Family Interview to Enable Donation of Organs for Transplantation: Evidence-based Practice

Moraes, Edvaldo Leal de; Santos, Marcelo José dos; Silva, L.B. de Barros e; Pilan, L.A.S. de Lima; Lima, E.A.A. de; Santana, Alexandre Chagas; Martins, Maristela Santini

doi:10.1016/j.transproceed.2018.02.056

Cited by 12 publications

(13 citation statements)

References 29 publications

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“…Previous investigations have pointed to the fact that "inhospital reasons" may be at least partly responsible for increased refusal rates [10][11][12][13]. We found that prolonged waiting time, i.e., time from first contact of the next of kin to meeting a physician, appeared as a potential factor that might affect refusal rates.…”

Section: Discussionmentioning

confidence: 55%

“…My next of kin received the best possiblecare before he/she died. fully applies  partly applies  does not apply 1.9. I/we had to wait too long until I/we could visit the patient. fully applies  partly applies  does not apply 1.10 I/we had to wait too long until I/we could talk to an ICU doctor. fully applies  partly applies  does not apply 1.11 During the stay at the ICU I had enough time to be with my next of kin. fully applies  partly applies  does not apply 1.12 The premises during the conversations were adequate. fully applies  partly applies  does not apply 1 13. At what time of day was the first conversation regarding possible organ donation held?…”

mentioning

confidence: 99%

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Organ donation in the ICU – a survey on next of kin response in two Swiss academic centres

Nebiker¹,

Bloch²,

Fedakar³

et al. 2021

Swiss Med Wkly

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AIM OF THE STUDY: In the Swiss population, attitudes to organ donation are mostly positive. However, a high refusal rate by the next of kin may be observed. We aimed to investigate potential underlying reasons. METHODS: In two independent Swiss tertiary care academic centres 167 next of kin were confronted with potential organ donation, over a period of 18 to 24 months. Of these, 147 could be contacted and were asked ≥6 months later to participate in a post-hoc survey (72-item questionnaire). Aspects related to conversations, time and care in the intensive care unit (ICU), underlying concepts for organ donation, impact on mourning, and other potential influencing factors were addressed. RESULTS: The overall return rate was 66%. Seventy four of 77 (96%) next of kin stated that the request for organ donation was appropriate and they agreed to address the issue. Personal attitudes of next of kin regarding organ donation correlated with the decision for or against organ donation (p <0.0001). Thirteen percent (8/62) reported that conversations with ICU physicians changed their decision. In 56% (18/32) of reports when organ donation was refused, the next of kin stated that presence of a documented will might have changed their decisions. Mourning was reported to be impaired by the request for organ donation in 8% (6/71), facilitated in 14% (10/71) and not affected in 77% (55/71) of cases. Twenty-seven percent (16/59) indicated that an opt-out policy for organ donation would subjectively have facilitated their decision and 81% (34/42) of consenting next of kin stated that an objection law should be put into place (p <0.0001).CONCLUSIONS: In this observational study, the majority of the next of kin stated that addressing organ donation did not affect mourning. Presence of a presumed will could likely facilitate grief and provide comfort for affected families.

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Section: Discussionmentioning

confidence: 55%

mentioning

confidence: 99%

Organ donation in the ICU – a survey on next of kin response in two Swiss academic centres

Nebiker¹,

Bloch²,

Fedakar³

et al. 2021

Swiss Med Wkly

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“…In some cases, they were not sure whether the donated organs had been given to the right individuals or not. De Moraes showed that establishing a decent and constructive relationship based on trust between the medical team and the family members of brain-dead patients can improve the chance of giving consent to organ donation [47]. Therefore, it is necessary to clarify the process of organ donation and assure the families that the donation process is a completely fair process that delivers the donated organs to the right individuals.…”

Section: Discussionmentioning

confidence: 99%

The obstacles to organ donation following brain death in Iran: a qualitative study

et al. 2020

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Background: Organ donation following brain death has become an important way of supplying organs for transplantation in many countries. This practice is less common in Iran for different reasons. Therefore, this study aims to explore the obstacles to organ donation following brain death in Iran. Methods: This qualitative research was conducted following the conventional content analysis method. The study population consisted of individuals with a history of brain death among their blood relatives who refused to donate the organs. Snowball sampling was employed to select the participants. In-depth semi-structured interviews were conducted for data gathering. Theoretical saturation was achieved through 20 interviews. Data analysis was done following the steps proposed by Graneheim and Lundman. Lincoln and Guba's criteria were used to ensure data rigor and transferability of the study. Results: Data analyses revealed 185 codes, 23 categories, and seven themes including, poor knowledge about brain death and organ transplantation from a dead body, cultural beliefs, religious beliefs, deficiencies of requesting process, fear and concerns, inability to make a decision, and social learning. Conclusion: There were several factors in families' reluctance to donate organs of a brain-dead patient. Through improving knowledge and changing cultural beliefs in society, it is possible to take large steps towards promoting organ donation from brain-dead patients.

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“…Angehörige werten das Überbringen der Nachricht des Hirntodes in der Regel auch später noch als ein kritisches Ereignis, das zu krisenha em Erleben bis hin zu langfristigen psychosozialen Beeinträchtigungen führen kann [14,18]. Die Situation der Entscheidung für oder gegen eine Transplantation ist emotional äußerst belastend und mit Trauer, Unsicherheiten sowie Ängsten vor dem To d d e s na he n A nge hörige n ve rbu nd e n. Eine autonome Entscheidung der Angehörigen kann nur erfolgen, wenn diese sich hierfür emotional in der Lage fühlen [11,13]. Daher ist eine entlastende empathische Gesprächsführung wichtig, denn das Ergebnis der Entscheidung begleitet die Angehörigen ihr weiteres Leben.…”

Section: Entscheidungsprozess Aus Angehörigensichtunclassified

Gesprächsführung mit Angehörigen

Jöbges

Denke

Kumpf

et al. 2018

Med Klin Intensivmed Notfmed

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Hintergrund Angehörigengespräche zur Organspende sind Teil eines komplexen Entscheidungsprozesses. Fehlt das direkte Einverständnis eines potenziellen Spenders zur Organspende, müssen Angehörige Auskunft über einen möglichen Organspendewunsch geben, im Rahmen der erweiterten Zustimmung in eine Organspende einwilligen und gleichzeitig das akute Versterben eines nahestehenden Menschen bewältigen. Fragestellung Was ist beim Angehörigengespräch zu beachten, um Angehörige während des Entscheidungsprozesses optimal zu unterstützen? Material und Methode Narratives Review. Ergebnisse Im Rahmen eines möglichen oder vorliegenden irreversiblen Hirnfunktionsausfalls dienen Gespräche mit Angehörigen bzw. juristischen Stellvertretern dem Überbringen der schlechten Nachricht, der Feststellung eines potenziellen Organspendewunschs und der Erläuterung der resultierenden Vorgehensweisen. Eine Gesprächsstrategie, wie die SPIKES-oder VALUE-Strategie, unterstützt Angehörige bei der emotionalen und kognitiven Bewältigung und gibt den Behandlern Sicherheit in der Gesprächsführung. Ein respektvoller, wertschätzender und kompetenter Umgang des Teams mit dem Patienten bzw. Verstorbenem und den Angehörigen trägt zur Zustimmung von Angehörigen zur Organspende bei. Schlussfolgerungen Vertrauensvolle Betreuung der Angehörigen im Prozess der Entscheidung hinsichtlich einer möglichen Organspende verlangt auch vom Behandlungsteam das Beherrschen von den Gesprächstechniken, die in Krisensituationen Anwendung finden. Besteht eine belastbare Beziehung zwischen Behandlungsteam und Angehörigen, die auf Informationsvermittlung, Offenheit, Vertrauen und Empathie beruhen, können Angehörige viel eher eine für sie tragbare und nachhaltige Entscheidung treffen.

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Family Interview to Enable Donation of Organs for Transplantation: Evidence-based Practice

Cited by 12 publications

References 29 publications

Organ donation in the ICU – a survey on next of kin response in two Swiss academic centres

Organ donation in the ICU – a survey on next of kin response in two Swiss academic centres

The obstacles to organ donation following brain death in Iran: a qualitative study

Gesprächsführung mit Angehörigen

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