Reza Nejatollahi Seyed Mohammad, Abdolmohammadi Yazdan, Ahmadi Sepideh, Hasanzade Arman, Hosseini Fatemeh, Mohseni Arshia, Shafaghi Shadi, Mokhber Dezfuli Mojtaba, Ghorbani Fariba
Department of Hepato-Pancreato-Biliary and Transplant Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Korean J Transplant. 2023 Dec 31;37(4):241-249. doi: 10.4285/kjt.23.0049. Epub 2023 Nov 24.
Obtaining consent from potential donor families is a challenging step in the donation process and is influenced by various factors.
In this cross-sectional study, we utilized a questionnaire containing 14 questions about facilitators and barriers in the family interview process. The questionnaire was distributed in March 2023 to intensive care unit (ICU) nurses who had experience with donor family interviews. We collected the opinions of these respondents on hospital performance and drew comparisons between the studied hospitals.
A total of 60 participating ICU nurses provided mean scores for hospital performance in family interviews of 2.60±0.84 for type I hospitals (those providing neurosurgery and trauma care) and 2.035±0.890 for type II hospitals (those without neurosurgery and trauma services; P=0.04). The mean scores for public and private hospitals were 1.86±0.86 and 2.59±0.85, respectively (P=0.008). Based on the findings, the most important facilitators were the availability of organ donation staff and access to a professional team for family discussions. Conversely, poor physician communication skills and limited communication capabilities among medical staff were identified as significant barriers. Implementation of a professional team for family interviews was found to be more critical for type II hospitals. Poor physician communication skills were a significant concern in public hospitals, while families' lack of awareness of patient prognosis emerged as a key barrier in private hospitals.
This study highlights numerous facilitators and barriers that vary across hospitals. Addressing these issues individually and developing tailored plans to enhance hospital performance in interviewing donor families is essential.
在捐赠过程中,获得潜在捐赠者家属的同意是具有挑战性的一步,且受到多种因素影响。
在这项横断面研究中,我们使用了一份包含14个关于家庭访谈过程中的促进因素和障碍问题的问卷。该问卷于2023年3月分发给有捐赠者家属访谈经验的重症监护病房(ICU)护士。我们收集了这些受访者对医院表现的意见,并对研究的医院进行了比较。
共有60名参与的ICU护士给出了I类医院(提供神经外科和创伤护理的医院)家庭访谈中医院表现的平均分为2.60±0.84,II类医院(不提供神经外科和创伤服务的医院)为2.035±0.890(P = 0.04)。公立医院和私立医院的平均得分分别为1.86±0.86和2.59±0.85(P = 0.008)。根据研究结果,最重要的促进因素是器官捐赠工作人员的可用性以及有专业团队进行家庭讨论。相反,医生沟通技巧差和医务人员沟通能力有限被确定为重大障碍。发现组建专业的家庭访谈团队对II类医院更为关键。医生沟通技巧差在公立医院是一个重大问题,而私立医院中家庭对患者预后缺乏了解成为关键障碍。
本研究突出了众多因医院而异的促进因素和障碍。单独解决这些问题并制定量身定制的计划以提高医院在访谈捐赠者家属方面的表现至关重要。