐赠决定产生争议而带来的压力(77%)以及他人对捐赠的贬低所带来的压力(45%)。受试者报告的积极影响包括因帮助他人而产生的成就感(36%)、对生活的感激之情增加(32%)、家庭关系更亲密(23%)以及计划将生活目标转向医学研究(9%)。受试者期望移植团队提供有关器官接受者的信息(73%)、提交必要文件以便家庭成员能够从保险公司获得医疗费用(68%)、帮助解决与事故相关的法律程序和理赔(64%)以及不过度宣扬他们的捐赠决定(64%)。
尽管所有受试者都表示器官捐赠是正确的决定,但捐赠决定并未使台湾捐赠者家庭免受消极的心理认知丧亲之痛。器官捐赠的影响受到受试者的社会文化、精神和法律背景以及他们丧亲之痛性质的影响。