Lalehgani Hedayatallah, Babaee Sima, Yazdannick Ahmad Reza, Alimohammadi Nasrollah, Saneie Behnam, Ramezannejad Pantea
Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Surgery, School of Medicine, Acquired Immunodeficiency Research Center, Al-Zahra Hospital, Dubai, United Arab Emirates.
J Educ Health Promot. 2024 Mar 28;13:87. doi: 10.4103/jehp.jehp_457_23. eCollection 2024.
In many countries, the consent of family members is required for organ donation from brain-dead patients who are potential candidates for organ donation. In this regard, knowing the factors affecting family members' decision for organ donation can help improve the conditions. This qualitative study aimed to identify the factors affecting family members' decision-making regarding donation of brain-dead patients' organs.
This research applied qualitative research by focusing on the content analysis approach. The study started from April 2021 in Al-Zahra Hospital in Isfahan and Ayatollah Kashani in Shahrekord and continued until data saturation was reached (September 1401). Participants were assigned to one of three groups: brain-dead patients' family members who consented to organ donation, brain-dead patients' family members who declined to consent to organ donation, and people involved in the organ donation process. The sample was selected using the purposive sampling method. The data were collected using unstructured interviews and the field survey method. In this study, a qualitative content analysis with a contractual approach was used to analyze the data.
The analysis of the collected data using different methods yielded 11 main categories, including 1) unresponsive healthcare system, 2) inadequate support from government systems, 3) weakness of social work organizations, 4) fear of being stigmatized, 5) cultural values, 6) symbolization, 7) perpetuation and the society's attitude, 8) development of personality system and generalism, 9) human values, 10) spiritual maturity, and 11) belief-religious challenges, leading finally to three themes, including 1) structural and functional weakness of systems, 2) sociocultural factors, and 3) worldview.
The findings of the present research were able to identify the roots and social factors affecting Iranian families' decisions regarding the consent or nonconsent of brain-dead patient members. Health system administrators and organ donation committees in medical sciences universities in Iran can try to solve the shortage of donated organs by using the specific social aspects introduced in this study. It is also recommended to design effective models for more satisfaction of family members for brain death patient organ donation in healthcare based on the underlying concepts of this study.
在许多国家，对于潜在的器官捐献脑死亡患者，需要获得其家庭成员的同意才能进行器官捐献。在这方面，了解影响家庭成员器官捐献决策的因素有助于改善相关情况。这项定性研究旨在确定影响家庭成员对脑死亡患者器官捐献决策的因素。
本研究采用聚焦内容分析法的定性研究方法。该研究于2021年4月在伊斯法罕的扎赫拉医院和沙赫鲁德的阿亚图拉·卡尚尼医院开始，并持续至数据饱和（1401年9月）。参与者被分为三组之一：同意器官捐献的脑死亡患者家庭成员、拒绝同意器官捐献的脑死亡患者家庭成员以及参与器官捐献过程的人员。样本采用目的抽样法选取。数据通过非结构化访谈和实地调查法收集。在本研究中，采用基于契约方法的定性内容分析法对数据进行分析。
使用不同方法对收集到的数据进行分析，得出11个主要类别，包括1）无响应的医疗保健系统，2）政府系统支持不足，3）社会工作组织薄弱，4）害怕被污名化，5）文化价值观，6）象征化，7）延续性和社会态度，8）人格系统发展与普遍主义，9）人类价值观，10）精神成熟度，11）信仰 - 宗教挑战，最终形成三个主题，包括1）系统的结构和功能弱点，2）社会文化因素，3）世界观。
本研究结果能够确定影响伊朗家庭对脑死亡患者成员同意或不同意器官捐献决策的根源和社会因素。伊朗卫生系统管理人员和医学科学大学的器官捐献委员会可以尝试利用本研究中介绍的特定社会方面来解决器官捐献短缺问题。还建议基于本研究的基本概念设计有效的模式，以使家庭成员对医疗保健中脑死亡患者器官捐献更满意。
