Siminoff Laura A, Lawrence Renee H, Arnold Robert M
Department of Bioethics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Crit Care Med. 2003 Jan;31(1):146-51. doi: 10.1097/00003246-200301000-00023.
Black families donate at a lower rate than white families. To help develop effective interventions, we compared black and white families' experiences.
To compare the organ donation request experiences of black and white patients' families with the hope of identifying factors to better inform consent-rate interventions among blacks.
Chart reviews were conducted on files of all deceased patients. Audiotaped in-person interviews were conducted with family members, and telephone interviews were conducted with involved healthcare providers and organ procurement organization staff.
Nine trauma hospitals located in southwest Pennsylvania and northeast Ohio.
A sample of 415 families of organ donor-eligible patients (61 black, 354 white).
Measures of families' attitudes about and experiences with donation and transplantation.
White families were more likely to be correctly perceived as receptive to donation. Black families viewed as receptive were less likely to be engaged in discussing as many donation-related issues as white families (p <.01). They were also less likely to have spoken to an organ procurement organization representative (p =.024) and were given fewer opportunities to consider the decision with healthcare provider or organ procurement organization staff. Black families had less knowledge about their family member's wishes, expressed less-favorable attitudes toward organ donation and the health care system, and, finally, were less likely than white families to donate organs (p =.001). A minority of black families (32.8%) knew about the need for more black donors.
Interventions to increase consent among blacks need to encourage openness about organ donation within the black community and change healthcare provider and organ procurement organization attitudes and practices toward black families as potential donor families.
黑人家庭的捐赠率低于白人家庭。为了帮助制定有效的干预措施，我们比较了黑人和白人家庭的经历。
比较黑人和白人患者家庭在器官捐赠请求方面的经历，以期找出相关因素，为提高黑人的同意率干预措施提供更充分的信息。
对所有已故患者的档案进行图表审查。对家庭成员进行面对面的录音访谈，并对相关医疗保健提供者和器官获取组织工作人员进行电话访谈。
位于宾夕法尼亚州西南部和俄亥俄州东北部的九家创伤医院。
415个符合器官捐赠条件患者的家庭样本（61个黑人家庭，354个白人家庭）。
家庭对捐赠和移植的态度及经历的测量指标。
白人家庭更有可能被正确地认为愿意接受捐赠。被视为愿意接受捐赠的黑人家庭与白人家庭相比，讨论与捐赠相关问题的可能性较小（p<.01）。他们与器官获取组织代表交谈的可能性也较小（p =.024），并且与医疗保健提供者或器官获取组织工作人员一起考虑捐赠决定的机会也较少。黑人家庭对其家庭成员的意愿了解较少，对器官捐赠和医疗保健系统的态度不太积极，最后，他们捐赠器官的可能性比白人家庭小（p =.001）。少数黑人家庭（32.8%）知道需要更多黑人捐赠者。
提高黑人同意率的干预措施需要鼓励黑人社区内部对器官捐赠持开放态度，并改变医疗保健提供者和器官获取组织对黑人家庭作为潜在捐赠家庭的态度和做法。
