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理解协作时代的器官捐赠:一项关于工作人员和家属体验的定性研究。

Understanding organ donation in the collaborative era: a qualitative study of staff and family experiences.

机构信息

Centre for Ethics in Medicine and Society, Department of Medicine, Monash University, Melbourne, Victoria, Australia.

出版信息

Intern Med J. 2009 Sep;39(9):588-94. doi: 10.1111/j.1445-5994.2008.01826.x. Epub 2008 Nov 3.

Abstract

BACKGROUND

Despite the success of the Breakthrough Collaborative Methodology (BCM) in increasing organ donation rates there has been little published evidence on the effect of the BCM on the wider attitudes and experiences of those involved in organ donation. This study sought to identify whether the National Organ Donation Collaborative in Australia had any additional influence on improving the experiences of staff and family members in the organ donation process.

METHODS

IN-depth qualitative interviews with 17 family members from 13 families who had agreed to the organ donation of a deceased relative and 25 nurses and intensive care specialists at the Alfred Hospital, Melbourne, Victoria were carried out.

RESULTS

The key factor in family members' decision to donate was prior knowledge of the deceased's donation wish. Although most family members did not regret their decision to donate, many were deeply dissatistified and, at times, confused by the technical and administrative nature of the donation process. Most staff members commented that the key community message about donation should be to encourage people to discuss donation rather than urging people to sign donor registers.

CONCLUSION

This study identified valuable insights into the processes by which family members and intensive care unit staff deal with the actual processes of donation. Findings suggest that the process for families is far more complex than a simple agreement or refusal to donate. This study suggests that we should not assume that 'rates' of donation in Australia would increase merely through administrative programmes or marketing campaigns.

摘要

背景

尽管突破协作方法(BCM)在提高器官捐赠率方面取得了成功,但关于 BCM 对参与器官捐赠的人员更广泛的态度和经验的影响,几乎没有发表过相关证据。本研究旨在确定澳大利亚国家器官捐赠协作组织是否对改善器官捐赠过程中工作人员和家属的体验有任何额外影响。

方法

对来自维多利亚州墨尔本阿尔弗雷德医院的 13 个家庭的 17 名家属(同意捐赠已故亲属器官)和 25 名护士和重症监护专家进行了深入的定性访谈。

结果

家属决定捐赠的关键因素是事先了解死者的捐赠意愿。尽管大多数家属对捐赠决定并不后悔,但许多人对此深感不满,有时对捐赠过程的技术和行政性质感到困惑。大多数工作人员评论说,关于捐赠的关键社区信息应该是鼓励人们讨论捐赠,而不是敦促人们签署捐赠登记。

结论

本研究深入了解了家属和重症监护病房工作人员处理实际捐赠过程的方式。研究结果表明,对于家属来说,这个过程远比简单地同意或拒绝捐赠复杂得多。本研究表明,我们不应仅仅通过行政计划或营销活动来假设澳大利亚的“捐赠率”会提高。

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