Department of Biomedical Ethics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Biomedical Ethics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Transplant Proc. 2022 Sep;54(7):1750-1758. doi: 10.1016/j.transproceed.2022.04.026. Epub 2022 Aug 16.
There are several psychosocial and ethical issues surrounding the decision making of living kidney transplant donors. This study aimed to determine what health care professionals (HPs) consider in their clinical practice and their attitudes toward donors' decision-making processes.
Face-to-face semistructured interviews were conducted with 15 HPs. A thematic analysis was performed to categorize the thematic elements of the transcripts. All procedures were approved by the relevant review board and conducted in accordance with the Declaration of Helsinki.
Six main categories-maintaining family relationships, improving donor understanding, supporting voluntary decision making, setting the environment for the examination, having different attitudes toward the donor's intentions, and resisting confirmation of intent-were identified. The HPs provided diverse considerations to respect the donors' autonomy.
In clinical practice, there is a lack of practical methods to confirm living donors' levels of understanding and spontaneity, suggesting that these methods need to be established. Factors related to family functioning may reflect the unique culture of Japan, and this may be indicative of the need to consider treatment based on cultural values.
活体肾移植供者的决策涉及到若干心理社会和伦理问题。本研究旨在确定医护人员在临床实践中考虑哪些因素，以及他们对供者决策过程的态度。
对 15 名医护人员进行了面对面的半结构化访谈。采用主题分析法对转录本的主题要素进行分类。所有程序均获得相关审查委员会的批准，并按照《赫尔辛基宣言》进行。
确定了 6 个主要类别：维持家庭关系、增进供者理解、支持自愿决策、为检查创造环境、对供者意图有不同态度以及抵制确认意图。医护人员提供了各种考虑因素以尊重供者的自主权。
在临床实践中，缺乏确认活体供者理解程度和自发性的实用方法，表明需要建立这些方法。与家庭功能相关的因素可能反映了日本独特的文化，这可能表明需要根据文化价值观考虑治疗方法。
