Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T06:45:55.576Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  10 April 2014

Jorge S. López Martínez
Affiliation:
Universidad Autónoma de Madrid
María Jesús Martín López
Affiliation:
Universidad Autónoma de Madrid
Barbara Scandroglio
Affiliation:
Universidad Autónoma de Madrid
José Manuel Martínez García*
Affiliation:
Universidad Autónoma de Madrid
*
Correspondence concerning this article should be addressed to: José Manuel Martínez García, Universidad Autónoma de Madrid, Facultad de Psicología, Ciudad Universitaria Cantoblanco, 28049 Madrid (Spain). E-mail: [email protected]

Abstract

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.

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.

Type
Articles
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albarracín, D., Johnson, B.T., & Zanna, M.P. (2005): The handbook of attitudes. Mahwah, NJ: Erlbaum.Google Scholar
Álvarez-Gayou, J.L. (2003). Cómo hacer investigación cualitativa. Fundamentos y metodología. México: Paidós Educador.Google Scholar
Baron, R.A., & Byrne, D. (2005). Social psychology (10th ed.). Boston: Allyn & Bacon. [Spanish translation: Psicología social (10ª ed.). Madrid: Pearson-Prentice Hall, 2005].Google Scholar
Domínguez, J.M., Murillo, F., Muñoz, A., & Pérez, M.A. (1992). Psychological aspects leading to refusal of organ donation in southwest Spain. Transplantation Proceedings, 24, 2526.Google Scholar
Festinger, L. (1957): A theory of cognitive dissonance. Evanston, Ill: Row Peterson.CrossRefGoogle Scholar
Fernández Liria, A., & Rodríguez Vega, A. (2002). Intervención en crisis. Madrid. Síntesis.Google Scholar
Fernández Millán, J.M. (2005). Apoyo psicológico en situaciones de emergencia. Madrid. Pirámide.Google Scholar
Frutos, M.A., Blanca, M.J., Rando, B., Ruíz, P., & Rosel, J. (1994). Actitudes de las familias donantes y no donantes de órganos. Revista Española de Trasplantes, 3, 163169.Google Scholar
Glaser, B.G. & Strauss, A.L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company.Google Scholar
Haddow, G. (2004). Donor and nondonor families' accounts of communication and relations with healthcare professionals. Prog Transplant, 14, 4148.CrossRefGoogle ScholarPubMed
Jacoby, L.H., Breitkopf, C.R., & Pease, E.A. (2005). A qualitative examination of the needs of families faced with the option of organ donation. Dimensions of Critical Care Nursing; Jul/Aug, 24, 183189.CrossRefGoogle ScholarPubMed
Lazarus, S.R., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.Google Scholar
Martínez, J.M., López, J.S., Martín, A., Martín, M.J., Scandroglio, B., & Martín, J.M. (2001). Organ donation and familiy decision-taking within the Spanish donation system. Social Science, & Medicine, 53, 405421.CrossRefGoogle Scholar
Matesanz, R. (2006). El milagro de los trasplantes. De la donación de órganos a las células madre. Madrid: La Esfera de los Libros.Google Scholar
Miles, M.B. (1994). Qualitative data analysis. Thousand Oaks, CA: Sage.Google Scholar
Pearson, I.Y., Bazeley, P., Spencer-Plane, T., Chapman, J.R., & Robertson, P. (1995). A survey of families of brain dead patients. Their experiences, attitudes to organ donation and transplantation. Anaesthesia and Intensive Care, 23, 8895.CrossRefGoogle ScholarPubMed
Pelletier, M. (1992). The organ donor family members' perception of stressful situations during the organ donation experience. Journal of Advanced Nursing, 17, 9097.CrossRefGoogle ScholarPubMed
Pelletier, M. (1993a). The needs of family members of organ and tissue donors. Heart and Lung, 22, 151157.Google ScholarPubMed
Pelletier, M. (1993b). Emotions experienced and coping strategies used by family members of organ donors. Canadian Journal of Nursing Research, 25, 6373.Google ScholarPubMed
Pratkanis, A.R. (2007). The Science of social influence: Advances and future progress. New York: Psychology Press.Google Scholar
Rosel, J., Frutos, M.A., Blanca, M.J., & Ruíz, P. (1995). La decisión de donar órganos. Variables contextuales y consecuencias de la decisión. Psicothema, 7, 605618.Google Scholar
Rubin, B., & Bloch, E. (1998). Crisis intervention and trauma resonse. Theory and practice. New York: Springer. [Spanish translation: Intervención en crisis y respuesta al trauma. Teoría y práctica. Bilbao: Desclée de Brouwer, 2001].Google Scholar
Sanner, M. (2006). People's attitudes and reactions to organ donation. Mortality, 11, 133150.CrossRefGoogle Scholar
Savaria, D.T., Rovelli, M.A., Schweixer, R.T.(1990). Donor family surveys provide useful information for organ procurement. Transplantation Proceedings, 22, 316317.Google ScholarPubMed
Schütt, G.R. (2002). 25 years of organ donation: European initiatives to increase organ donation. Transplantation Proceedings, 34, 20052006.CrossRefGoogle ScholarPubMed
Simmons, R.G., Klein, S.D., & Simmons, R.L. (1987). Gift of life: The social and psychological impact of organ transplantation. New York: Wiley.Google Scholar
Sque, M., & Payne, S.A. (1996). Dissonant loss: The experiences of donor relatives. Social Science and Medicine, 43, 13591370.CrossRefGoogle ScholarPubMed
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. London: Sage.Google Scholar
Taylor, S. J., & Bodgan, R. (1984). Introduction to qualitative research methods. The search for meanings. New York: Wiley. [Spanish translation: Introducción a los métodos cualitativos en investigación. Barcelona: Paidós Básica, 1997].Google Scholar
Tversky, A., & Kahneman, D. (1980). Casual schemas in judgements under uncertainty: Heuristics and biases. In Fishbein, M. (Ed.), Progress in social pyschology (pp. 4972). Hillsdale, NJ: Erlbaum.Google Scholar
Tymstra, T., Heyink, J.W., Pruim, J., & Slooff, M.J. (1992). Experience of bereaved relatives who granted or refused permission for organ donation. Family Practice, 9, 141144CrossRefGoogle ScholarPubMed