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急诊科脑死亡通知的障碍。

Barriers to Brain Death Notifications From Emergency Departments.

作者信息

Akkas Meltem, Demir Mehmet Cihat

机构信息

Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Department of Emergency Medicine, Sinop Atatürk State Hospital, Sinop, Turkey.

出版信息

Transplant Proc. 2019 Sep;51(7):2171-2175. doi: 10.1016/j.transproceed.2019.02.049. Epub 2019 Jul 18.

DOI:10.1016/j.transproceed.2019.02.049
PMID:31327476
Abstract

PURPOSE

Emergency departments (EDs) are a new focus of interest in recent years as a possible solution for increasing organ donations, as, EDs are full of missed opportunities. In this study, we aimed to determine the barriers to the identification and referral by emergency medicine physicians (EMPs) of potential brain death (BD) cases.

MATERIALS AND METHODS

The participants of the study consist of 252 EMPs who had answered the questionnaire sent via e-mail.

FINDINGS

The following causes were found in the questionnaire: (1) negative attitudes and lack of knowledge about organ donation in society (63.1%); (2) religious beliefs (57.5%); (3) family refusal (57.1%); (4) disruption of bodily integrity (45.6%); (5) inadequate knowledge of doctors (50.4%); (6) difficulties in predicting the prognosis of the patient and diagnosing BD in EDs (40.1%); (7) fear of negative reactions from relatives of patients (37.7%); (8) the absence of an organ procurement unit (OPU) (36.5%); (9) lack of ideal candidates (27%); (10) increased workload in EDs (23.8%); and (11) fear of legal problems arising (23.8%). Of the participants, 42.9% stated that there was an OPU in their hospital. Of the participants, 15.8% reported that they have good communication with the OPU.

CONCLUSIONS

Negative attitudes and lack of knowledge about organ donation in society, religious beliefs, inadequate knowledge of EMPs, and the absence of an OPU in hospitals are important barriers to organ donor notification from EDs. Increasing social awareness and increasing of the level of knowledge of EMPs and close cooperation between OPU and EDs will significantly contribute to the increase of organ donor notifications from EDs.

摘要

目的

近年来,急诊科作为增加器官捐献的一种可能解决方案成为了新的关注焦点,因为急诊科存在大量错失的机会。在本研究中,我们旨在确定急诊医学医生识别和转诊潜在脑死亡病例的障碍。

材料与方法

本研究的参与者包括252名通过电子邮件回复问卷的急诊医学医生。

结果

问卷中发现了以下原因:(1)社会对器官捐献的负面态度和知识缺乏(63.1%);(2)宗教信仰(57.5%);(3)家属拒绝(57.1%);(4)身体完整性受损(45.6%);(5)医生知识不足(50.4%);(6)在急诊科预测患者预后和诊断脑死亡存在困难(40.1%);(7)担心患者亲属的负面反应(37.7%);(8)缺乏器官获取单位(36.5%);(9)缺乏理想的候选人(27%);(10)急诊科工作量增加(23.8%);以及(11)担心出现法律问题(23.8%)。参与者中,42.9%表示他们所在医院有器官获取单位。参与者中,15.8%报告称他们与器官获取单位沟通良好。

结论

社会对器官捐献的负面态度和知识缺乏、宗教信仰、急诊医学医生知识不足以及医院缺乏器官获取单位是急诊科器官捐献通知的重要障碍。提高社会意识、提升急诊医学医生的知识水平以及器官获取单位与急诊科之间的密切合作将显著有助于增加急诊科的器官捐献通知。

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