重症监护病房医护人员对器官捐献的认知和参与的调查分析

The manner of ICU staff towards organ donation

【摘要】目的调查和分析全面实施公民逝世后器官捐献（DCD）政策后重症监护室（ICU）医护人员对器官捐献的认知和参与情况，以提高DCD捐献率。方法对参加中华医学会第9次全国重症医学年会及在2015年5—7月期间参加省级重症医学研讨会的参会者作随机问卷调查，共512名受访者接受了问卷调查，收回有效问卷489份（95．51％）。问卷共分3个部分，对受访者的人口学资料，DCD的知晓和参与情况，DCD劝捐工作的意愿，以及DCD推广与展望等内容进行了调查。结果问卷结果显示，489名受访者对DCD的知晓率总体为97．75％，62．37％的受访者曾参与器官捐献工作，而未参与DCD工作的主要原因为不熟悉捐献程序（86．09％），医患关系紧张（79．55％），受宗教、伦理影响（56．24％），缺乏DCD相关知识（52．76％），受中国传统观念的影响（50．10％），以及协调员态度不积极（37．22％）。416名（85．07％）受访者表示愿意参与DCD相关工作。391名（79．96％）受访者认为加强社会捐献知识的宣传教育及加大法规政策对医护人员的保护是提高捐献成功率的关键。结论实施DCD5年来，尽管ICU医护人员的知晓率已明显较以往提高，但仍缺乏普遍参与意识。民众缺乏DCD相关知识，法制对医护人员保障的滞后是直接影响DCD的致关因素。

Objective To investigate the past participation and their future intention of donation after citizen death （DCD） work of attendees. Methods A questionnaire study was carried out in the 9th Chinese ICU annual congress and local workshops taken part in difference provinces and cities from May 2015 to July 2015. A 12-multiple self choice questionnaires, collecting the demographic data of attendees and analyzing the ratio of DCD awareness and participation, their attitude towards DCD, and future recommendation of DCD development, were facilitated and immediately collected back. Results A total of 512 questionnaires were collected and 489 were available. 97. 75~ of the attendees have been awareness of DCD and 62. 37% have ever participated in DCD activity, During the whole survey, 85.07~ of them expressed their willingness of future DCD activities participation. The current fierce conflict between medical workers and patients was selected to the main barrier of DCD work. The enforcement of DCD population and organ donation law were most recommended to improve donation success. Conclusion It is the fifth year after DCD programme initiation and full implementation since last year. Despite the obvious raise of DCD recognition among ICU staff, there is still long way to go ahead to the era of satisfactory donation rate. The hostility between medical workers and patients is the main barrier for ICU workers for DCD promotion.