家属对亲属器官捐献决定的影响因素及对策研究

Influential Factors and Strategy of Relatives＇ Decision of Organ Donation

【目的】通过参与协调的潜在心脏死亡遗体器官捐献（DCD）案例，探讨影响家属决定亲属器官捐献的因素及解决对策。【方法】2010年3月至2011年3月，对51例潜在捐献者家属进行开放式访谈，探讨协调介入时间和环境、协调员的专业水平、家属对脑死亡及捐献流程信息的了解、家庭组成对家属捐献决定的影响。【结果】成功捐献的案例，协调员介入协调时机均为家属放弃治疗后；地点均在医院但相对私密，家庭组成多为核心家庭，家属理解脑死亡并充分了解捐献流程相关信息。6例捐献发生在协调员专业技能成熟后。家属拒绝捐献的首要原因为害怕其他亲属及周围邻居的质疑，紧随其后的原因为家属对捐献体制及捐献器官使用情况的质疑。【结论】家属决定受多种因素影响，建立国家级器官捐献登记、分配平台，普及器官捐献知识，创造捐献的社会舆论氛围，规范潜在DCD医疗机构行为，加强协调员专业知识培训，对提高我国器官捐献数量和捐献率有重要意义。

[Objective]To explore the factors influencing relatives＇ decision of organ donation and put forward the corresponding resolutions through participating the potential DCD cases. [Methods]Open interviews were applied in 51 potential donor relatives between March 2010 and March 2011. The effect of the time and environment of coordination, the expertise of the coordinator, the understanding of brain death and donation process information and the family members on the relatives＇ decision of organ donation were analyzed. IRe- sults]The coordinator participated in the coordination of successful donation cases after relatives gave up the treatment. The place was in the hospital and private. They were mainly nuclear families. Thc relatives knew brain death and understood the information of donation process completely. Six cases offered organ donation after the coordinators had full professional skills. The primary reason that families refused to donate was the fearing of the opinions of other relatives and neighbors, and the second reason was the queries to donation sys- tem and the disposition of donors＂ organs. [Conclusion] The relatives＇ decision of organ donation is influenced by various factors. It is important to establish the platform of the registration and allocation of national organ donation, spread the organ donation knowledge, set the social public opinion atmosphere, unify the behavior of potential DCD institutions and strengthen the skill training of coordinators for improving the number and rate of organ donation.