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Presenter: Sandra, Neate, Melbourne, Australia
Authors: Sandra Neate, Michelle Skinner, Claudia Marck, George Jelinek, Bernadette HIckey, Bernadine Dwyer, Tracey Weiland
Understanding Family Decisions Regarding Organ Donation
Sandra Neate1,3, Michelle Skinner5, Claudia Marck2, George Jelinek3,2, Bernadette HIckey4, Bernadine Dwyer6, Tracey Weiland3,2
1Emergency Department, St Vincent's Hospital Melbourne, Melbourne, Australia, 2Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Australia, 3Department of Medicine, University of Melbourne, Melbourne, Australia, 4Intensive Care Unit, St Vincent's Hospital, Melbourne, Australia, 5DonateLife Victoria, Melbourne, Australia, 6Australian Organ and Tissue Authority, Canberra, Australia
Aim: To assist an understanding of factors influencing family decisions about organ donation (OD).
Methods: Face to face or telephone interviews with one or more members of families asked to consider OD. Purposive sampling ensured representation by families who consented to and declined donation. Qualitative exploration of families’ experiences of the request, decision-making and process around OD. Interviews were audio-recorded, transcribed and thematic analysis identified issues important to participants.
Results: Eligible families who had been asked to consider OD from four Melbourne hospitals were invited to participate. Families of intended organ donors, organ donors and families who declined donation were interviewed. Reasons for consenting to donation included: prior discussion regarding or knowledge of loved one’s wishes; donation was consistent with loved one’s values; wanting something good to come from a tragic situation; and understanding the rareness of the opportunity to donate. Reasons for declining OD included: no prior discussion regarding or knowledge of loved one’s wishes; knowing loved one did not wish to donate; cultural/religious reasons; prolonged time to donation/wanting it all to be over; not realising the decision needed to be made rapidly; too much to take in; not wanting to put the deceased through anything more; specific aspects of the conversation; and OD being raised “too early”. Several families noted an influence of the donation conversation on their ultimate decision.
Conclusion: Conversations about OD, and other events or experiences in the hospital, can influence family decisions regarding OD. Knowledge of the factors influencing families’ decisions may assist those conducting donation conversations.
1The authors wish to acknowledge the contributions of Dr Helen Opdam, Dr Rohit D'Costa; Dr Sam Radford, Dr Forbes McGain and the Nurse Donation Specialists of St Vincent's, Royal Melbourne, Austin and Western Hospitals Melbourne.
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