A Comparison of Request Process and Outcomes in Donation After Cardiac Death and Donation After Brain Death: Results From a National Study.
A Comparison of Request Process and Outcomes in Donation After Cardiac Death and Donation After Brain Death: Results From a National Study.
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DOI：
10.1111/ajt.14084
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发表时间：
2017-05
期刊：
影响因子：
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通讯作者：
Traino HM
中科院分区：
文献类型：
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作者：
Siminoff LA;Alolod GP;Wilson-Genderson M;Yuen EYN;Traino HM
现有的文献指出，医疗服务提供者的不适与捐赠后，心脏死亡（DCD）和他们的看法，公众的不情愿的程序。使用一个国家的样本，我们报告的沟通内容的实际DCD和捐赠后脑死亡（DBD）的方法，器官采购组织（OPO）的请求者和比较家庭决策者（FDM）的经验，这两种方式。我们使用经验证的方案招募了1，601名FDM; 347名（21.7%）是潜在的DCD供体。半结构化的电话访谈获得了FDM的社会人口学数据，捐赠倾向，方法评估，最终结果和证实原因。初始分析包括双变量分析。多级混合模型比较了代表授权结果和DCD/DBD状态的组。DCD和DBD病例的家庭授权无显著差异。社会人口特征和授权之间存在统计学显著关联，白色FDM比黑人FDM更有可能授权DCD或DBD。两种模式的FDM对请求者技能、讨论的主题、满意度和拒绝原因的评价相似。研究结果表明，DCD/DBD的区别可能不显着的家庭。我们建议使用类似的沟通技巧和策略，在方法和教育活动的发展公众的接受DCD。
Available literature points to healthcare providers’ discomfort with donation after cardiac death (DCD) and their perception of the public’s reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers’ (FDMs’) experiences of both modalities. We recruited 1,601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semi-structured telephone interviews yielded FDMs’ sociodemographic data, predisposition toward donation, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with White FDMs more likely to authorize DCD or DBD than Black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and reasons for refusal. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar communication skills and strategies during approaches and the development of education campaigns about the public’s acceptance of DCD.