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Shim L, Wensley C, Casement J, Parke R. What determinants impact deceased organ donation consent in the adult intensive care unit? An integrative review exploring the perspectives of staff and families. Aust Crit Care 2024; 37:638-650. [PMID: 38216416 DOI: 10.1016/j.aucc.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Deceased organ donation saves lives. Donation processes in New Zealand operate under an opt-in system, which requires consent from families of patients diagnosed with brain death or circulatory death while in the intensivecare unit. The donation demand and supply mismatch is a global phenomenon. OBJECTIVES The objective of this study was to understand the determinants of deceased organ donation decisions in the adult intensive care setting from the perspectives of staff and families. METHODS An integrative review based on Whittemore and Knafl's approach searched literature through databases CINAHL Plus, SCOPUS, Proquest Medline Ovid, and manual ancestry searches. Inclusion/exclusion criteria screened for pertinent literature, which were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Selected studies were appraised using a generic scoring tool, and data were systematically extracted and coded onto spreadsheets using inductive, thematic analysis. RESULTS A total of 21 studies (12 qualitative, seven quantitative, two mixed methods) were included. Publication dates ranged from 1993 to 2021 from multiple countries (18 opt-in, three opt-out systems). Four overarching themes pertaining to families and staff were generated. Important knowledge related to families' knowledge deficits around brain death, the purpose of ventilation, donation procedures, patients' wishes, and staffs' lack of training. Challenging communication highlighted miscommunications due to language choices and interrupted continuity of care during staff-family interactions. Internal determinants explored the cultural, spiritual, and emotional perspectives of families, while staff faced a sense of burden and conflicting values in delivering care between donors and recipients. External determinants related to the clinical environment impacting on grieving families, while for the staff, it explained concerns around resources and organisational processes. CONCLUSIONS Factors underpinning deceased organ donation are multifaceted and complex. Staff actions and families' decisions are inextricably intertwined. Modifiable factors include a lack of formal training and communicational skills and environmental limitations of an intensive care setting.
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Affiliation(s)
- Lydia Shim
- Auckland City Hospital Department of Critical Care Medicine, Te Toka Tumai, Grafton, New Zealand; School of Nursing, The University of Auckland, Faculty of Medical and Health Sciences, Grafton, New Zealand.
| | - Cynthia Wensley
- School of Nursing, The University of Auckland, Faculty of Medical and Health Sciences, Grafton, New Zealand.
| | - Jonathan Casement
- Organ Donation New Zealand, New Zealand Blood Service, 71 Great South Rd, Epsom PO Box 99 431, Newmarket, Auckland 1149, New Zealand; Intensive Care Unit, North Shore Hospital, Waitemata, Te Whatu Ora, Auckland, New Zealand.
| | - Rachael Parke
- School of Nursing, The University of Auckland, Faculty of Medical and Health Sciences, Grafton, New Zealand; Cardiothoracic and Vascular Intensive Care Unit, Te Toka Tumai Auckland, Grafton, New Zealand.
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Dicks SG, Northam HL, van Haren FM, Boer DP. The bereavement experiences of families of potential organ donors: a qualitative longitudinal case study illuminating opportunities for family care. Int J Qual Stud Health Well-being 2023; 18:2149100. [PMID: 36469685 PMCID: PMC9731585 DOI: 10.1080/17482631.2022.2149100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature. METHOD Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death. FINDINGS Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient's death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement. RECOMMENDATIONS Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs. CONCLUSION The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow.
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Affiliation(s)
- Sean G. Dicks
- Department of Psychology, University of Canberra, Canberra, Australia,CONTACT Sean G. Dicks Department of Psychology, University of Canberra, Kirinari St, Bruce, Canberra2617, Australia
| | - Holly L. Northam
- Department of Nursing and Midwifery, University of Canberra, Canberra, Australia
| | | | - Douglas P. Boer
- Department of Psychology, University of Canberra, Canberra, Australia
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Lalegani HA, Babaei S, Alimohammadi N, Yazdannik A, Sanei B, Ramezannezhad P. A Critical Ethnographic Study of Families of Brain-Dead Patients: Their Experiences and Attitudes to Organ Donation. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:536-543. [PMID: 37869701 PMCID: PMC10588912 DOI: 10.4103/ijnmr.ijnmr_267_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/04/2023] [Accepted: 03/15/2023] [Indexed: 10/24/2023]
Abstract
Background Despite the difficulty of making decisions providing facilitating mediators and removing barriers to making decisions about choosing the right path to donate the organs of brain-dead patients by families can assist in improving the services and help the lives of fellow human beings. This study aimed to explain the decision-making mediator for organ donation in families with brain-dead patients in a cultural context. Materials and Methods This qualitative study with a critical ethnographic approach was conducted based on Carspecken's stages from August 2021 to March 2022. In this regard, 22 participants were selected through the purposive sampling method and considering the inclusion and exclusion criteria. Sampling was continued until data saturation. After obtaining the required ethical approval, data collection was performed through observation, semi-structured interviews, and document review. All data were recorded and managed using MAXQDA 18 software. Results Based on the results, the main themes and subthemes of this study included "inefficient decision-making mediator" (the shadow of the socioeconomic situation on the medical status of organ recipients, as well as pessimistic influential individuals, social accountability, dialect difference, and ethnic beliefs) and "efficient decision-making mediator" (social learning, material, and spiritual motivation, mother role, and divine reward). Conclusions The results of this study, derived from a cultural context, can be applied to carrying out future applied and empirical research. Moreover, they can be used in the field of various nursing roles, especially management, care, and education.
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Affiliation(s)
- Hedayat Allah Lalegani
- phD of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Babaei
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrollah Alimohammadi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Yazdannik
- Assistant Professor of Nursing, Department of Critical Care Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Shahrekord, Iran
| | - Behnam Sanei
- Associate Professor of Kidney Transplantation, Department of Surgery, School of Medicine, Acquired Immunodeficiency Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Shahrekord, Iran
| | - Pantea Ramezannezhad
- Assistant Professor of Forensic Medicine, Department of Emergency Medicine, School of Medicine, Kashani Hospital, Shahrekord University of Medical Sciences,Shahrekord, Iran
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Experiência de famílias de doadores falecidos durante o processo de doação de órgãos: um estudo qualitativo. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao004334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bjelland S, Jones K. A Systematic Review on Improving the Family Experience After Consent for Deceased Organ Donation. Prog Transplant 2022; 32:152-166. [DOI: 10.1177/15269248221087429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The demand for transplanted organs outweighs the supply and intensifies the need to improve care for donor families. Studies have shown inadequate care by hospital staff can increase posttraumatic stress disorder and complicated grief in these families but putting solutions into practice remains slow. Objective This systematic review identified factors that relieve or contribute to distress for deceased organ donor families in the time since the decision to donate. Additionally, it provides insights into potential improvements at public health, educational, and health system levels to address these deficiencies. Methods Search terms included organ don*, famil* or relati*, family-centered, grief, and experience*. The search covered original research articles, published in English, from 2014 to July 2021. Results Four key themes emerged among the studies. (a) Understanding factors that affect the emotional aftermath can help staff prevent posttraumatic stress disorder and complicated grief. (b) Improving communication by hospital staff includes: avoiding medical jargon, providing adequate audio and visual explanations, and understanding that the next of kin is struggling to comprehend the tragedy and the information they are being told. (c) End-of-life care such as memory making, bringing in palliative care resources, and parting ceremonies can assist with familial coping as well as staff interactions. (d) Families want more support in the months and years after the donation decision. Discussion Changes at multiple levels can improve the quality of care for families whose relative gave the gift of life, but more research and translation into practice are needed.
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Affiliation(s)
- Sonja Bjelland
- University of Illinois at Chicago College of Nursing, Urbana, IL, USA
| | - Krista Jones
- Department of Population Health Nursing Science, University of Illinois at Chicago College of Nursing, Urbana, IL, USA
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Luo A, He H, Xu Z, Deng X, Xie W. Social Support of Organ Donor Families in China: A Quantitative and Qualitative Study. Front Public Health 2021; 9:746126. [PMID: 34869161 PMCID: PMC8637885 DOI: 10.3389/fpubh.2021.746126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Donor families experienced a difficult time during and after the process of organ donation. There is a necessity to understand the support they received and what they need to help them get through a painful time. This study aimed to investigate the social support level and social support needs of the donor families in China. Methods: A cross-sectional study was conducted among 102 donor families using a questionnaire to investigate their demographics and social support level. To further understand their social support needs, in-depth interviews were conducted among 9 donor families. Results: Findings of the study showed that (1) Most of the family members (74, 72.6%) lacked social support, and only a small number of families (28, 27.5%) received sufficient social support (2). The coping style had an impact on the overall social support level (P = 0.014) (3). There was a lack of emotional support, information support and material support toward the donor's family members. Both emotional support and material support are significantly needed. Conclusions: The overall social support level remained insufficient and the utilization degree of social support was low. Organ donor families are in desperate need of material and emotional support. The level of social support is largely influenced by the donor familie's coping style. Compared with a negative coping style, donor families who adopted a positive coping style acquire more social support.
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Affiliation(s)
- Aijing Luo
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Haiyan He
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Zehua Xu
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,Public Health College of Central South University, Changsha, China
| | - Xuantong Deng
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China
| | - Wenzhao Xie
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
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Living-Donor Liver Transplant in Oman: A Quantitative Cross-Sectional Study of Donors' Experiences and Challenges. J Transplant 2021; 2021:4251814. [PMID: 34820137 PMCID: PMC8608518 DOI: 10.1155/2021/4251814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background In Oman, the first liver transplant was performed at the Royal Hospital (RH) in September 2017. Since then, thirteen cases have been operated on at the RH. All of these cases were living-donor liver transplants (LDLT), and the remaining cases were treated in India with a total of approximately 193 recipients. To provide an in-depth overview of donor experiences, challenges, and perceptions, a cross-sectional study was conducted. Methods A cross-sectional study was conducted at one tertiary hospital in 2019. The survey was designed to collect data composed of closed and open-ended questions to reveal a thorough knowledge of the topic. Results A total of 50 of 120 donors responded to the survey with male dominance in the sample (68%) and 64% were aged 28 to 38 years. 66% of the respondents came to know about the donation through hospital staff. Interestingly, respondents (n = 8/12) who reported that fear of operation is the cause that prevents people from donating are among the male gender, while more men believe that the main cause is lack of knowledge. 90% of the respondents felt satisfied after donation. More men reported ambiguous feelings before donation. Moreover, married donors reported ambiguous feelings before donation (p = 0.008). The younger age group reported anxiety and doubt as a challenge through their donation experience. Conclusion This study revealed that donors have a positive feeling after donating as they have saved a life, as well as being empowered by family and community. The donors encourage individuals to donate a portion of their liver. Some crucial questions arose, such as anxiety before surgery, ambiguous feelings before surgery, and fatigue after surgery. These findings underscore the importance of a holistic approach that would enable donors to be well informed prior to surgery.
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Krampe N, Nebra Puertas A, Povar Echeverría M, Elmer J, Povar Marco J. Comparing demographics of organ donor referrals from the Intensive Care Unit and Outside Units. Transpl Int 2021; 34:2146-2153. [PMID: 34338368 DOI: 10.1111/tri.14001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Spanish organ donation system is a world leader in organ recovery. One of Spain's strategies is identification of organ donor referrals outside of the intensive care unit (ICU) for intensive care to facilitate organ donation (ICOD). There is limited data comparing the profiles of ICU-based and non-ICU ICOD referrals. METHODS This single-center retrospective chart review analyzed organ donor referrals of ICU and non-ICU patients to better understand the demographic and clinical differences between cohorts. The primary outcome was to understand if organ donation conversion rates were similar between ICU and non-ICU referrals. RESULTS We collected data from 745 organ donor referral candidates, 235 (32%) of whom entered ICOD protocols. Out of this cohort, 144 (61%) became an actual organ donor, 37 of whom (26%) were referred from non-ICU units. The ICU had the highest organ donor conversion rate (66% of ICU ICOD patients became actual organ donors) whereas non-ICU referrals had a 51% conversion rate. Non-ICU unit donors contributed to 21% and 26% of all kidney and liver donations, respectively. CONCLUSION Though organ referral candidates from non-ICU units contribute to a small proportion of actual donors, their donated organs are important to sustaining organ donation and transplant activity.
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Affiliation(s)
- Noah Krampe
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine
| | | | | | - Jonathan Elmer
- Department of Emergency Medicine, University of Pittsburgh, School of Medicine
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AlHajri L, AlHebsi A, AlSuwaidi M. How context affects people's willingness to register for the deceased organ donation programme. BMC Public Health 2021; 21:729. [PMID: 33858361 PMCID: PMC8048161 DOI: 10.1186/s12889-021-10753-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 04/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The deceased organ donation programme is new in the United Arab Emirates (UAE), and to improve acceptability, a broad understanding of public perspectives is thought to be helpful. Therefore, this study aims to explore the extent to which context plays a role in the willingness to register for the deceased organ donation programme in Dubai, UAE. METHODS This study used a qualitative methodology and was gauged by the tenets of a social ecological model and lay knowledge. Audio-recorded semi-structured interviews were conducted with 17 participants. The data were subsequently analysed thematically. RESULTS Four themes emerged from the dataset: fear and body integrity, family, relational ties and the identification of the recipient, religious conviction, and knowledge and personal experiences. The participants feared the whole process, were not aware of the religious outlook, and their knowledge regarding the programme was scarce. In addition, family-related factors, such as parental authority and hierarchy in the family, were also major influencers. CONCLUSION Using the social ecological model and lay knowledge helped to unravel the contextual factors that affected the willingness of participants to register for the deceased organ donation programme in Dubai, UAE, thereby enabling the development of a holistic understanding of deceased organ donation. The responses mainly stemmed from participants' social contexts; hence, awareness campaigns should be tailored to inform people about the technical aspects and address their contextual concerns.
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Affiliation(s)
- Lamia AlHajri
- Department of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates. .,Department of Health Research, Lancaster University, Lancashire, UK.
| | - Amna AlHebsi
- Department of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
| | - Maryam AlSuwaidi
- Department of Health Sciences, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
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Santos FGTD, Mezzavila VAM, Rodrigues TFCDS, Cardoso LCB, Silva MD, Oliveira RRD, Radovanovic CAT. Trend of transplants and organ and tissue donations in Brazil: a time series analysis. Rev Bras Enferm 2021; 74:e20200058. [PMID: 33681953 DOI: 10.1590/0034-7167-2020-0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to indentify the time trend of rates of organs and tissues effective donors, of reports and types of transplanted organs per million people of the Brazilian population. METHODS ecological study, of time series, about reports of organ donations and on transplants. The data were provided by the Registro Brasileiro de Transplantes and analyzed using polynomial regression. RESULTS an increasing trend was found for potential donors and effective donors, with an average increase of 2.33 and 0.92 per year, respectively. The South Region had the highest rate of potential donors (83.8) and effective donors (34.1) and the North Region, the lowest rate (20.2 and 3.9). The family refusal was the main obstacle to accomplish the donation. CONCLUSIONS the results show an increasing trend of potential donors and effective donors throughout Brazil, with emphasis on the southern region of the country. Among the main reasons for non-donation, it is worth emphasizing family refusal and medical contraindication prescription.
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Singh R, Varughese B, El-Menyar A, Shahbal S, Al Maslamani Y, Salam AM, Al Thani H. Opt-Out Consent at Different Levels of Attitude to Organ Donation: A Household Survey in Qatar. J Multidiscip Healthc 2021; 14:401-410. [PMID: 33633451 PMCID: PMC7901440 DOI: 10.2147/jmdh.s285011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/29/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Demand for an organ transplant is surpassing the number of organ donors and hence increasing waiting lists worldwide, compelling many countries to adopt an opt-out consent system for organ donation. Opt-out is used in several European countries and has increased organ registration rate. No study on this subject has been published from the gulf region to associate sociodemographic characteristics, knowledge, attitude, beliefs, and intention domains regarding an opt-out consent for organ donation. Materials and Methods A household survey was conducted between October and November 2016 using a validated questionnaire. Integer codes were assigned for qualitative data to interpret results at par with quantitative data for each domain to allow data for advanced statistical analysis. Results Of 1044 surveyed participants, 724 (69.34%) those aged 37.7±10.4 agreed to adopting an opt-out consent system of which 231 (29.4%) were Qatari citizens and 353 (48.8%) were males. Mean levels of indices such as attitude, behavioral beliefs, and intention domains to organ donation were found higher in opt out participants. After adjusting statistical significant variables, multivariate analysis showed that attitude index was associated to opt out system (OR: 16.7, 95% C.I.:10.6-26.3, p=0.001) whereas; knowledge index (OR: 0.25, 95% C.I.: 0.07-0.83, p=0.03), behavioral beliefs (OR: 0.55, 95% C.I.: 0.35-0.86, p=0.009) and intention indices (OR: 0.42, 95% C.I.: 0.20-0.87, p=0.02) were associated with opt-in system for organ donation in Qatar. Regression model was able to discriminate (AUC: 84%, 95% C.I.:81% to 87%) for opt-out consent. Future probabilities for opt-out consent were 0.80, 0.88, 0.92,0.95,0.96,0.97,0.99 and 0.993 for 0.20, 0.30, 0.40, 0.50, 0.60, 0.70, 0.80 and 0.90 attitude levels after using 200 re-samples to make traditional multivariate regression model to realistic model for the population. Conclusion The majority of the survey participants showed a good attitude but less knowledge, behavioral beliefs, and intention towards adopting an opt-out system for organ donation in Qatar.
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Affiliation(s)
- Rajvir Singh
- Cardiology Research Center, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar
| | | | | | - Saad Shahbal
- Cardiology Research Center, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar
| | | | - Amar M Salam
- Department of Cardiology & Cardiovascular Surgery, Hamad Medical Corporation, Doha, Qatar
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Ma J, Zeng L, Li T, Tian X, Wang L. Experiences of Families Following Organ Donation Consent: A Qualitative Systematic Review. Transplant Proc 2021; 53:501-512. [PMID: 33483168 DOI: 10.1016/j.transproceed.2020.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 09/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This systematic review synthesizes qualitative evidence on the experiences of donor families after consent to organ donation. METHODS This robust, qualitative systematic review included an exhaustive search of electronic databases, including PubMed, Scopus, EBSCO PsycINFO, and CINAHL Complete. Manual searches of reference lists and gray literature were conducted to achieve a comprehensive identification of all relevant research. A qualitative study design served to capture the experiences of donor families after organ donation consent. RESULTS A total of 6 articles that met the eligibility criteria were identified and included in this review. Three key themes emerged from the primary research: 1. family members were ambivalent about consent due to the ambiguity of brain death; 2. conversations about donation requirements proved uncomfortable; and 3. support is needed after donation. CONCLUSIONS Family members demonstrated ongoing ambivalence and distress that lasted for weeks after organ donation due to the ambiguity of brain death. Some family members were unhappy with having been approached for a conversation about organ donation. Donor families were not always able to deal with the difficulties they faced after their decision about organ donation. Health care professionals should provide ongoing care and updated information to family members. This review helped to identify family members' needs for both psychological and financial assistance.
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Affiliation(s)
- Juanjuan Ma
- Nursing Department, Shenzhen Shekou People's Hospital, Shenzhen, China
| | - Li Zeng
- Nursing Department, Shenzhen Shekou People's Hospital, Shenzhen, China.
| | - Tingjun Li
- The Second People's Hospital of Futian District, Shenzhen, China
| | - Xiaofei Tian
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Lili Wang
- Union Shenzhen Hospital (Nanshan Hospital), Shenzhen, China
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Kerstis B, Widarsson M. When Life Ceases-Relatives' Experiences When a Family Member Is Confirmed Brain Dead and Becomes a Potential Organ Donor-A Literature Review. SAGE Open Nurs 2021; 6:2377960820922031. [PMID: 33415278 PMCID: PMC7774436 DOI: 10.1177/2377960820922031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/26/2020] [Accepted: 04/04/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction Most healthcare professionals rarely experience situations of a request for organ donation being made to the patient's family and need to have knowledge and understanding of the relatives' experiences. Objective To describe relatives' experiences when a family member is confirmed brain dead and becomes a potential organ donor. Methods A literature review and a thematic data analysis were undertaken, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting process. A total of 18 papers, 15 qualitative and 3 quantitative, published from 2010 to 2019, were included. The electronic search was carried out in January 2019. Results The overarching theme When life ceases emerged as a description of relatives' experiences during the donation process, including five subthemes: cognitive dissonance and becoming overwhelmed with emotions, interacting with healthcare professionals, being in a complex decision-making process, the need for proximity and privacy, and feeling hope for the future. The relatives had different needs during the donation process. They were often in shock when the declaration of brain death was presented, and the donation request was made, which affected their ability to assimilate and understand information. They had difficulty understanding the concept of brain death. The healthcare professionals caring for the patient had an impact on how the relatives felt after the donation process. Furthermore, relatives needed follow-up to process their loss. Conclusion Caring science with an explicit relative perspective during the donor process is limited. The grief process is individual for every relative, as the donation process affects relatives' processing of their loss. We assert that intensive care unit nurses should be included when essential information is given, as they often work closest to the patient and her or his family. Furthermore, the relatives need to be followed up afterwards, in order to have questions answered and to process the grief, together with healthcare professionals who have insight into the hospital stay and the donation process.
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Affiliation(s)
- Birgitta Kerstis
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Margareta Widarsson
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Relationship Between Bereavement Reaction With Posttraumatic Stress Disorder and Depression in Organ Donor Families in Iran. J Neurosci Nurs 2020; 52:21-26. [PMID: 31842030 DOI: 10.1097/jnn.0000000000000486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to determine the relationship among bereavement, depression, and posttraumatic stress disorder (PTSD) in organ donor families in Iran. METHODS This is a correlational study of 96 family members of brain-dead patients whose organs were donated. Using census sampling method, we approached the families through the Kerman University's Organ Donation Center. Data were collected using the Core Bereavement Items, Beck Depression Inventory, and Impact of Event Scale-Revised. RESULTS The mean (SD) total score of bereavement, depression, and PTSD were 38.44 (9.25), 18.01 (12.92), and 41.90 (12.69), respectively. Among bereavement subscales, the highest mean (SD) score belonged to the "Images and Thoughts" (15.96 [4.16]) and the lowest belonged to "Grief" (10.57 [3.16]). Among different aspects of PTSD, the Intrusion subscale had the highest mean (SD) score (19.25 [6.22]), and the Hyperarousal subscale had the lowest (11.23 [5.34]). The Pearson correlation coefficient showed that bereavement was positively correlated with both depression (r = 0.72, P < .001) and PTSD (r = 0.59, P < .001). CONCLUSION Donor families experienced bereavement, PTSD, and depression after organ donation. Healthcare professionals should approach and assess these families for potential emotional-psychological consequences, provide emotional and practical support to alleviate their depression and PTSD, and assist them through the bereavement process.
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El-Menyar A, Al-Thani H, Mehta T, Varughese B, Al-Maslamani Y, Mekkodathil AA, Singh R. Beliefs and Intention to Organ Donation: A Household Survey. Int J Appl Basic Med Res 2020; 10:122-127. [PMID: 32566529 PMCID: PMC7289197 DOI: 10.4103/ijabmr.ijabmr_108_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/01/2019] [Accepted: 01/17/2020] [Indexed: 11/04/2022] Open
Abstract
Background Organ transplantation is considered as the last therapeutic option for the treatment for end-stage organ failure. However, the gap between the demand and supply of transplantable organs is still wide. Extensive researches have been conducted to understand this gap, and many countries have introduced Opt-out laws and have started targeted awareness programs. We aimed to assess, among the household residents, the normative behavior and beliefs and its correlation to intentions toward becoming organ donors. Subjects and Methods A household survey with the resident population of Qatar was conducted from October 2016 to November 2016. A sample of 1044 individuals aged 18 and above, residing in eight municipalities within the country, was selected using a two-stage systematic random sampling method to understand the relationship between organ donation intentions and behavioral, normative, and control beliefs. Independent female enumerators collected data on electronic tablets and exported to SPSS for data analysis. Results Data from 930/1044 (89%) individuals responded to the intention-related questions were taken for final analysis. Multivariate analysis brought out that behavioral beliefs (standardized beta coefficient = 0.25, t = 6.5, P = 0.001) and normative beliefs (standardized beta coefficient = 0.32, t = 8.4, P = 0.001) were significant contributors to intention to donate organs whereas control beliefs (standardized beta coefficient = -0.07, t = -2.3, P = 0.02) were negatively associated to organ donation intention. Conclusions Findings indicate that behavioral and normative beliefs play a very important role in contributing to the intention of the individual toward organ donation.
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Affiliation(s)
- Ayman El-Menyar
- Department of Surgery, Trauma and Vascular Surgery, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Trauma and Vascular Surgery, Doha, Qatar
| | - Tulika Mehta
- Department of Surgery, Trauma Surgery, Psychology, Hamad Medical Corporation, Doha, Qatar
| | - Betsy Varughese
- Department of Medicine, Research Section, Hamad Medical Corporation, Doha, Qatar
| | - Yousuf Al-Maslamani
- Department of Surgery, Transplant Section, Hamad General Hospital, Doha, Qatar
| | | | - Rajvir Singh
- Cardiology Research Center, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Chan HY. Remapping the organ donation ethical climate: a care ethics consideration. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:295-308. [PMID: 31811525 DOI: 10.1007/s11019-019-09934-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ shortage challenge, ranging from offering incentives to donors, addressing family refusals to donations and instituting presumed consent laws. Presumed consent as the favoured approach has not been universally effective in increasing actual transplants despite its appeal. Few considerations have been given to the broader ethical climate influencing the organ donation debate. This paper examines the ethical climate surrounding organ donation and identifies the challenges existing within such environments. It explores care ethics and its application to the donation system, demonstrating how it can influence the organ donation phases. The conclusion drawn from the analysis is that a caring ethical climate in the pre, during and post-transplant system respects donor autonomy, addresses family reluctance to agree to donation, facilitates the needs of the donee and creates an environment that promotes non-maleficence for all stakeholders.
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Simonsson J, Keijzer K, Södereld T, Forsberg A. Intensive critical care nurses' with limited experience: Experiences of caring for an organ donor during the donation process. J Clin Nurs 2020; 29:1614-1622. [PMID: 31971283 DOI: 10.1111/jocn.15195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/28/2019] [Accepted: 01/10/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe how intensive critical care nurses, whose experience is limited, experience caring for an organ donor during the donation process. BACKGROUND Intensive critical care nurses are involved in the care of organ donors and their relatives. This may be challenging and evoke a sense of providing an inhumane care. Few studies have explored how intensive critical care nurses whose experience is limited experience caring for an organ donor during the donation process. DESIGN An interview study with an inductive qualitative approach was conducted. The study was reported according to COREQ guidelines. METHODS This study was performed during 2019. Participants were intensive critical care nurses (n = 7) from different hospitals (n = 4) with <3 years of experience and involvement in the donation process at least once but no more than three times. Data were analysed using qualitative content analysis. FINDINGS Five categories emerged: the donation process is emotionally challenging; supporting relatives is an essential but demanding task; a complex and multifaceted process involving a high level of responsibility; needing appropriate prerequisites in the form of education and collegial support; and providing a dignified care based on respect for the organ donor. CONCLUSIONS Having limited experience as an intensive critical care nurse may not automatically mean that caring for an organ donor is experienced as more challenging than it is for a more-experienced colleague. However, certain intensive critical care nurses whose experience caring for an organ donor is limited found it to be highly demanding due to its complexity, specifically in regard to informing relatives of the loss of their loved one and providing them with support. RELEVANCE TO CLINICAL PRACTICE Our study revealed a need for further education. This need could be met by simulation tasks during the specialist education in intensive critical care nursing, where primarily ethical aspects and strategies for meeting with and supporting relatives should be examined and practiced.
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Affiliation(s)
- Johan Simonsson
- Intensive Care Unit, Karolinska Institutet, Stockholm, Sweden
| | - Karl Keijzer
- Intensive Care Unit, Östersund Hospital, Östersund, Sweden
| | - Theres Södereld
- Intensive Care Unit, Sunderby Hospital, Luleå, Sweden.,Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Angelica Forsberg
- Intensive Care Unit, Sunderby Hospital, Luleå, Sweden.,Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Dicks SG, Burkolter N, Jackson LC, Northam HL, Boer DP, van Haren FM. Grief, Stress, Trauma, and Support During the Organ Donation Process. Transplant Direct 2020; 6:e512. [PMID: 32047840 PMCID: PMC6964929 DOI: 10.1097/txd.0000000000000957] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/26/2022] Open
Abstract
The organ donation process is complex and stressful for the family of the potential donor and members of the multidisciplinary team who may experience grief, ethical dilemmas, vicarious trauma, or compassion fatigue. Several studies each explore the role of a specific healthcare group and the impact of inhospital processes on group members. We conducted a systematic literature search to identify such studies and a qualitative synthesis to consolidate findings and highlight features of the interaction and relationships between role players. Our results suggest that, while healthcare professionals have different roles, attitudes, and views, the experience of stressors and interdisciplinary tension is common. Nevertheless, staff are united by the goal of caring for the patient and family. We therefore propose that, while focusing on bereavement care and other aspects of the family's experience, staff can find other shared goals and develop understanding, trust, empathy, and respect for each other's positions, thereby improving functioning in the complex adaptive system that forms at this time. Education and training can equip staff to facilitate anticipatory mourning, family-led activities, and a meaningful parting from their relative, assisting families with their grief and increasing staff members' efficacy, confidence, and interdisciplinary teamwork. Knowledge of systems thinking and opportunities to share ideas and experiences will enable staff to appreciate each other's roles, while supportive mentors, self-care strategies, and meaningful feedback between role players will foster healthy adjustment and shared learning. A focus on psychosocial outcomes such as family satisfaction with the process, collaboration within the multidisciplinary team, and reduction in the role stress of healthcare professionals will contribute to family well-being as well as personal and professional growth for staff.
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Affiliation(s)
- Sean G. Dicks
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
| | | | | | - Holly L. Northam
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Douglas P. Boer
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Frank M.P. van Haren
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
- School of Medicine, Australian National University, Canberra, ACT, Australia
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Knihs NDS, Santos ACBD, Magalhães ALP, Barbosa SDFF, Paim SMS, Santos J. MANAGEMENT OF NURSE CARE IN THE ORGAN AND TISSUE DONATION PROCESS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to identify the activities developed by nurses in care management in the organ and tissue donation process. Method: this is a quantitative, retrospective, exploratory and descriptive study, carried out in two hospital institutions in southern Brazil, between June 2013 and June 2016. The sample consisted of 104 records of patients notified to the State Transplant Center. For data analysis, descriptive statistics were used. Results: at Institution A, 70.2% (73) of medical records were analyzed and at Institution B, 29.8% (31). As for activities developed by nurses, it is noteworthy that in the first, they carried out 1,299 management activities (93.7%) and in the second, 317 (53.9%). As for assistance activities, in the first, 507 (83.1%) and in the second, 217 (63.1%) activities. With regard to nursing care, care should be taken to maintain temperature, water balance and glycemic control. Conclusion: it was possible to identify that nurses develop a greater number of actions aimed at management issues in the donation process. As for assistance, there was a greater concern with maintaining the temperature.
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Abstract
OBJECTIVES To systematically review the global published literature defining a potential deceased organ donor and identifying clinical triggers for deceased organ donation identification and referral. DATA SOURCES Medline and Embase databases from January 2006 to September 2017. STUDY SELECTION All published studies containing a definition of a potential deceased organ donor and/or clinical triggers for referring a potential deceased organ donor were eligible for inclusion. Dual, independent screening was conducted of 3,857 citations. DATA EXTRACTION Data extraction was completed by one team member and verified by a second team member. Thematic content analysis was used to identify clinical criteria for potential deceased organ donation identification from the published definitions and clinical triggers. DATA SYNTHESIS One hundred twenty-four articles were included in the review. Criteria fell into four categories: Neurological, Medical Decision, Cardiorespiratory, and Administrative. Distinct and globally consistent sets of clinical criteria by type of deceased organ donation (neurologic death determination, controlled donation after circulatory determination of death, and uncontrolled donation after circulatory determination of death) are reported. CONCLUSIONS Use of the clinical criteria sets reported will reduce ambiguity associated with the deceased organ donor identification and the subsequent referral process, potentially reducing the number of missed donors and saving lives globally through increased transplantation.
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Poppe C, Akum S, Crombez G, Rogiers X, Hoste E. Evaluation of the quality of the communication and emotional support during the donation procedure: The use of the donor family questionnaire (DFQ). J Crit Care 2019; 53:198-206. [PMID: 31271955 DOI: 10.1016/j.jcrc.2019.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/26/2019] [Accepted: 06/14/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE A multi-centric study in Intensive Care units (ICU) and Emergency departments (ED) was designed to evaluate whether the provided communication and emotional support to the family in the context of organ donation met the international recommendations of the European Donor Hospital Education Program (EDHEP). MATERIALS AND METHODS Using a participatory approach and focus groups, a questionnaire was constructed: Donor Family questionnaire (DFQ). The questionnaire was distributed to 203 families. The data were analysed on item level. RESULTS Sixty-four families participated, and 89% considered the communication as tactful. Only 24.1% had a separate conversation about passing and donation, which is the recommendation. 88.5% reported they could count on emotional support in the first phase on the ICU/ED. This dropped during the parting phase and the aftercare. The physician is perceived as the most active caregiver in the emotional support during the entire procedure. CONCLUSIONS The DFQ is a useful instrument to evaluate the donor procedure. The physician is important in the first phases of the donor procedure for the medical explanation. Other disciplines could be more involved in the following phases to assure enough emotional support, but this issue requires further exploration.
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Affiliation(s)
- Carine Poppe
- Department of Internal Medicine and Pediatrics, Ghent University, Belgium.
| | - Sandra Akum
- Department of Internal Medicine and Pediatrics, Ghent University, Belgium
| | - Geert Crombez
- Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Xavier Rogiers
- Department of Hepato-billiary surgery, Ghent University, Belgium
| | - Eric Hoste
- Departement of Intensive care Medicine, Belgium and Research Foundation-Flanders, Ghent University, Brussels, Belgium
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22
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A mixed-methods study of organ donation in the intensive care unit: 22 actionable practices to improve organ donation. Can J Anaesth 2019; 66:686-695. [PMID: 30809778 DOI: 10.1007/s12630-019-01332-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/23/2018] [Accepted: 01/01/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Rates of organ donation vary between otherwise comparable intensive care units (ICUs) suggesting that the process of donation must vary between ICUs. The purpose of this study was to describe the process of organ donation from the perspective of ICU staff, identify important drivers of successful donation, and develop strategies to improve the process of donation. METHODS We conducted qualitative interviews with 32 ICU staff, including physicians, nurses, and respiratory therapists, using an interview guide developed from previous studies on organ donation. Using a qualitative descriptive approach, we coded interviews using qualitative content analysis. We integrated findings from the interviews in a mixed-methods analysis with previously published data from a document analysis and cross-sectional survey to identify practices that may enhance organ donation in the ICU. RESULTS Five major themes important to the organ donation process emerged from the interviews: i) staff relationship with organ donation coordinators; ii) standardized processes; iii) ICU staff beliefs; iv) integration of donation and high quality end-of-life care; v) feedback and staff support. In the mixed-methods analysis, we identified 22 actionable practices to enhance the process of organ donation in the ICU. CONCLUSION Incorporating the perspectives of ICU staff, we were able to identify 22 practice changes that may have a significant cumulative impact on donation outcomes. Future research is required to evaluate whether these findings account for the variability of donation rates between otherwise comparable ICUs.
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23
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Faria VS, Matos LN, Trotte LAC, Rey HCV, Guimarães TCF. Association between quality of life and prognosis of candidate patients for heart transplantation: a cross-sectional study. Rev Lat Am Enfermagem 2018; 26:e3054. [PMID: 30328977 PMCID: PMC6190485 DOI: 10.1590/1518-8345.2602.3054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/26/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE to verify the association between the prognostic scores and the quality of life of candidates for heart transplantation. METHOD a descriptive cross-sectional study with a convenience sample of 32 outpatients applying to heart transplantation. The prognosis was rated by the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM); and the quality of life by the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Pearson correlation test was applied. RESULTS the correlations found between general quality of life scores and prognostic scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r = -0.02), (SHFM/KCCQ r = -0.20). CONCLUSION the weak correlation between the prognostic and quality of life scores suggests a lack of association between the measures, i.e., worse prognosis does not mean worse quality of life and the same statement is true in the opposite direction.
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Affiliation(s)
| | | | | | - Helena Cramer Veiga Rey
- Instituto Nacional de Cardiologia, Coordenação de Ensino e Pesquisa,
Rio de Janeiro, RJ, Brazil
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Schaub F, Simons HG, Enders P, Bachmann BO, Roters S, Cursiefen C, Heindl LM. [Corneal donation : Dilemma between growing demand and declining donor rate]. Ophthalmologe 2017; 113:1058-1065. [PMID: 27260624 DOI: 10.1007/s00347-016-0281-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND One of the most important requirements for successful corneal transplantation is the availability of donor tissue and thus the approval for postmortem corneal tissue donation. The aim of this study was to investigate donor willingness compared to the continuously increasing demand in recent years. MATERIAL AND METHODS Archives of the local eye bank at the Department of Ophthalmology, University of Cologne, Germany in the time period between 1 July 2011 and 31 December 2015 were examined regarding the willingness for corneal donations in deceased patients from the University Hospital of Cologne. Absolute numbers of deceased, exclusion criteria for donation as well as the rate of negative and affirmative decisions were evaluated. RESULTS In 235 (5.1 %) out of 4593 deceased at the University Hospital of Cologne, corneal donation was accomplished during the observation period. Of the patients 2923 (63.6 %) were excluded because of absolute contraindications for corneal donation and the rate of absolute contraindications increased from 46.6 % in 2011 to 68.9 % in 2015. Willingness for corneal donation in potentially suitable deceased patients diminished from 34.9 % in 2011, to 34.3 % in 2012, 35.5 % in 2013, 28.4 % in 2014 and to 24.1 % in 2015. In relation to the total number of deceased, the number of corneal tissue donations decreased from 11.5 % in 2011 to 3.5 % in 2015. CONCLUSION Despite a rising demand, data from Cologne seem to indicate that the number of corneal donations has declined to some extent. In order to increase the number of corneal donors in the future, further educational work as well as standardization and optimization of the tissue donation process seem to be urgently needed.
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Affiliation(s)
- F Schaub
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
| | - H G Simons
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - P Enders
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - B O Bachmann
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - S Roters
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - C Cursiefen
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - L M Heindl
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
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