活体肾脏捐赠决策支持过程中的挑战:定性研究

IF 1.5 4区 医学 Q3 NURSING
Yuri Wada, Takayoshi Ueno, Koji Umeshita, Kuniko Hagiwara
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引用次数: 0

摘要

背景以往关于活体肾脏捐献者决策的研究表明,捐献者的自主权问题是捐献肾脏决策的固有问题。本研究旨在确定临床移植协调员在倡导活体肾脏移植捐献者自主权时在决策支持方面遇到的困难,并确定应对这些困难的方法。结果与困难相关的三个类别如下:协调员、捐献者候选人及其家属之间互动的固有问题;协调员所处环境和机构背景的问题;协调员在决策支持过程中所付出的情感劳动。此外,与方法有关的五个类别如下:根据协调员的护理经验评估捐献者的自主性;根据协调员的护理经验对捐献者及其家属进行干预;与医务人员顺利协调;作为协调员阐明并坚持自己的观点;随时准备保护捐献者。此外,我们可能需要从根本上审视移植团体,因为在这个团体中,权力支配是固有的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Challenges in decision‐making support processes regarding living kidney donation: A qualitative study
BackgroundPrevious studies on decision‐making of living kidney donors have indicated issues regarding donors' autonomy is inherent in decision‐making to donate their kidney. Establishing effective decision‐making support that guarantees autonomy of living kidney donor candidates is important.ObjectivesThe aim of this study was to identify the difficulties in the decision‐making support when clinical transplant coordinators advocating for the autonomy of donor candidates of living donor kidney transplantation and to identify the methods to deal with these difficulties.DesignA qualitative descriptive study.ParticipantsTen clinical transplant coordinators supporting living kidney donors.ApproachSemi‐structured interviews were conducted using an interview guide. The modified grounded theory approach was utilised to analyse.ResultsThree categories related to difficulties were as follows: issues inherent to the interaction between coordinators, donor candidates and their families; issues regarding the environment and institutional background in which coordinators operate; and emotional labour undertaken by coordinators in the decision‐making support process. Additionally, five categories related to methods were as follows: assessing the autonomy of donor candidates based on the coordinators nursing experience; interventions for the donor candidates and their family members based on the coordinators nursing experience; smooth coordination with medical staff; clarifying and asserting their views as coordinators; and readiness to protect the donor candidates.ConclusionThe involvement of highly experienced coordinators with excellent and assertive communication skills as well as the ability to reflect on their own practices is essential. Moreover, we may need to fundamentally review the transplant community, where power domination is inherent.
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来源期刊
Journal of renal care
Journal of renal care Nursing-Advanced and Specialized Nursing
CiteScore
3.50
自引率
5.30%
发文量
36
期刊介绍: The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.
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