Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation.
Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation.
复制标题
DOI：
10.1111/ajt.14165
复制
发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
Siminoff LA
中科院分区：
文献类型：
--
作者：
Traino HM;Molisani AJ;Siminoff LA
尽管联邦命令禁止基于“地理事故”分配实体器官用于移植，但可移植器官的地理差异是有据可查的。本研究探讨了器官捐献请求沟通的地区差异。来自9个合作器官采购组织的行政数据和来自1，339个家庭决策者（FDM）的访谈数据在8个地理位置不同的美国捐赠服务区（DSA）进行了比较。在DSA中，器官捐赠的授权率从60.4%到98.1%不等。授权率最低的三个区域的FDM报告了对讨论捐赠和请求过程所花费的时间的最低满意度;讨论与捐赠相关的主题最少;捐赠压力最高;以及对捐赠决定最不满意。OPO区域预测授权（比值比范围为8.14至0.24），讨论捐赠的时间（OR = 2.11），讨论捐赠相关主题的数量（OR = 1.14）和请求者的沟通技巧（OR = 1.14）。需要对器官捐献请求工作人员进行标准化培训，以确保在请求期间进行最高质量的沟通，优化所有地区的家庭捐赠授权率，并增加可用于移植的器官供应。
Although federal mandate prohibits the allocation of solid organs for transplantation based on “accidents of geography,” geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from 9 partnering Organ Procurement Organizations and interview data from 1,339 family decision makers (FDMs) were compared across 8 geographically distinct US donor service areas (DSA). Authorization to organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process; discussion of the least donation-related topics; the highest levels of pressure to donate; and, the least comfort with the donation decision. OPO region predicted authorization (Odds Ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters’ communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation.