A positive deviance approach to improve familial authorization for organ donation.
Clin Transplant
; 33(3): e13488, 2019 03.
Article
em En
| MEDLINE
| ID: mdl-30689228
ABSTRACT
The current study evaluates the Positive Deviance Donation Collaborative, a communication training program designed to identify and disseminate behaviors of requesters with above-average rates of familial authorization to organ donation. The program initiated with a cohort of 99 requesters from 11 OPOs. Requesters' quarterly authorization rates were monitored for 33 months, and their pre-/post-intervention skills in active-empathic listening and self-efficacy to request donation were assessed. Overall, requesters' mean quarterly authorization rate was 53.69% (SD = 4.54). Multilevel models were used to examine change in authorization rates and communication skills, as well as associations between skills and authorization. Low intraclass correlation coefficients for authorization rates established that most variance was due to within-requester variation, rather than OPOs (ρ = 0.0129) or requesters within OPOs (ρ = 0.0221). Models indicated that authorization rates and communication skills failed to improve following intervention and did not identify an association between post-intervention communication skills and authorization. Results provide a framework to discuss programmatic challenges including extensive requester turnover (ie, ~60%), management of data collection across multi-site interventions, and program content.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doadores de Tecidos
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Obtenção de Tecidos e Órgãos
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Família
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Transplante de Órgãos
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Comunicação
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Consentimento do Representante Legal
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Tomada de Decisões
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article