Fujita Misao, Akabayashi Akira, Slingsby Brian Taylor, Kosugi Shinji, Fujimoto Yasuhiro, Tanaka Koichi
Department of Biomedical Ethics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Liver Transpl. 2006 May;12(5):768-74. doi: 10.1002/lt.20689.
This study examined the decision-making processes of donors in adult-to-adult living donor liver transplantation. Twenty-two donors were interviewed using a semi-structured format. Interview contents were transcribed verbatim and analyzed qualitatively using grounded theory. A decision-making model was developed consisting of 5 stages: (1) recognition, (2) digestion, (3) decision-making, (4) reinforcement, and (5) resolution. The second and the third stages described donors' experiences of "reaching a decision"; the fourth and fifth stages described those of "facing transplantation." The central theme of this model was "having no choice," which consisted of 4 codes: (1) priority of life, (2) only LDLT, (3) for family, and (4) only me. In conclusion, this model can help health care professionals to understand the donor experience and, based on that understanding, to provide sufficient support to the donor.
本研究考察了成人活体肝移植供体的决策过程。采用半结构化形式对22名供体进行了访谈。访谈内容逐字记录，并运用扎根理论进行定性分析。构建了一个由五个阶段组成的决策模型：（1）认知，（2）领悟，（3）决策，（4）强化，以及（5）解决。第二和第三阶段描述了供体“做出决定”的经历；第四和第五阶段描述了“面对移植”的经历。该模型的核心主题是“别无选择”，它包含四个编码：（1）生命优先，（2）只能进行活体肝移植，（3）为了家人，以及（4）只有我能做。总之，该模型有助于医护人员理解供体的经历，并基于这种理解为供体提供充分的支持。
