EVALUATION OF A CONCEPTUAL MODEL OF ORGAN DONATION

这项修订后的提案是为了响应联邦政府提高全国器官捐赠率的倡议。有充分的证据表明，对捐献器官的需求远远超过了可移植器官的捐赠率，而提高捐赠率是临床移植领域面临的最关键的问题。到目前为止，研究工作主要集中在提高公众成为器官捐赠者的态度和意愿上，而相对较少的科学努力是为了确定那些最能预测实际近亲捐赠同意的因素。由于器官捐赠几乎完全取决于家庭成员的同意，因此我们必须加强对那些可能导致有利同意决定的变量的理解。使用Radecki和Jaccard开发的概念模型，我们将研究近亲信仰和态度以及对死者捐赠意图的了解与器官捐赠决定之间的关联。根据现有文献，假设与捐赠决策相关的变量包括：近亲信仰结构、对器官捐赠的态度和应对资源。在提出捐赠请求后两周内，将通过电话与大约250名提出捐赠请求的近亲进行面谈，并根据概念模型指导的几个变量进行评估。在数据分析中将采用分层Logistic回归。预计这项研究的结果将加深我们对影响器官捐赠同意的最显著的个人和背景因素的了解，并指导制定有效的请求策略。

This revised proposal is designed in response to the federal government's initiative to increase national organ donation rates. It is well documented that the need for donor organs far exceeds the rate at which viable organs are donated, and that increasing donation rates is the most critical issue facing the field of clinical transplantation. To date, research efforts have focused mostly on enhancing public attitudes and willingness to become organ donors with comparably less scientific effort to identify those factors that are most predictive of actual next-of-kin donation consent. Since organ donation depends almost exclusively on the consent of family members it is imperative that we enhance our understanding of those variables that are likely to lead to favorable consent decisions. Using a conceptual model developed by Radecki and Jaccard, we will examine the associations of next-of-kin beliefs and attitudes and knowledge of the deceased's donation intentions to organ donation decisions. Variables hypothesized to be associated with donation decisions based on the extant literature include: next-of-kin belief structure, attitude toward organ donation, and coping resources. Approximately 250 next-of-kin to whom a donation request was targeted will be interviewed by telephone within two weeks of the request and assessed on several variables guided by the conceptual model. Hierarchical logistic regression will be used in the data analysis. It is expected that results from this study will enhance our understanding of the most salient individual and contextual factors that affect organ donation consent and guide the development of effective request strategies.