The bereavement process of tissue donors' family members: responses of grief, posttraumatic stress, personal growth, and ongoing attachment.

CONTEXT: Donated tissues can save lives of critically burned patients and those needing a heart valve replacement. Tissues enhance the lives of a million recipients annually through transplants of corneas, bones, tendons, and vein grafts. Unfortunately, the need for some tissues exceeds their availability. OBJECTIVE: The goal of the quantitative component of this mixed methods study was to identify the grief, posttraumatic stress, personal growth, and ongoing attachment response of tissue donors' family members during a 2-year period. DESIGN: Simultaneous mixed methods design. PARTICIPANTS: The sample for this study consisted of 52 tissue donors' family members, mostly widows (83%). DATA COLLECTION AND ANALYSIS: Data were collected for 2 years to test changes in grief, posttraumatic stress, panic behavior, personal growth, and ongoing attachment. The bereaved participants experienced significantly fewer grief reactions, less posttraumatic stress, and greater personal growth. There was no significant difference in the ongoing attachment to their deceased loved ones. CONCLUSION: The results of this study may reinforce the positive meaning that tissue donors' family members can find in tissue donation. Findings also demonstrate that the bereavement process corroborates contemporary bereavement and attachment theories. Health professionals are encouraged to seek donations with less worry that tissue donors' family members will experience adverse outcomes during bereavement.

Making meaning in the legacy of tissue donation for donor families.

CONTEXT-Individuals needing lifesaving (heart valves, skin grafts for repair of critical burn injuries) and life-enhancing (corneas, bone and tendon grafts, skin, and veins) tissue donations outnumber the tissues available for transplant. OBJECTIVE-To describe the grief family members experienced 6 months after donation and to learn how family decision makers gained meaning from the decision to donate a loved one's tissues. This is phase 1 of a longitudinal study in which family decision makers will be surveyed again at 13 and 25 months after donation. DESIGN-Qualitative descriptive.Participants-One hundred seven family decision makers whose family member died a traumatic sudden death and who authorized donating tissues for transplant. DATA COLLECTION AND ANALYSIS-Data were written responses to the questions, "If you could ask or tell your dead family member something, what would it be?" and "What meaning does donating tissue to others have for you?" Data were analyzed by using content analysis procedures. RESULTS-Concepts derived from the first question represent the context of family members grieving the sudden death of a loved one. Concepts were (1) feeling empty, (2) missing and loving, (3) being grateful, and (4) having regrets. The concepts derived from the second question were (1) fulfilling their family member's wish, (2) doing the right thing, (3) believing something good came from the death, (4) helping others, and (5) living on. Reasons for donating were based, in part, on honoring the legacy of their loved ones who had given of themselves to others in life and now continued to give to others after death. CONCLUSION-The results of this study provide a basis for health professionals and donation staffs to better understand the context within which families grieve and give meaning to tissue donation.