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1.
Exp Clin Transplant ; 22(Suppl 4): 12-24, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38775692

RESUMO

Solid-organ transplantation remains the optimal therapeutic option for end-stage organ disease. Altruistic donation represents the ultimate sign of generosity and the most important gift of life. Currently, <10% of the global needs for transplant are fulfilled. Organ shortages result from an inability to provide an adequate organ supply to match demands. The recently observed stagnation in living kidney donations in the United States is related to a drop in all types of organ donations from living related donors, which has been paralleled with a steady and continuous increase in all living unrelated donations. Some forms of living unrelated donation represent a financially driven survival system within which wealthy recipients exploit poor donors. Low rates of altruistic donation are related to cultural barriers, religious obstacles, fear, and consequent distrust in the system. The low rate indicates a state of lack of societal solidarity, a consequence of the state of subconsciousness at the individual and collective levels that humanity is living in. Human domestication, the conditioning process that humans go through since birth and the primary facilitator of this subconscious state, is guarded through familial, social, cultural, religious, political, and mass media organizations, which are all under the influence of the monetary establishment. Acquired beliefs, mainly during the domestication process, influence our perception of the environment, our values, and ultimately our way of life. Unfortunately, this conditioning process is negatively enforced, leading to a stressful state. The powerful subconscious mind places humans in a permanent survival mode, resulting in loss of intelligence, indispensable for well-being and happiness. Altruistic donation requires a close cooperation between all parties involved in the donation process and necessitates a positive reprograming of our subconscious based on sharing, generosity, satisfaction, gratitude, trust, inner peace, and ultimately happiness, well-known constituents of unconditional love, which represents the peak of consciousness.


Assuntos
Altruísmo , Doadores Vivos , Obtenção de Tecidos e Órgãos , Humanos , Doadores Vivos/psicologia , Doadores Vivos/provisão & distribuição , Doações , Motivação , Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/psicologia , Necessidades e Demandas de Serviços de Saúde , Características Culturais , Doadores não Relacionados/psicologia
3.
J Clin Psychol Med Settings ; 29(4): 808-817, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35072842

RESUMO

How clinicians perform pre-surgical psychological evaluations (PSPE) for bariatric surgery remains variable across institutions. Bariatric PSPE guidelines state that self-report measures should be incorporated in the PSPE procedure, yet only 50-60% of PSPEs utilize patient self-report measures. Previous studies describing the presurgical psychological evaluation report a range of measures, however a gold standard in PSPE has yet to be agreed upon. Given this gap in how a presurgical psychological evaluation for bariatric patients is defined, incorporating more objective measures into this process may help clinicians identify specific areas in which a patient is struggling and benefit from additional psychosocial support. The present study proposes the use of the SIPAT, a semi-structured interview initially developed to assess organ transplant candidates, as part of this evaluation. A total of 292 adult patients underwent a pre-surgical psychological evaluation for bariatric surgery between November 2017 and February 2020 at a Midwest medical center. Patient average age was 45.2 (11.3) years and 83.3% were female. At time of analysis, 160 patients received bariatric surgery. Logistic regression and analyses of bivariate associations were conducted in R. The SIPAT exhibited good convergent validity via correlations with analogous scales on the PROMIS 43, and it yielded a small effect size predicting patients who ultimately received surgery. Accordingly, this semi-structured interview may be a useful tool to help differentiate patients for surgical candidacy.


Assuntos
Cirurgia Bariátrica , Transplante de Órgãos , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Cirurgia Bariátrica/psicologia , Transplante de Órgãos/psicologia , Autorrelato
4.
J Acad Consult Liaison Psychiatry ; 63(4): 345-353, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34863909

RESUMO

BACKGROUND: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive instrument developed to provide a standardized, objective, and evidence-based psychosocial evaluation of the main pretransplant psychosocial risk factors that may influence transplant outcomes. OBJECTIVE: Because established assessment procedures or standardized tools designed to perform pre-solid organ transplant psychosocial evaluation are currently unavailable in Japan, the present study aimed to develop and preliminarily validate the Japanese version of the SIPAT. METHODS: First, the Japanese version of the SIPAT was developed using standard forward-back-translation procedures. Then, the Japanese versions of the SIPAT and the Japanese version of Psychosocial Assessment of Candidates for Transplant were retrospectively and blindly applied to 107 transplant cases by 4 independent raters. RESULTS: The interrater reliability of the scores obtained with the Japanese version of the SIPAT was excellent (Pearson's correlation coefficient = 0.86). The concurrent validity of the SIPAT to the Psychosocial Assessment of Candidates for Transplant for each examiner was substantial (Spearman's rank correlation coefficient = -0.66). CONCLUSION: These findings suggest that the Japanese version of the SIPAT is a promising and reliable instrument. Further research is required to test the predictive validity of the Japanese version of the SIPAT.


Assuntos
Transplante de Órgãos , Japão , Transplante de Órgãos/psicologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco
5.
J Clin Psychol Med Settings ; 29(1): 137-149, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34043137

RESUMO

The SIPAT is a standardized measure for pre-transplant psychosocial evaluation. Previous SIPAT studies utilized a relatively small lung transplant sample and only included listed patients. This study characterized the SIPAT in 147 lung transplant candidates to better elucidate its utility. The average score corresponded to a minimally acceptable rating and nearly half of the patients had relative or absolute contraindications. Interstitial Lung Disease (ILD) patients scored more favorably than non-ILD patients (U = 7.69, p < .05). The Total (ß = - .05, SE = .018, p < .01), Social Support Subscale (ß = - .133, SE = .058, p < .05), and Psychosocial Stability and Psychopathology Subscale (ß = - .103, SE = .040, p < .05) significantly predicted listing status. The SIPAT has a unique profile in lung transplant candidates and demonstrated utility for guiding transplant decisions. Future research should examine which lung transplant outcomes are significantly associated with SIPAT scores.


Assuntos
Transplante de Pulmão , Transplante de Órgãos , Humanos , Transplante de Órgãos/psicologia , Estudos Retrospectivos , Apoio Social
6.
Liver Transpl ; 28(6): 936-944, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34596955

RESUMO

The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a validated interview tool to assess psychosocial well-being in candidates for solid organ transplants, with higher scores indicating greater vulnerability. We hypothesized that patients with alcohol-related liver disease (ALD) undergoing liver transplantation (LT) evaluation would have higher SIPAT scores than candidates with non-ALD, but that only patients with ALD who have low scores would be selected. We analyzed retrospectively consecutive adults undergoing LT evaluation from June 2018 to December 2019. Comparisons between patients with ALD and patients with non-ALD were made using the nonparametric Wilcoxon rank sum test plus a multivariate analysis to determine independent predictors for approval. In the study cohort of 358 patients, there were 199 (56%) patients with ALD with a mean age of 55 years, and 133 (67%) were men. There were 159 (44%) patients with non-ALD with a mean age of 57 years, and 95 (60%) were men. Mean Model for End-Stage Liver Disease-sodium scores were similar for selected versus not selected patients with ALD (25 versus 25.6) and selected versus not selected patients with non-ALD (18.3 versus 17.4), although the ALD group had substantially higher Model for End-Stage Liver Disease scores. Patients with ALD had higher mean SIPAT composite and individual domain scores compared with their non-ALD counterparts. SIPAT scores were not affected by age or sex. Proportionately more candidates with non-ALD were selected compared to candidates with ALD (68% versus 42%; P < 0.001; odds ratio for approval of non-ALD versus ALD, 2.9; 95% confidence interval, 1.8-4.7; P < 0.001). Composite SIPAT scores were lower in the selected versus nonselected in both ALD and non-ALD groups, although the SIPAT scores were significantly higher in selected patients with ALD (median, 39) than selected patients with non-ALD (median, 23; P = 0.001). Psychosocial assessment has a greater influence than acuity of liver failure on the selection of patients with ALD for LT listing, whereas psychosocial assessment has a minor influence on the selection of non-ALD candidates.


Assuntos
Doença Hepática Terminal , Hepatopatias Alcoólicas , Transplante de Fígado , Transplante de Órgãos , Adulto , Doença Hepática Terminal/diagnóstico , Doença Hepática Terminal/cirurgia , Feminino , Humanos , Hepatopatias Alcoólicas/complicações , Hepatopatias Alcoólicas/cirurgia , Transplante de Fígado/efeitos adversos , Masculino , Pessoa de Meia-Idade , Transplante de Órgãos/psicologia , Estudos Retrospectivos , Índice de Gravidade de Doença
7.
Transplant Proc ; 53(3): 779-785, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33741202

RESUMO

BACKGROUND: Standardized pretransplant psychosocial assessment is critically needed in Thailand to optimize medical and psychosocial outcomes after transplantation. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive and evidence-based tool that has demonstrated excellent reliability and predictive value in many psychosocial transplant studies. We translated the SIPAT into Thai and explored the validity and reliability of the SIPAT-Thai version among Thai transplant recipients. METHODS: We translated the original SIPAT into Thai following the World Health Organization's standard forward-backward translation procedure and then cross-sectionally assessed its validity and reliability in 110 Thai solid organ transplant candidates. The correlation between background data, total, and sectional scoring results of SIPAT-Thai were also analyzed. RESULTS: The SIPAT-Thai demonstrated moderate to good reliability, which was represented by internal consistency with a Cronbach α of .751 and interrater reliability with a κ value at 0.767. The index of item-objective congruence value was 0.94, indicating good the content validity. CONCLUSIONS: The SIPAT-Thai was systematically translated and shown to have acceptable validity and a moderate to good reliability index. The use of the SIPAT-Thai would provide a standardized, evidence-based, and a more systematic pretransplant psychosocial evaluation process for transplant candidates in Thailand.


Assuntos
Transplante de Órgãos/psicologia , Seleção de Pacientes , Inquéritos e Questionários/normas , Transplantados/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Reprodutibilidade dos Testes , Tailândia , Traduções
8.
Transplant Proc ; 53(2): 539-547, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33012544

RESUMO

BACKGROUND: Organ transplantation is considered one of the greatest advances of modern science, and it has given many patients a renewed lease on life. The demand for organs far exceeds the supply. Health professionals are fundamental in the process of organ procurement. OBJECTIVE: To assess the attitude, willingness, and associated factors in organ donation among health professionals of Gondar, Ethiopia. METHODS: Our cross-sectional study was conducted among 382 randomly selected health professionals in Gondar using a self-administered questionnaire. Multivariable logistic regression analysis was applied to analyze the data. RESULTS: Among health professionals, 79.1% had favorable attitude toward organ donation and 74.6% were willing to donate their organs. After adjusting for covariates, the odds of having a favorable attitude about organ donation were 3.2 and 11.9 times higher in the professions of laboratory technologists and medical doctors, respectively. By keeping all other variables constant, attitude was found to be positively associated with awareness (adjusted odds ratio [aOR] 12.74, 95% confidence interval [CI] 3.71-43.8) and being a member of the Red Cross Association (aOR 5.24, 95% CI 1.46-18.96). Willingness was positively associated with awareness (aOR 6.25, 95% CI 2.0-19.53), a member of the Red Cross Association (aOR 5.09, 95% CI 1.5-17.22), a laboratory technologist (aOR 3.57, 95% CI 1.37-9.29), and a medical doctor (aOR 6.52, 95 % CI 1.93-22.01). CONCLUSIONS: The main findings indicated that the majority of health professionals in Gondar had a favorable attitude toward organ donation and were willing to donate their organs in times of need.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Transplante de Órgãos/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Estudos Transversais , Etiópia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pesquisa Qualitativa , Inquéritos e Questionários , Adulto Jovem
9.
Medicine (Baltimore) ; 99(50): e23438, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327273

RESUMO

BACKGROUND: The organ donation in China has developed rapidly since fully launched donations after citizens death in 2015. This study was conducted to evaluate how the Chinese general public views changed on deceased organ donation, and to improve the donation process. METHODS: A total of 110 eligible studies, including 103, 410 individuals, were selected to analyze through searching PubMed, CBMdisc, CQVIP, CNKI, and Wanfang Data from Jan 1, 1990 to May 31, 2019. The pooled proportions (and 95% CIs) of cognition, attitudes and willingness related to organ donation were calculated using the Freeman-Tukey double arcsine transformation. RESULTS: The pooled proportions of knowing about organ donation and willing to donate increased from 84.6% (73.0-93.4) and 32.4% (23.9-41.6) before 2015, to 86.4% (74.5-95.1) and 39.9% (32.8-47.2) after 2015, respectively. The willingness to posthumous organ donation for cornea, heart, kidney, and liver had a significant improvement. Especially, the proportion of willingness to donate cornea increased to 56.0% (43.3-68.3) after 2015, from 39.2% (31.2-47.4) before 2015. However, although 69.7% (62.7-76.4) of participants approved the deceased organ donation, only 35.6% (29.7-41.8) and 43.9% (37.2-50.8) were willing to donate their own and relatives organs postmortem, respectively. The leading reasons for refraining from donating organs postmortem were distrusting the medical professionals (49.8%, 35.2-64.4) and traditional Chinese values (40.6%, 32.4-49.0). Popularizing knowledge about organ donation (61.5%, 45.7-76.1), humanitarian aid (57.1%, 48.8-65.3), and priority of using donated organs for relatives (53.1%, 30.8-74.7) were the applauded strategies to improve the willingness to posthumous organ donation. CONCLUSIONS: The willingness toward posthumous organ donation has a significant improvement among Chinese general public since 2015, however, several important measures still need to be taken to promote the favorable attitudes and willingness toward organ donation.


Assuntos
Povo Asiático/psicologia , Transplante de Órgãos/psicologia , Obtenção de Tecidos e Órgãos/provisão & distribuição , Adulto , China , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários
10.
Saudi J Kidney Dis Transpl ; 31(3): 624-638, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32655049

RESUMO

Low organ donation rates are a major obstacle to the expansion of transplant opportunities in the Middle East. Awareness and opinion about organ donation affect willingness to donate. This study aims to evaluate public attitudes and knowledge about deceased organ donation (DOD) in Jordan in support of larger efforts to increase donor rates. A mixed qualitative and quantitative approach was used. Qualitative, one-on-one interviews were used to create a quantitative survey, which was administered to randomly-selected individuals over a 5-month period. The questionnaire used series of statements to evaluate knowledge and attitude about DOD on a scaling system and converted to scores (0-4). A total of 15 qualitative interviews and 500 quantitative surveys (78.4% response rate) were completed. Only 78 (15.6%) knew they could donate their organs after death. Only 49 (9.8%) were registered as donors, although 373 (74.6%) knew about the registration process. Internet (52.2%) and social media (51.0%) were the most common sources of information. The overall knowledge score was moderately high at 68.8% (2.75 ± 1.31). Misconceptions persisted about body disfigurement, diagnostic accuracy of brain-death, and waiting list equity. The total attitude score was moderately positive at 65.8% (2.63 ± 0.02). Public awareness campaigns (85.3%, 3.42 ± 0.95) and regulatory legislation (78.8%, 3.15 ± 0.99) were considered especially positive, while negative attitudes about religious approval and paid donation were present. Female respondents had significantly higher scores on organ donation significance (P = 0.007) and overall attitude (P = 0.035) than males. The results of this study demonstrate knowledge gaps, misconceptions, and negative opinions on topics related to organ donation in Jordan. However, participants recognized the importance of educational campaigns and regulatory legislation and would likely benefit from information from health-care providers and religious leaders.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem
11.
Transplant Proc ; 52(5): 1439-1441, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32217018

RESUMO

INTRODUCTION: There are differences in the attitude toward organ donation between Latin Americans living in Spain and those living in the United States. OBJECTIVE: We sought to analyze the socio-personal factors that can condition the difference in attitude toward donation between Latin Americans living in the United States and those living in Spain. MATERIALS AND METHODS: Participants in the study were Latin Americans living in Spain (group A; n=1237) and the United States (Florida) (group B; n=1450), extracted from the database of the International Collaborative Donor Project (PCID). Inclusion criteria were a sample population stratified by area, country of birth, age, and sex. The instrument used was a validated attitude questionnaire toward living kidney donation (PCID-DTO-Rios.) Participants were randomly selected to be surveyed according to stratification. RESULTS: The attitude in favor of Latin Americans residing in Spain (group A) was 60% (n=745) vs 33% (n=485) of residents in the United States (group B) (P < .001). The socio-personal profile of the Latin Americans in Spain compared with those in the United States indicates that they are mainly women (63.5% vs 43.7%, respectively), younger (31.78 vs 37.31 years, respectively), have more secondary education (21.2% vs 16.3%, respectively) and university studies (11% vs 6%, respectively), are of South American origin vs those who are Mexican and Central American, respectively, and there is a higher percentage of atheists/agnostics (8.1% vs 3.7%). However, the personal profile toward donation is similar in both groups, both for and against organ donation. CONCLUSIONS: The personal social profile of the Latin American resident in Spain is different from that of the resident in the United States. However, the psycho-social profile for and against organ donation is similar in both countries.


Assuntos
Emigrantes e Imigrantes/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Transplante de Órgãos/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Feminino , Hispânico ou Latino/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Social , Espanha , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
12.
Transplant Proc ; 52(2): 500-502, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32044085

RESUMO

BACKGROUND: Living donation is a potential source of organs that could help to reduce the organ transplant deficit. Given that we have a worldwide aging population, it is important to assess the opinion of older people toward this type of donation. OBJECTIVES: To analyze the attitude of people aged > 65 years toward living kidney donation (LKD) and living liver donation (LLD) and to investigate the variables affecting their attitudes. METHODS: A multicentric study was carried out using a representative sample of people > 65 years stratified by sex and geographic location in southeastern Spain (n = 420). The measurement instrument was a validated questionnaire about LKD and LLD. Statistics were analyzed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software. Descriptive analysis was carried out using Student t test, χ2 test, and a multivariate analysis. RESULTS: The questionnaire completion rate was 84% (n = 351) with 88% (n = 310) in favor of LKD, and 89% (n = 311) in favor of LLD. Favorable attitude decreased to 3% when the donation under consideration was unrelated. Attitudes toward LKD and LLD were associated with having received information from the television (P = .016 and P = .045) and from friends (P = .017 and P = .03); accepting an autopsy after death (P = .001 and P = .002); and not being worried about scars (P = .015 and P = .044). In the multivariate analysis, the following variables continued to be significant: having received information from the television (odds ratio [OR], 2) and from friends (OR, 10.3); and the acceptance of an autopsy (OR, 2). CONCLUSIONS: Older people are in favor of both LKD and LLD, assuming it is a related donation. In addition, the information the elderly population receives regarding organ donation and transplantation affects their attitudes.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doadores Vivos , Transplante de Órgãos/psicologia , Obtenção de Tecidos e Órgãos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Análise Multivariada , Razão de Chances , Espanha , Inquéritos e Questionários , Coleta de Tecidos e Órgãos/métodos , Coleta de Tecidos e Órgãos/psicologia
13.
Psychosomatics ; 61(2): 127-134, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31928784

RESUMO

BACKGROUND: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive instrument developed to accurately assess the main pretransplant psychosocial risk factors that may impact transplant outcomes. OBJECTIVE: As neither established assessment procedures nor standardized tools designed to perform pretransplant psychosocial evaluation are currently available in Italy, the present study was designed to develop and preliminarily validate the Italian version of the SIPAT. METHODS: First, our team developed the Italian version of the SIPAT, following standard forward-back translation procedures. Then, the Italian version of the SIPAT was retrospectively and blindly applied to 118 randomly selected transplant cases (40 heart, 40 lung, and 38 liver) by 2 independent examiners. Information about the patients' final transplant listing recommendation (i.e., listing vs. deferral) was independently collected from the respective transplant teams. RESULTS: The inter-rater reliability of the Italian version of the SIPAT scores was substantial (Cohen's kappa = 0.77; P < 0.001). Moreover, the predictive value of the SIPAT ratings on the final transplant listing recommendation (i.e., listing vs. deferral) for each examiner was significant (both P < 0.05). CONCLUSION: Current findings suggest that SIPAT is a promising and reliable instrument in its Italian version. Given these excellent psychometric characteristics, the use of the SIPAT as part of the pretransplant psychosocial evaluation in Italian medical settings is highly encouraged.


Assuntos
Transplante de Órgãos/psicologia , Determinação da Personalidade/estatística & dados numéricos , Funcionamento Psicossocial , Adulto , Comparação Transcultural , Feminino , Transplante de Coração/psicologia , Humanos , Itália , Transplante de Fígado/psicologia , Transplante de Pulmão/psicologia , Masculino , Programas de Rastreamento/estatística & dados numéricos , Variações Dependentes do Observador , Valor Preditivo dos Testes , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Fatores de Risco , Resultado do Tratamento
14.
Am J Obstet Gynecol ; 222(6): 584.e1-584.e5, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31981513

RESUMO

While uterus transplantation was once considered only a theoretical possibility for patients with uterine factor infertility, researchers have now developed methods of transplantation that have led to successful pregnancies with multiple children born to date. Because of the unique and significant nature of this type of research, it has been undertaken with collaboration not only with scientists and physicians but also with bioethicists, who paved the initial path for research of uterus transplantation to take place. As the science of uterus transplantation continues to advance, so too must the public dialogue among obstetrician/gynecologists, transplant surgeons, bioethicists, and other key stakeholders in defining the continued direction of research in addition to planning for the clinical implementation of uterus transplantation as a therapeutic option. Given the rapid advances in this field, the time has come to revisit the fundamental questions raised at the inception of uterus transplantation and, looking forward, determine the future of this approach given emerging data on the procedure's impact on individuals, families, and society.


Assuntos
Infertilidade Feminina/cirurgia , Transplante de Órgãos/ética , Útero/transplante , Transtornos 46, XX do Desenvolvimento Sexual/complicações , Atitude Frente a Saúde , Cesárea , Anormalidades Congênitas , Transferência Embrionária , Feminino , Rejeição de Enxerto/prevenção & controle , Acessibilidade aos Serviços de Saúde , Humanos , Histerectomia , Imunossupressores/uso terapêutico , Infertilidade Feminina/etiologia , Infertilidade Feminina/psicologia , Cobertura do Seguro , Seguro Saúde , Ductos Paramesonéfricos/anormalidades , Transplante de Órgãos/economia , Transplante de Órgãos/legislação & jurisprudência , Transplante de Órgãos/psicologia , Preferência do Paciente , Aderências Teciduais/complicações , Obtenção de Tecidos e Órgãos , Doenças Uterinas/complicações
15.
J Relig Health ; 59(4): 1810-1823, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31309441

RESUMO

Medical advancements over the past decades brought organ transplantation as a definitive therapy for different end-stage organ failure. However, non-availability of organs required for transplantation is a major challenge worldwide. We aimed to determine the knowledge and willingness to donate organs in various populations and settings in the Middle Eastern region. Literature searches were conducted on PubMed, MEDLINE, Cochrane, and Google scholar electronic databases. Different combinations of search terms such as "organ donation"; "knowledge", "awareness"; "beliefs", "willingness"; and "attitude" along with the country names were used. Additional searches using reference lists of studies and review articles were conducted. Data were extracted using standardized excel form and pilot tested. Three authors independently abstracted the data using a data collection form. Results from different studies were pooled for the analysis when appropriate. The search yielded 1806 articles; 1000 duplicates and review articles were excluded, and a further 792 articles not relevant were excluded. Finally, 14 original studies met the inclusion criteria. Total pooled sample size for assessing knowledge was 6697 and for willingness was 8714. Pooled overall knowledge regarding organ donation was 69% with a 95% CI [64.5, 73.5]. Pooled overall willingness to donate organ was 49.8% with a 95% CI [41.3, 58.4]. Knowledge about organ donation and willingness to donate organs varies in different population and settings in the Middle East. These in fact are linked to multiple social factors ultimately leads to 'consent' for donating organs by a potential donor. Family's influence; religious, traditional and spiritual beliefs; and status of ethnic, minority, and immigrant populace are the important determinants of the decision for organ donation. Understandings on social determinants in organ donation remain crucial and should be addressed while developing policies and organizational developments.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doadores de Tecidos , Humanos , Oriente Médio , Transplante de Órgãos/psicologia , Inquéritos e Questionários , Doadores de Tecidos/psicologia , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos
16.
Ther Apher Dial ; 24(2): 178-183, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31373767

RESUMO

Nurses are required to understand and meet the physiological needs of the family members of the patients hospitalized in transplant wards of the hospitals. Considering the importance of this issue, this study aimed to investigate the psychosocial needs of the families with an organ transplant patient. The study employed a cross-sectional design and was conducted in Afzalipour Educational Hospital affiliated to the Kerman University of Medical Sciences in 2018. The 45-item questionnaire of the psychosocial needs was applied to assess the psychosocial needs of the families with an organ transplant patient, including kidney, liver, and bone marrow. The quota sampling method was used and 230 participants completed the survey. Data were analyzed using descriptive mean and SD and analytical statistics independent t-test, anova, and Pearson's correlation coefficient tests by SPSS 22 (version 22, SPSS, Chicago Inc., IL). The results indicated that the mean scores of psychological needs of families with transplanted patients hospitalized in three wards of bone marrow, kidney, and liver were at a high level (143/16 ± 12/29). The mean scores of psychosocial needs in the bone marrow transplantation ward (148/60 ± 8/18) were significantly higher than those of the patients hospitalized in the liver (141/24 ± 16/41) and kidney (141/25 ± 11/30) wards. A significant difference was observed among the three wards of the liver, kidney, and bone marrow transplantation with regard to the provided support, information, and proximity. To improve the psychological needs of the family members with patients hospitalized in transplant wards and reduce their mental reactions, they should be provided with more precise information about the patient's treatment procedure.


Assuntos
Família/psicologia , Necessidades e Demandas de Serviços de Saúde , Hospitalização , Transplante de Órgãos/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
17.
Transplant Proc ; 51(8): 2508-2513, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31473008

RESUMO

BACKGROUND: Financial incentives for deceased organ donation are associated with many controversial ethical issues. This study examines the perspectives of medical students and staff members on financial incentives for the families of brain-dead organ donors. METHODOLOGY: A structured survey form was used between December 7, 2017 and January 28, 2018 to elicit opinions on financial incentives for the families of brain-dead organ donors. Forty-three medical staff members and 81 medical students participated in the survey voluntarily. The opinions on the financial incentive system and the relationship between willingness to give information about organ donation to families and a financial incentive system were assessed. RESULTS: The majority of the participants (81.4%) had positive thoughts on organ donation. More than half of the participants (60.5%) thought that the financial incentive system did not erode the ethical purity of organ donation. As charge doctors, most respondents (84.6%) were willing to give information about organ donation to family members in the presence of financial incentives. However, the percentage decreased significantly to 60.5% when financial incentive was no longer factored into consideration (P < .001). LIMITATION: The study population is small, and the participants are not representative of the general population. CONCLUSION: The opinions of medical students and medical staff on financial incentives for deceased organ donation were generally positive. Financial incentives proved to be a potential influencing factor as an option of organ donation to be given to families.


Assuntos
Apoio Financeiro , Corpo Clínico/psicologia , Transplante de Órgãos/psicologia , Estudantes de Medicina/psicologia , Obtenção de Tecidos e Órgãos/economia , Adulto , Atitude , Atitude do Pessoal de Saúde , Morte Encefálica , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Transplante de Órgãos/economia , República da Coreia , Inquéritos e Questionários , Doadores de Tecidos/psicologia
18.
Pediatr Transplant ; 23(8): e13577, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31512800

RESUMO

This study examined patient-reported sleep quality in a single-center cross-sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty-nine adolescents (M = 16.51 years; SD = 1.63) who received a solid organ transplant (kidney: n = 25; liver: n = 24; heart: n = 20) completed self-report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t = -3.60; P ≤ .001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r = -.31 to -.40), and higher physical and psychosocial HRQOL (r = .33-.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non-Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Transplante de Órgãos/psicologia , Complicações Pós-Operatórias/psicologia , Qualidade de Vida , Sono , Transplantados/psicologia , Adolescente , Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Saúde das Minorias , Complicações Pós-Operatórias/epidemiologia , Autorrelato
19.
Transplant Proc ; 51(6): 1644-1650, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31255357

RESUMO

BACKGROUND: Romanian laypeople's and health professionals' views on living organ donation were examined. METHODS: From July 2015 to May 2016, 263 adults (among them 31 physicians and 20 nurses) judged the acceptability of living organ donation in 42 realistic scenarios composed of varying levels of 6 factors: 1. type of organ, 2. whether it could have been obtained from a cadaver, 3. donor-recipient relationship, 4. donor's level of autonomy, 5. financial compensation, and 6. patients' level of responsibility for their illness. In all scenarios, the patients were in need of either a kidney or liver transplantation. RESULTS: The ratings were subjected to cluster analysis and analyses of variance. Seven qualitatively different positions were found that were termed never acceptable (12%), free market (44%), compensation (12%), altruism (6%), always acceptable (16%), responsibility (4%), and undetermined (6%). Physicians were more frequently in the free market or in the compensation clusters (81%) than laypeople (51%). CONCLUSION: Only a few participants held the altruism model, even though this model has been promoted as the normative model by the World Health Organization and by most national legislations, including the legislation in Romania. Instead, the free market position and its variant-the compensation position-can be considered the majority positions (66%) in Romania.


Assuntos
Doadores Vivos/psicologia , Enfermeiras e Enfermeiros/psicologia , Transplante de Órgãos/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Médicos/psicologia , Adulto , Altruísmo , Análise de Variância , Atitude do Pessoal de Saúde , Análise por Conglomerados , Compensação e Reparação , Etnicidade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Romênia , Obtenção de Tecidos e Órgãos/métodos
20.
Clinics (Sao Paulo) ; 74: e743, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038645

RESUMO

OBJECTIVES: Despite the contribution of awareness campaigns to the rise of organ donation rates in Brazil, younger folks are subject to few awareness actions. Records on the effect of informative campaigns at improving opinion and knowledge of undergraduates about organ donation are scarce. This study aimed to assess the effect of informative material about organ donation on changes in the trend of answers to a questionnaire compared to the answers of a control group. METHODS: Two randomized groups were compared, receiving the same standardized questionnaire. One group was supplied informative material on the subject, while the other was not. The questionnaire was sent to undergraduate students from two Brazilian universities. Statistical analysis was performed using Student's t-test, Chi-square test and multinomial regression tests. Adopted significance was 5%. RESULTS: There were 739 responses to the questionnaire. Mean age was 22 years, with a majority of women. Six of 14 questions displayed a change in the answer pattern of the experimental group compared to controls (p<0.05). Opinion on organ donation had changes in 2 of 7 analyzed questions (p<0.05). Knowledge on the subject had a shift in answer patterns in 4 of 7 questions. Regression demonstrated 3 items that were not influenced by respondents' age. CONCLUSION: There is controversy regarding the benefit of exposure to informative material. Negative changes were noted in the trust in transplantation as a safe treatment. Positive results regarding technical knowledge were obtained. Better results may be obtained by designing informative material tailored towards the student's specific concerns.


Assuntos
Promoção da Saúde , Transplante de Órgãos/psicologia , Estudantes/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Adulto Jovem
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