Clarke Alexis, Mitchell Annie, Abraham Charles
Peninsula College of Medicine and Dentistry, University of Exeter, UK.
Br J Health Psychol. 2014 May;19(2):393-408. doi: 10.1111/bjhp.12048. Epub 2013 May 21.
Kidney donation from a living donor to an unknown recipient has been legal in the UK since 2006. Yet there is little research into the experiences of unspecified kidney donors (UKDs) in interaction with the health care systems.
This article explores the experiences of 14 UKDs recruited through four regional transplant co-ordinating centres in England. At interview, they were invited to share their donation stories and discuss the antecedents, social, and psychological processes involved. Interviews were audio-taped and transcribed.
Transcripts were analysed using a grounded theory approach employing a constant comparison methodology. Themes emerging from the data were named to form categories organized around the central focus of the research, forming an analytical story of UKDs' experiences.
Two major categories emerged: 'connected to others' and 'uneasy negotiations with others'. 'Connected to others' encompasses the motivations and psychological and social consequences of UKD. 'Uneasy negotiations with others' refer to the concerns and conflicts that arose during the donation process.
This study highlights the importance of social relationships on the process and outcomes of UKD. These UKDs report both intra- and interpersonal benefits from donation. The donation process, however, also created interpersonal stress, and conflicting messages about the acceptability of their donation were experienced in UKDs' personal lives and in their interactions with health care services. Findings are discussed with reference to the wider literature on UKD and altruism and in relation to implications for clinical practice.
What is already known on this subject? Unspecified living kidney donation is an under-researched area with only three research papers published worldwide that report on the motivations and experiences of donors. These studies indicate that donors endorse pro-social values and receive positive interpersonal and intrapersonal benefits from donation. What does this study add? UKDs' experiences are made explicit and provide a framework for future research. Social connections (capital) are an important precursor to and outcome from donation. Assumptions of pathological motivations were encountered by donors in their personal life and within the NHS.
自2006年起，在英国，活体肾脏捐赠给未知受赠者已属合法行为。然而，对于未指定肾脏捐赠者（UKD）与医疗保健系统互动的经历，却鲜有研究。
本文探讨了通过英格兰四个地区移植协调中心招募的14名未指定肾脏捐赠者的经历。在访谈中，邀请他们分享捐赠故事，并讨论其中涉及的前期因素、社会和心理过程。访谈进行了录音和转录。
使用扎根理论方法，采用持续比较法对转录文本进行分析。从数据中浮现的主题被命名，以形成围绕研究核心焦点组织的类别，构建出未指定肾脏捐赠者经历的分析性故事。
出现了两个主要类别：“与他人建立联系”和“与他人进行艰难谈判”。“与他人建立联系”涵盖了未指定肾脏捐赠者的动机以及心理和社会后果。“与他人进行艰难谈判”指的是捐赠过程中出现的担忧和冲突。
本研究凸显了社会关系对未指定肾脏捐赠者捐赠过程及结果的重要性。这些未指定肾脏捐赠者报告了捐赠带来的个人内部和人际间的益处。然而，捐赠过程也造成了人际压力，他们在个人生活以及与医疗保健服务的互动中，都经历了关于其捐赠可接受性的相互矛盾的信息。结合关于未指定肾脏捐赠者和利他主义的更广泛文献，对研究结果进行了讨论，并探讨了其对临床实践的影响。
关于该主题已知的情况是什么？未指定活体肾脏捐赠是一个研究不足的领域，全球仅发表了三篇关于捐赠者动机和经历的研究论文。这些研究表明，捐赠者认可亲社会价值观，并从捐赠中获得积极的人际和个人内部益处。本研究增加了什么？明确了未指定肾脏捐赠者的经历，并为未来研究提供了一个框架。社会联系（资本）是捐赠的重要前提和结果。捐赠者在个人生活和国民保健制度内部都遇到了对其动机存在病态假设的情况。
