Organ Donation and Transplantation Coordinators' Experience and needs for ethics education.

BACKGROUND: Transplant coordinators face ethical conflicts in various situations, such as deciding who should receive organ donations and how to consider patient costs and such conflicts are expected to be more frequent in Korea, as organ transplant coordinators in the country perform both organ acquisition and transplantation. RESEARCH AIM: This study aims to develop an ethics education program to enhance organ transplant coordinators' ethical competence and address the ethical conflicts faced by them during clinical practice. RESEARCH DESIGN: A descriptive study. PARTICIPANTS AND RESEARCH CONTEXT: An online survey was conducted from March 22 to May 28, 2021. The study was conducted among 160 registered members of the Korea Organ Transplant Coordinators Association. Ultimately, 87 participants agreed to participate in the study. ETHICAL CONSIDERATIONS: Permission to conduct the study was obtained from the Institutional Review Board. RESULTS: The study revealed variations in the degree of ethical conflict based on the participants' general characteristics. Furthermore, organ transplant coordinators exhibited high levels of ethical competence and expressed a need for ethics education. The findings also indicated a positive correlation between higher ethical competence and greater demand for ethics education. CONCLUSIONS: Based on the findings, developing standardized ethics education programs tailored to organ transplant coordinators is recommended. These programs should focus on improving ethical decision-making skills and establishing professional ethics. The education provided should be practical, applicable in the clinical setting, and responsive to the participants' awareness and concerns regarding ethics education.

Delta Neutrophil Index as a New Early Mortality Predictor after Liver Transplantation.

BACKGROUND: Patients with liver disease display numerous defects of the immune system, so infection is a frequent complication of both acute and chronic liver disease. These infections are independently associated with poor outcomes after liver transplantation. Our objective was to evaluate the delta neutrophil index (DNI), a new inflammation marker, as a predictor of survival after liver transplantation (LT). METHODS: This observational study retrospectively evaluated the records of 712 patients who underwent LT from January 2010 to February 2018. DNI was evaluated at pre-transplantation and 1, 7, 14, and 30 days after operation. Statistical analysis was performed using the T-test or chi-square test, and logistic regression analysis. RESULTS: The mean MELD score was 16.7 ± 9.4 (0-48). There were 125 mortality cases (17.8%) after liver transplantation. Mean DNI was 1.61 at pre-transplantation, 3.94 one day after operation, 2.67 seven days after operation, 1.61 fourteen days after operation, and 1.64 thirty days after operation, respectively. In multivariate analysis, DNI seven and fourteen days after operation was revealed as an independent prognostic factor for mortality after liver transplantation (p = 0.040 and p < 0.0001). CONCLUSIONS: The DNI is a simple and reliable predictor of patient mortality after liver transplantation.

Development of video-based educational materials for kidney-transplant patients.

INTRODUCTION: Treatment adherence has been evaluated as a major predictor of long-term outcome, and education has been suggested to improve adherence. Considering the characteristics of adult learners, it is necessary to implement educational programs that meet the needs of transplant patients. Multimedia education may be well-suited for this. This study aims to develop video education materials in accordance with transplant patients' self-care needs. METHODS: This study includes a literature review and patient interviews aimed at developing video education materials for the self-care needs of patients who underwent renal transplant surgery at a university hospital in Seoul. Ten patients were interviewed about the desired educational content, accessibility, and other preferences. After verifying the validity of the data, the video scenarios were produced and satisfaction surveys were conducted. RESULTS: Eleven self-care education items were identified through interviews with 10 kidney transplant patients. The expert validation of video-based educational content result was high (mean CVI = 0.94). The mean score of the patients' satisfaction evaluation of the completed 7-minute video instructional materials was also high (4.55 on a 5-point Likert scale). CONCLUSION: Findings indicate that the video education materials will meet the needs of adult learners and mitigate the limitations of the existing education programs by increasing interest and motivation and may contribute to increased treatment adherence and ultimately, positively effect self-care for new transplant patients.

[Health problems and psychosocial adaptation of children with cancer].

PURPOSE: The purpose of this study was to describe health problems and psychosocial adaptation in children with cancer and to determine the relationship between these two variables. METHOD: The data were collected from parents of 61 children with cancer, aged 4-11 years at one university hospital in Seoul. The instruments for this study were the Korea Child Behavior Check List (KCBCL) and a physical symptom checklist developed by the researchers. RESULT: The major health problems were coughing, sleeping disturbances, fatigue and weakness. The total behavior problem score for children in the cancer group was higher than the score for those in the norm group. The scores on the scales for withdrawal, somatic complaints, social immaturity, and internalizing problems were higher in the children with cancer compared to normative findings. Scores on social and school competence in the cancer group were lower than the norms for healthy children. The relationship between health problems and psychosocial adaptation was significant in the subscales of withdrawal, anxiety/depression, internalizing problems and social involvement in the off therapy group. CONCLUSIONS: This study shows the various areas that need further study in caring for children with cancer.