Academic journal article The Spanish Journal of Psychology

Family Perception of the Process of Organ Donation. Qualitative Psychosocial Analysis of the Subjective Interpretation of Donor and Nondonor Families

Academic journal article The Spanish Journal of Psychology

Family Perception of the Process of Organ Donation. Qualitative Psychosocial Analysis of the Subjective Interpretation of Donor and Nondonor Families

Article excerpt

Family perception of organ donation has been explored by numerous authors using statements by the people who decided whether or not to donate the organs of a relative in a situation of brain death. Within this tradition, in this work, we analyze the discourse of six families who granted permission for organ donation and three who refused. We describe the process-based interpretation of this experience and identify psychosocial variables and processes that further our understanding of the decision finally adopted. We have identified two heuristics that guide family decision when organ donation is requested: the explicit or inferred will of the deceased and family attitudes to organ donation and transplant. It is postulated that the interaction of these two factors explains a large amount of the decisions made. We also hypothesize that a marked discrepancy between these two factors increases the importance of other aspects, especially the role of the transplant coordinator and of other healthcare personnel. These results support, at a social level, the implementation of transplant promotion programs; and at a healthcare level, the combined use of techniques of crisis intervention and attitude change.

Keywords: qualitative study, organ donation, perception, families, interview

El estudio de la percepción familiar sobre donación de órganos ha sido abordado por numerosos autores partiendo de declaraciones de personas que habían decidido si donaban los órganos de un familiar en situación de muerte cerebral. Inserto en esta tradición, este trabajo analiza cualitativamente el discurso de seis familias que concedieron la donación de órganos y de tres que la denegaron. Describe la interpretación procesal de esta experiencia e identifica variables y procesos psicosociales que permitan comprender la decisión adoptada. Se identifican dos heurísticos que orientan la decisión familiar ante la petición de donación de órganos: la voluntad manifestada o inferida del fallecido y las actitudes familiares hacia la donación y el trasplante de órganos de los decisores; se postula que la interacción de ambos explica una parte significativa de las decisiones adoptadas. También se hipotetiza que una fuerte discrepancia entre estos dos procesos favorece que otros factores (especialmente la actuación del coordinador de trasplantes y del personal sanitario) adquieran mayor importancia en la decisión familiar. Los resultados apoyan, a nivel social, la aplicación de programas de promoción del trasplante y, a nivel hospitalario, la aplicación de intervenciones que integren técnicas de intervención en crisis y de persuasión y cambio de actitudes.

Palabras clave: estudio cualitativo, donación de órganos, percepción, familias, entrevista

Many efforts have been made to promote organ donation in western countries, although only in Spain has there been a notable and continued increase (Matesanz, 2006; Schütt, 2002). Multidisciplinary research on donation and organ transplant has contributed effectively to extending transplant, necessarily related to obtaining permission to extract the organs of a recently deceased relative (Jacoby, Breitkopf, & Pease, 2005; Sanner, 2006). Some of the studies on the psychosocial determinants of organ donation have attempted to analyze the opinions and emotions generated by the donation process in the relatives of potential organ donors, in order to identify factors that may facilitate or inhibit granting permission. These investigations have made considerable advances in our understanding of the family perception of organ donation and have promoted the development of specific training processes for transplant coordinators (Matesanz, 2006), the healthcare personnel who are responsible for obtaining the express family consent that makes possible a generous act such as organ donation.

This kind of research began in 1971, with a longitudinal study of 35 families of 14 kidney donors (Simmons, Klein, & Simmons, 1987) that identified two factors that have been the most frequently cited in subsequent investigations: empathy with kidney patients and the wish to achieve some kind of immortality for the deceased relative. …

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