Avilés Lissette
Nursing Studies Department, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
PLoS One. 2024 Dec 23;19(12):e0312462. doi: 10.1371/journal.pone.0312462. eCollection 2024.
Approaching families to discuss deceased organ donation authorisation is considered one of the central stages of the organ donation process. In many countries, specialist nurses lead the organ donation process, approach and support families. However, how these encounters occur is not yet fully understood. A constructivist grounded theory methodology was used to conceptualise the process of approaching families from the perspectives of healthcare professionals and families. Data collected included six months of observations across two large hospitals in Chile, documents, interviews and focus groups with 71 participants including healthcare professionals involved in the organ donation process, and bereaved families who were approached for organ donation conversations. The theory Reading the family was developed to explain the relational process of how nurse organ donor coordinators approach families to negotiate organ donation authorization. It explains the sophisticated and skilled process of accessing, assessing and managing family's emotions to negotiate organ donation authorization as a family unit. The theory has two dimensions, indirect and direct, which refers to when and how nurses read families emotions to lead organ donation conversations and support bereaved families' decision-making process. These dimensions critically depend on the clinicians set of beliefs and communication processes. Understanding the complexities of approaching families is essential for practice and policymaking, particularly when there is a trend towards individual decision-making instead of understanding organ donation as a family affair. Reading the family could be eventually applied in other contexts and situations that involve navigating difficult conversations, and therefore, further research is needed and suggested to assess the feasibility of its application.
与家属探讨 deceased 器官捐赠授权被认为是器官捐赠过程的核心阶段之一。在许多国家，专业护士主导器官捐赠过程，与家属接触并提供支持。然而，这些接触是如何发生的尚未完全明了。本研究采用建构主义扎根理论方法，从医护人员和家属的角度对与家属接触的过程进行概念化。收集的数据包括在智利两家大型医院进行的为期六个月的观察、文件、访谈以及焦点小组，参与者有71人，包括参与器官捐赠过程的医护人员以及被邀请进行器官捐赠谈话的丧亲家属。“读懂家庭”理论旨在解释护士器官捐赠协调员如何与家属接触以协商器官捐赠授权的关系过程。它阐释了作为一个家庭单位，获取、评估和管理家属情绪以协商器官捐赠授权这一复杂而熟练的过程。该理论有间接和直接两个维度，分别指护士何时以及如何读懂家属情绪以引导器官捐赠谈话并支持丧亲家属的决策过程。这些维度严重依赖于临床医生的信念体系和沟通流程。理解与家属接触的复杂性对于实践和政策制定至关重要，尤其是当存在倾向于个人决策而非将器官捐赠视为家庭事务的趋势时。“读懂家庭”理论最终可能应用于其他涉及艰难谈话的情境中，因此，需要并建议进一步开展研究以评估其应用的可行性。 （注：原文中“deceased”在医学语境下结合上下文推测可能是指“已故的”，但这个词在文中使用似乎不太准确，正常器官捐赠语境下一般说“逝者”等更合适表述，这里按原文翻译。）
