临床医生和亲属在受控循环死亡后捐献的经验:一项前性定性研究
Thomas Denise1, Mathilde Cœur2, Laurent Martin-Lefevre3
1Medical Intensive Care Unit and Famiréa Research Group, Saint-Louis University Hospital, AP-HP Nord, Paris, France.
Annals of intensive care
|March 6, 2026
概括
循环死亡后的受控捐赠 (cDCD) 涉及医疗保健团队和家庭的三个阶段:希望,死亡的接受和捐赠. 了解这些阶段可以在cDCD过程中改善支持和沟通.
科学领域:
- 医学伦理 医学伦理
- 移植医学 移植医学
- 密集护理医学 密集护理医学
背景情况:
- 循环死亡后的受控捐献 (cDCD) 是一种被广泛采用的器官捐献策略.
- 有效的cDCD需要密集护理单位 (ICU),器官采购组织 (OPO) 和家庭之间的无协作.
- 关于参与cDCD的利益相关者生活经验的数据有限.
研究的目的:
- 探索ICU团队,器官采购团队和亲属在cDCD过程中的经验.
- 从利益相关方的角度确定cDCD实施中的关键挑战和促进者.
主要方法:
- 使用焦点小组与ICU和OPO专业人员进行定性研究,并与cDCD捐赠者的亲属进行半结构面试.
- 解释性现象学分析 (IPA) 应用于采访和焦点小组数据.
- 这项研究是在PRODON随机对照试验框架内在法国五家医院进行的.
主要成果:
- 对于专业人士和亲属来说,cDCD过程分为三个不同的阶段:最初的不确定性和希望,过渡到接受不可避免的死亡,以及生命结束时的捐赠请求.
- 医疗保健专业人员有时在实现"良好的死亡"和cDCD的技术成功之间经历了冲突.
- 亲属需要足够的时间来处理cDCD的概念,并了解其程序方面.
结论:
- 认识到cDCD过程的三个阶段,可以加强对亲属的支持.
- 更清晰的职业角色定义和改善团队间的沟通对于成功的cDCD至关重要.
- 这种理解可以优化ICU和器官采购团队之间的合作.
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