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土耳其家庭医生视角下患者对器官捐赠的态度与意愿及对医疗保健系统的不信任

Attitudes and Willingness of Patients Toward Organ Donation and Distrust in the Health Care System: Insights from Turkish Family Physicians.

作者信息

Mercan Baspinar Melike, Gorukmez Sundus, Gultekin Ulusan Ayca, Ulusan Cemil, Batmaz Ceyhun Dikmen, Dabak Mustafa Resat, Basat Okcan

机构信息

Department of Family Medicine, University of Health Sciences, Gaziosmanpasa Training and Research Hospital, Gaziosmanpasa, Istanbul, Turkey.

Department of Family Medicine, University of Health Sciences, Sultangazi Haseki Training and Research Hospital, Turkey.

出版信息

Transplant Proc. 2024 Nov;56(9):1922-1930. doi: 10.1016/j.transproceed.2024.10.011. Epub 2024 Nov 2.

Abstract

OBJECTIVES

Organ transplant recipients express trust in their physicians with the phrase, "I entrust my life first to Allah and then to you." However, trust is not reflected in organ donor rates in Turkey despite the rising incidence of end-stage organ failures. The aim of this study was to map individuals' attitudes, willingness, and behavior toward organ donation, relationships with distrust in the health care system, religious aspects, and demographic variables.

MATERIALS AND METHODS

In a descriptive cross-sectional approach, a face-to-face questionnaire was issued to randomly selected 557 patients in family medicine clinics of 2 tertiary hospitals in Istanbul City. Positive and negative attitudes' subscales of the organ donation attitude scale and distrust in the health care system scale were used.

RESULTS

The organ donation rate was 12.4%, and 37.9% of participants were willing to donate. A higher education level revealed higher rates of willingness but did not supply a higher donation rate (P = .001, P = .048). The liver was the organ with the most potential to donate (90.3%). The average positive and negative attitude scores toward organ donation were 48.10 ± 21.41 and 72.11 ± 26.47, highlighting negative tendency. The rate of refusals donated for religious reasons was 30.1%. It was observed that individuals who religiously refused organ donation were less willing to donate and showed higher distrust in the health care system (P < .001; P < .001), but they exhibited more positive and less negative donation attitude scores vs others (P < .001; P < .001). Approximately half of the participants reported awareness of organ donation law and brain death principles supporting a significantly higher donation rate (P < .001; P < .001).

CONCLUSIONS

Our findings highlight a crucial mismatch among willingness, attitudes, distrust, religious aspects, and actual behavior regarding organ donation. Strategically, educational materials and interventions on relevant laws, brain death principles, and reasons for becoming donors may be more effective than focusing solely on increasing donation rates.

摘要

目的

器官移植受者用“我首先将生命托付给真主,然后托付给你”这句话来表达他们对医生的信任。然而,尽管终末期器官衰竭的发病率不断上升,但土耳其的器官捐献率却未能体现出这种信任。本研究的目的是梳理个人对器官捐献的态度、意愿和行为,以及与对医疗保健系统的不信任、宗教因素和人口统计学变量之间的关系。

材料与方法

采用描述性横断面研究方法,对伊斯坦布尔市两家三级医院家庭医学诊所中随机选取的557名患者进行面对面问卷调查。使用了器官捐献态度量表的积极和消极态度子量表以及医疗保健系统不信任量表。

结果

器官捐献率为12.4%,37.9%的参与者愿意捐献。较高的教育水平显示出较高的意愿率,但并未带来更高的捐献率(P = 0.001,P = 0.048)。肝脏是最具捐献潜力的器官(90.3%)。对器官捐献的平均积极和消极态度得分分别为48.10±21.41和72.11±26.47,显示出消极倾向。因宗教原因拒绝捐献的比例为30.1%。据观察,出于宗教原因拒绝器官捐献的个体捐献意愿较低,对医疗保健系统的不信任程度较高(P < 0.001;P < 0.001),但与其他人相比,他们表现出更积极和更消极的捐献态度得分(P < 0.001;P < 0.001)。约一半的参与者表示了解器官捐献法和脑死亡原则,这与显著更高的捐献率相关(P < 0.001;P < 0.001)。

结论

我们的研究结果突出了在器官捐献的意愿、态度、不信任、宗教因素和实际行为之间存在的关键不匹配。从策略上讲,关于相关法律、脑死亡原则和成为捐献者的原因的教育材料和干预措施可能比仅仅专注于提高捐献率更有效。

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