Research Office of Chronic Disease Management and Rehabilitation, Nursing Department, Wuxi School of Medicine, Jiangnan University, No.1800 Lihu Avenue, Wuxi 214122, China.
Int J Environ Res Public Health. 2023 Mar 5;20(5):4599. doi: 10.3390/ijerph20054599.
Providing early lung transplantation referral services should be considered to reduce pre-transplant mortality in patients with advanced disease. This study aimed to explore the reasons for lung transplantation referral decisions in patients and provide evidence for the development of transplantation referral services. This was a qualitative, retrospective, and descriptive study involving conventional content analysis. Patients in evaluation, listing, and post-transplant stages were interviewed. A total of 35 participants (25 male and 10 female) were interviewed. Four main themes were defined: (1) expectations for lung transplantation leading to the decision (a gamble for a silver lining, a return to normal life, and occupation); (2) facing uncertain outcomes (personal luck arranging everything; belief in success; incidents leading to "It's decided then"; hesitation when making a decision due to fear); (3) facing various information from peers, doctors, and so on; (4) complex policy and societal support (providing transplantation referral services earlier, family attachment and oral approval responses contribute to the referral decision, and so on). The findings of this study might enrich existing referral services, including training for family members and healthcare providers, a checklist and package of critical events in the patient lung transplantation referral decision-making process, precision services based on behavioral personas, and a curriculum to enhance patient decision self-efficacy.
应当考虑提供早期肺移植转介服务，以降低晚期疾病患者的移植前死亡率。本研究旨在探讨患者进行肺移植转介决策的原因，并为转介服务的发展提供证据。这是一项定性、回顾性和描述性研究，采用常规内容分析。对处于评估、列入名单和移植后阶段的患者进行了访谈。共有 35 名参与者（25 名男性和 10 名女性）接受了采访。确定了四个主要主题：（1）肺移植决策的期望（一线生机的赌博、回归正常生活和职业）；（2）面对不确定的结果（个人运气安排一切；对成功的信念；导致“那就决定了”的事件；因恐惧而犹豫不决）；（3）面对来自同行、医生等的各种信息；（4）复杂的政策和社会支持（更早地提供移植转介服务、家庭依附和口头同意反应有助于转介决策等）。本研究的结果可能丰富现有的转介服务，包括对家庭成员和医疗保健提供者的培训、患者肺移植转介决策过程中关键事件的检查表和一揽子计划、基于行为角色的精准服务以及增强患者决策自我效能的课程。
