Thornton J Daryl, Curtis J Randall, Allen Margaret D
Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH 44109, USA.
J Natl Med Assoc. 2006 Jun;98(6):897-904.
A useful framework for initiating organ donation discussions in the primary care setting may help increase willingness to donate and thereby increase the frequency of organ transplantation. Given the lower willingness to donate among African Americans and that a higher proportion of African Americans die while waiting for an organ transplant, this is an important group to consider in such an approach. We examined the association among completion of a living will and willingness to donate and the influence of race in this relationship.
A nationwide telephone interview survey using random digit dialing of households in high- and low-density African-American census blocks.
One hundred-eighty-eight adults participated (41% cooperation rate). In a multivariate model, factors associated with willingness to donate included having signed a living will (OR=2.43, 95% CI=1.13-5.23), talking with a physician about organ donation (OR=3.04, 95% CI=1.07-8.67) and white race (OR=2.5, 95% CI=1.23-5).
The public is generally supportive of organ donation although African Americans remain less willing to donate after controlling for confounding variables. Physicians interested in increasing donation rates should consider incorporating organ donation into discussions of advance care planning and end-of-life care.
在基层医疗环境中启动器官捐赠讨论的有用框架可能有助于提高捐赠意愿，从而增加器官移植的频率。鉴于非裔美国人的捐赠意愿较低，且有较高比例的非裔美国人在等待器官移植时死亡，在这种方法中该群体是一个需要考虑的重要群体。我们研究了生前预嘱的完成情况与捐赠意愿之间的关联以及种族在这种关系中的影响。
采用随机数字拨号对高密度和低密度非裔美国人普查街区的家庭进行全国性电话访谈调查。
188名成年人参与（合作率为41%）。在多变量模型中，与捐赠意愿相关的因素包括签署生前预嘱（比值比=2.43，95%置信区间=1.13 - 5.23）、与医生谈论器官捐赠（比值比=3.04，95%置信区间=1.07 - 8.67）以及白人种族（比值比=2.5，95%置信区间=1.23 - 5）。
公众总体上支持器官捐赠，尽管在控制混杂变量后非裔美国人的捐赠意愿仍然较低。对提高捐赠率感兴趣的医生应考虑将器官捐赠纳入临终关怀计划和临终护理的讨论中。
