Mapping trust relationships in organ donation and transplantation: a conceptual model.

The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates.

Family bereavement and organ donation in Spain: a mixed method, prospective cohort study protocol.

INTRODUCTION: There is a discrepancy in the literature as to whether authorising or refusing the recovery of organs for transplantation is of direct benefit to families in their subsequent grieving process. This study aims to explore the impact of the family interview to pose the option of posthumous donation and the decision to authorise or refuse organ recovery on the grieving process of potential donors' relatives. METHODS AND ANALYSIS: A protocol for mixed methods, prospective cohort longitudinal study is proposed. Researchers do not randomly assign participants to groups. Instead, participants are considered to belong to one of three groups based on factors related to their experiences at the hospital. In this regard, families in G1, G2 and G3 would be those who authorised organ donation, declined organ donation or were not asked about organ donation, respectively. Their grieving process is monitored at three points in time: 1 month after the patient's death, when a semistructured interview focused on the lived experience during the donation process is carried out, 3 months and 9 months after the death. At the second and third time points, relatives' grieving process is assessed using six psychometric tests: State-Trait Anxiety Inventory, Beck Depression Inventory-II, Inventory of Complicated Grief, The Impact of Event Scale: Revised, Posttraumatic Growth Inventory and Connor-Davidson Resilience Scale. Descriptive statistics (means, SDs and frequencies) are computed for each group and time point. Through a series of regression models, differences between groups in the evolution of bereavement are estimated. Additionally, qualitative analyses of the semistructured interviews are conducted using the ATLAS.ti software. ETHICS AND DISSEMINATION: This study involves human participants and was approved by Comité Coordinador de Ética de la Investigación Biomédica de Andalucía (CCEIBA) ID:1052-N-21. The results will be disseminated at congresses and ordinary academic forums. Participants gave informed consent to participate in the study before taking part.

[Feminist public health, another view on the pandemic.] / Por una salud pública feminista, otra lectura sobre la pandemia.

Theorists of the ethics and politics of care, with their feminist and intersectional analyses, have spent decades trying to leave their mark on clinical practice and political structures . In them, extensive processes of humanization of the relationship between professionals and people who need their care are required, without neglecting inequalities due to gender, social class or belonging to vulnerable minority groups that go through health and disease experiences in the community. society. It is evident that our institutions must be extensively rethought in their foundations; from nursing homes to highly technological ICUs; from the saturation of primary care to the lack of specialized personnel. In areas such as nursing, great emphasis is placed on models based on interdependence and the particular context to generate another care framework , while fighting for hierarchies and invisibilities related to highly feminized professions . Not surprisingly, the reflections that follow are signed by three women with hybrid profiles who have dedicated part of our working life to the field of primary and hospital care (both in nursing and in physiotherapy) and, in turn, to research and teaching in bioethics, philosophy and humanities. We have experienced in our flesh the contradictions between a will to serve and some axes of oppression connatural to the institutions.

Las teóricas de las éticas y políticas del cuidado, con sus análisis en clave feminista e interseccional, llevan décadas intentando dejar huella en la práctica clínica y en las estructuras políticas . En ellas, se requieren amplios procesos de humanización de la relación entre profesionales y personas que necesitan su atención, sin dejar de lado las desigualdades por motivos de género, clase social o pertenencia a colectivos vulnerables minoritarios que atraviesan las vivencias de salud y enfermedad en la sociedad. Es evidente que nuestras instituciones deben ser ampliamente repensadas en sus fundamentos; desde las residencias de ancianos a las UCI altamente tecnologizadas; desde la saturación de la atención primaria a la falta de personal especializado. En ámbitos como la enfermería se hace gran hincapié en los modelos basados en la interdependencia y el contexto particular para generar otro marco de asistencia , a la vez que se lucha por las jerarquías e invisibilidades relacionadas con las profesiones altamente feminizadas . No en vano las reflexiones que siguen las firman tres mujeres con perfiles híbridos que hemos dedicado parte de nuestra vida laboral al ámbito de la atención primaria y hospitalaria (tanto en enfermería como en fisioterapia) y, a su vez, a la investigación y la docencia en bioética, filosofía y humanidades. Hemos vivido en nuestras carnes las contradicciones entre una voluntad de servicio y unos ejes de opresión connaturales a las instituciones.