Perceived Support Among Families Deciding About Organ Donation for Their Loved Ones: Donor Vs Nondonor Next Of Kin

Abstract

Background Families' experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families' support needs during this traumatic time is an obligation and a challenge for critical care staff. Objectives (1) To elicit family members' accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families' donation decision. Methods Retrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demo graphic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care. Results One hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for them selves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent. Conclusions Specific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole. (American Journal of Critical Care. 2010;19:e52-e62) Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Identify at least 2 types of information that family members found to be helpful when considering organ donation for a brain-dead relative. 2. Describe bereavement care. 3. Discuss at least 3 reasons why relatives did not consent to donation for their loved ones.

A Review on Family Approval on Organ Donation

“…Ailelerin beyin ölümüne ilişkin sorularının cevapsız bırakılması da organ bağışını kabul etmemeleriyle sonuçlanabilmektedir (Can, 2016;Dejong ve ark.., 1998;Franz, DeJong, Wolfe, Reitsma ve Beasley, 1997;Jacoby ve Jaccard, 2010;Kirste, Muthny ve Wilms, 1988;Morioka, 2001;Sammons, 1988;Siminoff, Burant ve Younger, 2004). Aileler beyin ölümü gerçekleşen kişinin komada mı yoksa ölü mü olduğu, kalp atıyor olmasına rağmen ölümün gerçekleşip gerçekleşmediği, beyin ölümü gerçekleşen kişinin iyileşip iyileşemeyeceği gibi pek çok çelişki yaşamaktadırlar (Dejong ve ark., 1998).…”

“…Bu süreçte, ani olarak bir yakınını kaybetmenin yarattığı duygusal karmaşa ve sevdiklerinin vücudu pembe, sıcak ve hala kalbi atarken beyin ölümünü anlamak ve ölümü kabullenmek neredeyse imkansız hale gelebilmektedir. Beyin ölümü hakkında bilgilendirilme yapılmasının ve beyin ölümünü anlamaları ve ölümü kabullenmeleri için aileye süre verilmesinin, aile onayını anlamlı olarak arttırdığı yapılan araştırmalarda tutarlı olarak gösterilmiştir (Jacoby ve Jaccard, 2010;Kirste, Muthny ve Wilms, 1988;Sammons, 1988).…”

A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation

“…These characteristics are representative of the FDM population reported in earlier studies. 9,13,21 A comparison of adult versus pediatric patients found significant sociodemographic differences. Compared with FDMs of adult patients, pediatric patient FDMs were, as would be expected, younger (41.1 vs 48.5 mean years; P , .001) and a higher percentage were divorced or separated (19.9% vs 12.8%) or never married (17.3% vs 13.1%) ( Table 1).…”

“…6,11,12 The donation decision may hinge on the professional and friendly demeanor of providers 6 and their perception as being more trusting, sincere, sensitive, and respectful of the family. 7,11,13 In addition, several qualitative studies indicate that families often view organ donation as a means of coping with the loss of a child, including giving meaning to the death and maintaining a connection with the deceased after the death. 6,[14][15][16][17] Empathy for other parents and children in need of transplants and an acknowledgment of the ability "to save another life" through donation also motivates some families to donate.…”

A Virtuous Death: Organ Donation and Eudaimonia

“…Doing so would amount to a major betrayal of their relative, and an irrevocable one at that. Indeed, the evidence suggests that many families who overrule donation come to regret doing so (Jacoby and Jaccard 2010) This means that a person whose family vetoes donation has her eudaimonia harmed triply-an early death, followed by a thwarted wish to donate organs due to family denial of that wish, followed by increased suffering of relatives due to that denial (not to mention the suffering of those who will die because donation does not go ahead and that of their families). The importance of respecting the wish to donate is even greater for secular patients, who do not expect any afterlife whatsoever; for religious patients, the wish to donate is merely the last mortal wish.…”