The experiences of clinical staff approaching families for organ donation consent: A systematic review and thematic synthesis of qualitative studies

IF 3.6 2区 医学 Q2 IMMUNOLOGY
L.H.M. Pengel , V. Mazarello-Paes , D. Paredes-Zapata , G.C. Oniscu , C. Gouveia Gaglianone , L. Zhu , Y. Wang , N. Dhanda , J. Tocher , L. Aviles
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Abstract

Healthcare professionals (HCPs) play an essential role in organ donation (OD) particularly when approaching families to discuss consent to OD. We synthesized the evidence on experiences of HCPs when approaching potential organ donor families. Fourteen electronic databases were searched to identify studies describing HCP experiences or associations between HCP experiences and consent rates. Methodological quality was assessed by independent reviewers using the Mixed Methods Appraisal Tool. Qualitative data were analysed using thematic synthesis, while quantitative data were summarized by narrative review. Ninety-two studies were included. HCP experiences were conceptualised as a paradox due to the challenges to negotiate the boundaries between life and death. Organisational and personal aspects broadly shape the experiences of professionals. Studies suggest that staff experiences can be improved by training and education, however, quantitative studies did not show a strong association between OD training and improved consent rates. The complexities of the family approach were evident in the variety of interactions between HCPs and the donor family, which may explain why there is no uniform approach across settings and countries. The review highlights the challenges faced by professionals when negotiating policy and practice and informs recommendations to support staff involved in the OD process worldwide.
临床工作人员接触器官捐赠同意家属的经验:定性研究的系统回顾和专题综合
医疗保健专业人员(HCPs)在器官捐赠(OD)中发挥着至关重要的作用,特别是在接近家属讨论同意OD时。我们综合了HCPs接触潜在器官供体家庭时的经验。检索了14个电子数据库,以确定描述HCP经历或HCP经历与同意率之间关系的研究。方法学质量由独立评审员使用混合方法评估工具进行评估。定性数据采用专题综合法分析,定量数据采用叙述性综述法总结。纳入92项研究。HCP的体验被概念化为一种悖论,因为它挑战了生死之间的界限。组织和个人方面广泛地塑造了专业人士的经历。研究表明,培训和教育可以改善工作人员的经验,但是,数量研究并没有显示OD培训与提高同意率之间的密切联系。家庭方法的复杂性在卫生保健提供者与供体家庭之间的各种相互作用中显而易见,这可能解释了为什么在不同的环境和国家没有统一的方法。该审查强调了专业人员在谈判政策和实践时面临的挑战,并提供了建议,以支持世界各地参与OD流程的工作人员。
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来源期刊
Transplantation Reviews
Transplantation Reviews IMMUNOLOGY-TRANSPLANTATION
CiteScore
7.50
自引率
2.50%
发文量
40
审稿时长
29 days
期刊介绍: Transplantation Reviews contains state-of-the-art review articles on both clinical and experimental transplantation. The journal features invited articles by authorities in immunology, transplantation medicine and surgery.
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