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循环判定死亡后心脏捐献:加拿大医护人员和公众认知的混合方法研究方案。

Cardiac donation after circulatory determination of death: protocol for a mixed-methods study of healthcare provider and public perceptions in Canada.

机构信息

Department of Medicine, Western University, London, Ontario, Canada

Department of Medicine, Western University, London, Ontario, Canada.

出版信息

BMJ Open. 2020 Jul 20;10(7):e033932. doi: 10.1136/bmjopen-2019-033932.

Abstract

INTRODUCTION

Cardiac transplantation remains the best treatment for patients with end-stage heart disease that is refractory to medical or device therapies, however, a major challenge for heart transplantation is the persistent discrepancy between the number of patients on waiting lists and the number of available hearts. While other countries (eg, UK, Australia and Belgium) have explored and implemented alternative models of transplantation, such as cardiac donation after circulatory determination of death (DCDD) to alleviate transplantation wait times, ethical concerns have hindered implementation in some countries. This study aims to explore the attitudes and opinions of healthcare providers and the public about cardiac DCDD in order to identify and describe opportunities and challenges in ensuring that proposed cardiac DCDD procedures in Canada are consistent with Canadian values and ethical norms.

METHODS AND ANALYSIS

This study will include two parts that will be conducted concurrently. Part 1 is a qualitative study consisting of semi-structured interviews with Canadian healthcare providers who routinely care for organ donors and/or transplant recipients to describe their perceptions about cardiac DCDD. Part 2 is a convergent parallel mixed-methods design consisting of a series of focus groups and follow-up surveys with members of the Canadian general public to describe their perceptions about cardiac DCDD.

ETHICS AND DISSEMINATION

This study has been approved by the Research Ethics Board at Western University. The findings will be presented at regional and national conferences and reported in peer-reviewed publications.

摘要

简介

心脏移植仍然是治疗对药物或器械治疗有抗药性的终末期心脏病患者的最佳方法,然而,心脏移植的一个主要挑战是等待名单上的患者数量与可用心脏数量之间持续存在差距。虽然其他国家(例如英国、澳大利亚和比利时)已经探索并实施了心脏移植的替代模式,例如循环死亡判定后的心脏捐献(DCDD),以减轻移植等待时间,但一些国家的伦理问题阻碍了其实施。本研究旨在探讨医疗保健提供者和公众对心脏 DCDD 的态度和意见,以便确定和描述在确保加拿大拟议的心脏 DCDD 程序符合加拿大价值观和伦理规范方面的机会和挑战。

方法和分析

本研究将包括两个并行进行的部分。第 1 部分是一项定性研究,包括对经常照顾器官捐献者和/或移植受者的加拿大医疗保健提供者进行半结构式访谈,以描述他们对心脏 DCDD 的看法。第 2 部分是一个并行混合方法设计,包括一系列焦点小组和对加拿大普通公众成员的后续调查,以描述他们对心脏 DCDD 的看法。

伦理和传播

本研究已获得西安大略大学伦理委员会的批准。研究结果将在区域和国家会议上进行报告,并在同行评议的出版物中发表。

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