The factors of family's decision to offer the relative organ donation and the solution
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摘要:
目的通过潜在心脏死亡人体器官捐献(DCD)案例的访谈工作，探讨家属对亲属器官捐献决定的影响因素分析及应对措施，为制定临床上缓解器官供应紧缺的应对方案提供依据。 方法选取2015年1月~2016年1月参与本移植医学中心协调的潜在DCD案例62例，对潜在DCD者的家属通过专业调查人员进行访谈，通过对DCD案例成败分析、访谈时机、调查人员专业度、家属对器官捐献接受程度、家庭成员构造、家庭成员对DCD决定的影响等调查，探索家属对亲属器官捐献决定的影响因素分析及应对措施。 结果捐献成功的主要因素：（1）与家属访谈的时机均为家属放弃治疗之后；（2）家属接受临床DCD的概念及流程，对DCD体制和使用情况不会质疑；（3）调查人员通过DCD访谈技巧培训；（4）患者家庭构造是核心家庭，DCD讨论参与者只有核心的家庭成员。 结论家属对亲属DCD的决定受多种因素的影响，政府与医疗机构需要规范DCD 体制，加强调查人员的专业培训，宣传DCD知识，改良DCD的社会舆论，建立国家级DCD登记与分配平台，进而缓解器官供应紧缺的难题，提高我国DCD数量和捐献率具有重要的临床意义。 Abstract:Objective To explore the factors influencing family decision to offer the relative organ donation and the solution by the interview work of the donation after the citizen's death(DCD), providing the basis for alleviate the shortage of organ in the clinical supply plan. Methods A total of 62 cases with the potential DCD who were treated and analyzed in the transplantation medicine center from Jan. 2015 to Jan. 2016 were recruited as the study objects, the influence factors were explored on the decision analysis of the families to relatives organ donation and counter measures, of DCD case analysis, interview time, investigators professional degree, by the interview work of the DCD, the family acceptance for organ donation, the family structure, and the impact of family members to DCD decided. Results The key success factors of the DCD :(1) Interview time were chosed when the all family members gived up after the treatment; (2)the concept and process of the clinical DCD and the usage of DCD system would not be questioned; (3)investigators were performed the skills training of the DCD interview;(4) the patient's family structure was nuclear family, the participants in the DCD discussion only were the core members of the family. Conclusion The DCD decision of family is influenced by many factors,the DCD system need to be standardized by the government and medical institutions , the professional training to the investigators can be strengthened, the DCD knowledge should spread,the social public opinion of the DCD have to improve,the national DCD registration and distribution platform can be established,the organ shortage must be alleviated and the quantity and donation rates of DCD can be improved in the important clinical significance. -
Key words:
- DCD /
- family members /
- shortage of supply /
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