School of Nursing & Midwifery, Queens University Belfast, Belfast, UK.
J Clin Nurs. 2018 Mar;27(5-6):e726-e738. doi: 10.1111/jocn.14154. Epub 2018 Jan 15.
To examine the role of healthcare professionals in the organ donation and transplantation process.
Globally, there remains a perennial disequilibrium between organ donation and organ transplantation. Several factors account for this disequilibrium; however, as healthcare professionals are not only strategically positioned as the primary intermediaries between organ donors and transplant recipients, but also professionally situated as the implementers of organ donation and transplantation processes, they are often blamed for the global organ shortage.
Mixed-method systematic review using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 checklist.
Databases were searched including CINAHL, MEDLINE, Web of Science and EMBASE using the search terms "organ donation," "healthcare professionals," "awareness" and "roles" to retrieve relevant publications.
Thirteen publications met the inclusion criteria. The global organ shortage is neither contingent upon unavailability of suitable organs nor exclusively dependent upon healthcare professionals. Instead, the existence of disequilibrium between organ donation and transplantation is necessitated by a web of factors. These include the following: healthcare professionals' attitudes towards, and experience of, the organ donation and transplantation process, underpinned by professional education, specialist clinical area and duration of professional practice; conflicts of interests; ethical dilemmas; altruistic values towards organ donation; and varied organ donation legislations in different legal jurisdictions.
This review maintains that if this web of factors is to be adequately addressed by healthcare systems in different global and legal jurisdictions, there should be sufficient organs voluntarily donated to meet all transplantation needs.
There is a suggestion that healthcare professionals partly account for the global shortage in organ donation, but there is a need to examine how healthcare professionals' roles, knowledge, awareness, skills and competencies might impact upon the organ donation and transplantation process.
探讨医疗保健专业人员在器官捐献和移植过程中的作用。
在全球范围内，器官捐献和移植之间仍然存在着长期的不平衡。造成这种不平衡的原因有很多；然而，由于医疗保健专业人员不仅是器官捐献者和移植接受者之间的主要中介，而且是器官捐献和移植过程的专业执行者，他们经常被指责为全球器官短缺的原因。
使用 2015 年系统评价和荟萃分析报告的首选报告项目清单，进行混合方法系统评价。
使用 CINAHL、MEDLINE、Web of Science 和 EMBASE 数据库，使用“器官捐献”、“医疗保健专业人员”、“意识”和“角色”等检索词检索相关出版物。
符合纳入标准的有 13 篇出版物。全球器官短缺既不是由于缺乏合适的器官造成的，也不是完全依赖于医疗保健专业人员。相反，器官捐献和移植之间的不平衡是由一系列因素造成的。这些因素包括：医疗保健专业人员对器官捐献和移植过程的态度和经验，这些态度和经验受到专业教育、专业临床领域和专业实践时间的影响；利益冲突；伦理困境；对器官捐献的利他价值观；以及不同法律管辖区的器官捐献立法的差异。
本综述认为，如果不同全球和法律司法管辖区的医疗系统要充分解决这一网络因素，就应该有足够的自愿捐献器官来满足所有的移植需求。
有证据表明，医疗保健专业人员在一定程度上导致了全球器官捐献短缺，但需要研究医疗保健专业人员的角色、知识、意识、技能和能力如何影响器官捐献和移植过程。
