Role of quality of care and treatment in faciliting decision making and consent to organ donation in brain dead family: a qualitative study

Document Type : Original Quantitative and Qualitative Research Paper

Authors

1 Assistant professor of Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 Associate Professor of Nursing, Department of Nursing, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran

3 Professor of Nursing, Evidence Based Care Research Center; Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Caring for family is essential for organ donation request and decision making process and nurses are responsible for family caring.
Aim: the present study have performed to explore the role of quality of care and treatment in facilitating decision making and consent to organ donation in family of the  brain death patient.
Methods: A qualitative research approach with its focus on the content analysis was exploited. Participants were 26 brain-dead families who consented or refused from organ donation. Sampling method has started as purposive and continued as theoretical in transplantation center in Mashhad University of Medical Sciences in 2012. Accordingly, 38 unstructured interviews were conducted and data were analyzed using conventional content analysis.
Data collection process included 38 unstructured in- depth interviews request.
Results: The analysis of the data leads to extraction of 610 initial codes and 13 categories and 4 themes including viewing the sufficiency of the care and treatment of the injured patients, empathic and effective communication, emotional support and giving assurance. From the abovementioned themes, “Motivational atmosphere of the decision-making” was extracted as the central theme.
Conclusion: This study showed that health care and the team can play a significant role in brain dead family decision making and guiding it towards the consent or refuse to donate the organ. It is recommended that a specialized team consisting of doctors and nurses is formed this specialized training give them rely on caring of family in this complication situation (Communicational skills, support and mourning consulting).

Keywords

Main Subjects

References

  1. Baumrucker SJ, Stolick M, Morris GM, Carter GT, Sheldon JE. Brain Death and Organ Transplantation. Am J HospPalliat Care 2007; 24(4): 325-30.
  2. Verble M, Worth J. Fears and Concerns Expressed by Families in the Donation Discussion. Prog Transplant 2000; 10(1):48-53.
  3. Vincent A, Logan L. Consent for Organ Donation. Br J Anaesth 2012; 108 (Suppl. 1): i80–7
  4. Randhawa G. Death and Organ Donation: Meeting the Needs of multiethnic and Multifaith Populations. Br J Anaesth 2012; 108(1): i88–i91.
  5. Evanisko MJ, Beasley CL, Brigham LE, Capossela C, Cosgrove GR, Light J, Mellor S, Poretsky A, McNamara P. Readiness of Critical Care Physicians and Nurses to Handle Requests for Organ Donation. Am J Crit Care 1998; 7(1):4-12.
  6. McCoy J, Argue P. The Role of Critical Care Nurses in Organ Donation: A Case Study. Crit Care Nurs 1999; 19(2):48-52.
  7. Saviozzi A, Bozzi G, De-Simone P, Filipponi F. Refusal to Donate after Brain Death. Transplant Proc 2011; 43(1):280-1.
  8. Pelletier-Hibbert M. Coping Strategies Used by Nurses to Deal with the Care of Organ Donors and Their Families. Heart Lung 1998; 27(4):230-7.
  9. Lucia M, Wey H. Caring for Organ Donors: The Intensive Care Unit Nurses’ View. Qual Health Res 2000; 10(6): 788-805.
  10. Ingvar F.I, Bergbom I,Engberg H, Haljam H. Brain Death in ICU and Associated Nursing Care Challenges Concerning Patients and Families. Intensive Crit Care Nurs 1998; 14:21- 9.
  11. Ertin H, Harmanci AK, Mahmutoglu FS, Basagaoglu I. Nurse-Focused Ethical Solutions to Problems in Organ Transplantation. Nurs Ethics 2010; 17(6):705-14
  12. Eckenrod EL. Psychological-Emotional Trauma of Donor Families. Transplant Proc 2008; 40:1061–3
  13. Sque M. Researching the Bereaved: an Investigator’s Experience. Nurs Ethic2007; 7 (1):23-34.
  14. Fry S, Warren NA. Perceived Needs of Critical Care Family Members: a Phenomenological Discourse. Crit Care Nurse 2007; 30(2):181-8.
  15. Bond AE, Draeger CR, Mandleco B, Donnelly M. Needs of Family Members of Patients with Severe Traumatic Brain Injury: Implications for Evidence-Based Practice. Crit Care Nurse 2003; 23(4):63-72.
  16. Duff D. Family Impact and Influence Following Severe Traumatic Brain Injury. Axone 2006; 27(2):9-23
  17. Saberifiroozi M, Serati AR, Malekhosseini SA, Salahi H, Bahador A, Lankarani KB, Taghavi SA, Alizadeh M, Fattahi MR, Dehbashi N,Gholami S. Analysis of patients Listed for Liver Transplantation in Shiraz, Iran. Indian J Gastroenterology 2006; 25(1): 11-13.
  18. Ghods AJ. Organ Transplantation in Iran. Saudi J Kidney Dis Transpl 2007; 18(4):648-55.
  19. Polit DF, Beck CT. Essentials of Nursing Research: Methods, Appraisal and Utilization, 6th edition. Philadelphia: Lippincott Williams& Wilkins; 2006.
  20. Elo S, Kyngas H. The Qualitative Content Analysis Process. J Adv Nurs 2008; 62(1): 107-15.
  21. Iman M,Noshadi MR. Qualitative Content Analysis. Pazhuhesh, 2012;.3(2): 15-44[in persion]
  22. Krippendorff K. Content Analysis: An Introduction to Its Methodology, 2nd edition. Michigan: Sage; 2004.
  23. Sanner MA. Two Perspectives on Organ Donation: Experiences of Potential Donor Families and Intensive Care Physicians of the Same Event. J Crit Care 2007; 22(4):296-304.
  24. Long T, Sque M, Payne S.Organ and tissue donation: Exploring the Needs of Families. At, 7th Annual Symposium in Organ Donation and Transplantation, UMIST, Manchester, UK, 8 Oct 2003. Available at:http://eprints.soton.ac.uk/26720/
  25. Blok GA, van Dalen J, Jager KJ, Ryan M, Wijnen RM, Wight C, Morton JM, Morley M, Cohen B. The European Donor Hospital Education Programme (EDHEP): Addressing the Training Needs of Doctors and Nurses who Break Bad News, Care For The Bereaved, And Request donation. Transpl Int 1999; 12(3):161-7.
  26. Tong YF, Holroyd EA, Cheng B. Needs and Experiences of Hong Kong Chinese Cadaveric Organ Donor Families. Hong Kong J Nephrol 2006; 8(1):24-32.
  27. Kesselring A, Kainz M, Kiss A. Traumatic Memories of Relatives Regarding Brain death, Request for Organ Donation and Interactions with Professionals in the ICU. Am J Transplant 2007; 7: 211–7.
  28. Long T, Sque M, Payne S. Information Sharing: Its Impacton Donor and Nondonor Families’ Experiences in the Hospital. Prog Transplant 2006; 6(2):144- 9.
  29. Sque M, Long T, Payne S. Organ Donation: Key Factors Influencing Families' Decision-Making. Transpl Proc 2005; 37(2): 543-6.
  30. Wall R, Engelberg R, Gries C, Glavan B, Curtis J. Spiritual Care of Families in the Intensive Care Unit. Crit Care Med 2007; 35(4):1084e- 90.
  31. Bell L. Support for Families Deciding about Organ Donation. Am J Crit Care 2010; 19(5):462.
  32. Shih FJ, Lai MK, Lin MH, Lin HY, Tsao CI, Chou LL, Chu SH. Impact of Cadaveric Organ Donation on Taiwanese Donor Families during the First 6 Months after Donation. Psychosom Med 2001; 63(1):69-78
  33. BellaliT, Papazoglou I, Papadatou D. Empirically Based Recommendations to Support Parents Facing the Dilemma of Pediatric Cadaverorgan Donation. Intensive Crit Care Nurs 2007; 23: 216-25

6.      Schnell S. Organ Donation and Neuroscience Nursing: You're Role in the Process. J Neurosci Nurs 1999; 31(2):66-72.

7.      Johnson C. The Nurse's Role in Organ Donationfrom a Brainstem Dead Patient: Management of the Family. Intensive Crit Care Nurs 1992; 8(3):140-8
11.  Coyle M.A. Meeting The Needs of the Family: The Role of the Specialist Nurse in the Management of Brain Death. Intensive Crit Care Nurs 2000; 16, 45–50.
12.  Jacoby LH, Breitkopf CR, Pease EA. A Qualitative Examination of the Needs of Families Faced with the Option of Organ Donation. DimensCrit Care Nurs 2005; 24(4):183-9.
Evidence Based Care
Volume 3, Issue 3 - Serial Number 3
شماره پیاپی هشتم
October 2013
Pages 19-32

Files

Share

How to cite

Statistics