| Objective:Organ transplantation is an important means to save the lives of patients.Potential organ donors can provide substantial donor for organ transplant,but there are a large number of potential organ donors in ICU ware not digged,ICU nurses have long time caring the patients,they have the chance to identify potential organ donors and help families make donation decisions,they are an important group to promote the development of organ donation.This study conducted a systematic survey of ICU nurses' knowledge of organ donation,their willingness to donate and their willingness to persuade others to donate organs,analyzed the reasons affecting their participation in organ donation,and proposed corresponding strategies,so as to improve the enthusiasm of ICU nurses in organ donation,improve the rate of organ donation and better promote the development of organ transplantation in China.Methods:The research process is divided into two parts,and the results are investigated and analyzed by combining quantitative research with qualitative research.1.A questionnaire survey on ICU nurses in Chongqing was used to understand their knowledge,attitude and willingness of organ donation and analyze the influencing factors.First,cluster sampling method was used to select all the general hospitals with organ transplantation qualifications in Chongqing,namely Southwest Hospital,Xinqiao Hospital,Daping Hospital and the First Affiliated Hospital of Chongqing Medical University,totaling 4 hospitals.Using convenience sampling method selected 321 ICU nurses working in intensive care unit,neurosurgery ICU,hepatobiliary surgery ICU and other ICUs in the above hospitals,then a questionnaire survey was conducted among the selected ICU nurses.The questionnaire includes the self-designed general information table,the organ donation knowledge scale,the organ donation attitude scale and the organ donation intention scale developed by Shi Lizhu from Taiwan in 1998.Data entry was performed by Excel software,and statistical analysis was performed by SPSS20.0 software.2.The qualitative research method was used to analyze the ICU nurses' willingness to donate their own organs and their willingness to persuade others to donate organs.Personal depth interview in qualitative research was used,a semi-structured interview outline was prepared based on the literature review.ICU nurses were taken as the research objects,and the sample size was determined based on the principle of information saturation.The survey is divided into two parts: one part is a survey on the willingness of 16 ICU nurses to donate organs;the other part is a survey of 18 ICU nurses' willingness to persuade others to donate organs.After the interview,the interview recording was transcribed into words,and Colaizzi's seven-step analysis method of phenomenological research was used to analyze the data,from which the theme was extracted.Results:1.Current situation and influencing factors of knowledge,attitude and willingness of ICU nurses to organ donation in Chongqing.A total of 337 questionnaires were issued,and 321 valid questionnaires were collected,with an effective rate of 95.3%.The 321 ICU nurses' organ donation cognitive score was 7.00(7.00~8.00)(the full score is 10 points),organ donation attitude score was 3.51±0.91(the full score is 7 points),organ donation willingness median score is 2.00(2.00~3.00)(the full score is 5 points),seven of the 321 ICU nurses are willing to donate organs,accounting for 2.2% of the total number of the investigation,and only one of them agreed to sign the organ donation card,accounting for 0.3% of the total number.Factors influencing the willingness of organ donation include blood donation experience,family members' attitude towards organ donation and experience in persuading organ donation.Among them,unpaid blood donation experience and family members' attitude towards organ donation are also factors influencing the attitude of ICU nurses towards organ donation.2.Interview results of ICU nurses' willingness to donate their own organs in Chongqing.A total of 16 ICU nurses were interviewed.There are 6 big themes and 12 sub-themes.(1)the influence of traditional cultural thought: the concept of the corpse;the concept of martyrdom.(2)family members attitude and emotional factors: ICU nurses take the families' feelings into account,worrying about aggravating the pain of losing relative;family members' attitude towards organ donation influence ICU nurses' decision to donate.(3)the ethical dilemma brought about by organ donor acquisition: worry about the body will not be respected;unable to undergo organ removing surgery.(4)the negative effects brought by organ transplantation: maintenance and side effects after organ transplantation;immune rejection results in waste of donor organs.(5)lacking of recognition of organ donation: lacking of thinking about the problems related to organ donation;Cumbersome donation processes can cause problems.(6)a series of problems exited in organ donation management policy: misunderstandings brought by economic compensation;unfair donor distribution resulted by the high cost of transplantation.3.The qualitative interview results of ICU nurses' s willingness to persuade others to donate their organs in Chongqing.18 ICU nurses were interviewed about their willingness to persuade others to donate organs.Four major themes and 11 sub-themes were extracted.(1)limitations of the professional role of nurses: ICU nurses' organ donation job responsibilities are unknown,the role is not clear;the heavy work task,limited time to communicate with patients' families;lacking of the recognition from patients' families,lacking organ donation information shared by doctors;(2)influence of family members' negative emotions: family members expect too much for the treatment result,the death of the patient brings a heavy blow,family members have a negative attitude to donate;(3)the lack of medical institutions organ donation training: organ donation knowledge popularization is insufficient,the lack of organ donation communication skills related training;(4)the impact of social conservative ideas: misunderstanding caused by economic compensation system,negative impact brought by the tension between doctors and patients.Conclusion:1.ICU nurses in Chongqing still need to improve their knowledge of organ donation,their attitude towards organ donation is neutral and their willingness towards donating their own organs is not high.ICU nurses who have positive attitude towards organ donation,experience of unpaid blood donation or experience of encouraging donation,have relatively high willingness to donate organs.2.In addition to the traditional concept and the influence of family values in China,ICU nurses are also affected by the negative aspects of organ harvesting surgery and the negative effects of organ transplantation surgery,they have doubt about the distribution of the donors,the cost of the organ transplantation,economic compensation of organ donation.3.Due to the lack of relevant training and policy guarantee of organ donation,the ICU nurses surveyed in this group lack of organ donation related knowledge,and it is difficult for them to get support from doctors and patients' families when they participate in organ donation,and they are not active to participate in organ donation. |
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