公民逝世后器官捐献潜在供者家庭捐献意向调查

Investigation of family attitudes toward organ donation after citizen death in China

目的调查国内潜在供者家庭成员对于心脏死亡器官捐献(DCD)及其移植的意向及态度。方法这项研究通过预约会面或电话问答,以调查问卷的形式完成。位于中国西北地区的西安交通大学医学院第一附属医院针对DCD潜在供者的家庭成员完成了这一调查。通过大量的文献回顾以及红十字会协调员、医师和供者家庭的信息反馈,我们最终总结出了包含12项问题的调查问卷,基于参与者的回答我们给予相应的5级Likert评分。结果 174例参与者包括女性56例(32.2%),男性118例(67.8%)。绝大多数人年龄分布于41~50岁(n=63,36.2%)、31~40岁(n=59,33.9%)以及≤30岁(n=36,20.7%)。意向调查结果表示同意的前5名问题分别为:①DCD劝捐工作的最佳人选为红十字会协调人员(n=160,92%);②供者是英雄(n=143,82.2%);③以身为供者家庭成员为荣(n=136,78.2%);④器官捐献后,与同事间的关系得到改善(n=124,71.3%);⑤与器官受者的关系得以加强(n=123 70.7%)。DCD劝捐工作的最佳人选顺序为:红十字会协调人员(n=160,92%)、非移植专业医生(n=104,59.8%)、社会工作者(n=36,20.7%)及移植医生(n=25,14.4%)。潜在供者家庭成员不同意捐献的两个主要原因是:坚持"死后全尸"的认知,不愿再因器官切取手术而遭罪(n=51,41.5%);怕引起邻居、亲戚及朋友的误解(n=28,22.8%)。结论这项研究揭示了目前国内人们对于DCD器官捐献的认知及态度。得到的数据值得我们深思,关注潜在DCD供者及其家庭所思所想将有助于专业人士将来更好的实践。

Objective The purpose of this study was to investigate the attitudes trend and characteristics of family members of potential donation after cardiac death(DCD)donors in China. Methods This largest single center cohort study was performed by an interview or by telephone using a questionnaire. The family members of potential DCD donors were recruited from the first affiliated hospital, medical college of Xi'an Jiaotong university located in a metropolitan area of northwest of China. The 12-item attitude questionnaire was specifically developed from the literature review and coordinator, physician, and donor's family feedback. The participants were asked to rate the queries on a 5-point Likert intensity scale. Results The 174 participants included 56(32.2%) women and 118(67.8%) men. Most of people were aged between 41 and 50 years old(n = 63, 36.2%), 31 and 40 years old(n =59,33.9%), and less than 30 years old(n = 36,20.7%). The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization(RCO)(n = 160,92%), donor was a hero(n = 143,82.2%), honor to be a donor's family member(n = 136,78.2%), improved relationship with colleagues(n = 124,71.3%), and with recipient after donation(n = 12370.7%). The best person to suggest organ donation to a family was ranked as the coordinator of RCO(n = 160,92%), doctor unrelated to transplantation(n = 104,59.8%), social worker(n = 36,20.7%), and doctor related to transplantation(n = 25,14.4%). The top two reasons for non-consent to donation were the family insisted on intact body after patient death,and did not want to have surgery again(n = 51,41.5%), and feared that they would be misunderstood by neighbors,relatives and friends about donation(n = 28,22.8%). Conclusion This study revealed initial attitudes toward DCD organ donation in China. Some data afford insight to the decision-making procedure. The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.