Academic literature on the topic 'Organ donors Australia Psychology'

BACKGROUND: Deceased organ donation work-up typically takes 24 hours or more. Clinicians may thus discount the possibility of donation when the potential donor is physiologically unstable or family requirements do not allow this length of time. This may lead to loss of transplantable organs. In 2015, we introduced an expedited work-up guideline with the aim of facilitating donation in these circumstances and maximising donation potential. OBJECTIVE: To determine the number of expedited work-up (consent to retrieval procedure of 6 hours or less) donors from 2015 to 2018, compare their clinical and demographic characteristics with standard donors, and assess the outcome of transplanted organs and organ recipients. DESIGN: We performed a retrospective audit of the electronic database for all Victorian donors from 2015 to 2018. We obtained transplant outcome data from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). RESULTS: Overall, 38 expedited pathway donors donated 78 organs for transplantation (70 kidneys, four lungs, three livers, one pancreas). Of these, 55 retrieved kidneys were successfully transplanted. The lungs, livers and pancreas retrieved were all transplanted. For the kidney recipients, early graft dysfunction requiring dialysis was more common than with organs from the standard pathway (71% v 38%; P < 0.0001); however, short and medium term graft and patient survival were similar. Three recipients from the expedited pool experienced graft failure and two subsequently died. Of the two lung recipients, one died at day 622 of chronic rejection. CONCLUSIONS: Expedited pathway donation is feasible with acceptable donation outcomes. Clinicians should consider donation even when physiological instability or family requirements preclude standard organ donation work-up times.

An analysis of 2,034 actual organ donations by suicides for the years 2008–2010 indicated that women were more likely to be donors than were men and Blacks more likely to donate than were Whites. The sex difference was consistent with the responses of men and women to surveys of the general public about their willingness to become organ donors, but the ethnic difference was the reverse of the responses to surveys of the general public about their willingness to be organ donors. Future research should explore the role of the responses, positive vs negative toward organ donation, of the significant others of those dying from different causes of death, and the extent to which people have signed donor cards.

Should people be considered organ donors after their death unless they request not to be, or should they not be considered donors unless they request to be? Because people tend to stay with the default in a variety of domains, policymakers' choice of default has large and often important effects. In the United States, where the organ-donation policy default is “not a donor,” about 5,000 people die every year because there are too few donors. Four experiments examined two domains—being an organ donor and saving for retirement—where default effects occur and have important implications. The results indicate that default effects occur in part because policymakers' attitudes can be revealed through their choice of default, and people perceive the default as indicating the recommended course of action. Policymakers need to be aware of the implicit messages conveyed by their choice of default.

This issue of Critical Care and Resuscitation focuses on several key aspects of modern intensive care unit (ICU) practice in Australia and New Zealand. Organ donation is particularly prominent, with two original articles and a dedicatededitorial. 1, 2, 3 The first article provides strong evidence that, in more difficult organ donation family conversations (ie, when there is no evidence of organ donation registry presence and organ donation is not raised by the family), the likelihood of successful donation is significantly increased by such conversation being led by an organ donation specialist. As supported by the editorial, it is increasingly clear that in this field, like all other aspects of critical care practice, training and specialisation make a difference. The second article demonstrates that organ donation can be successfully achieved under time pressure, even for highly vasopressor-dependent donors, and with good long term outcome when applying an expedited organ donation process. The implications are clear.

Cold ischemia and hence travel time can adversely affect outcomes of islet isolation. The aim of this study was to compare the isolation and transplant outcomes of donor pancreata according to the distance from islet isolation facility. Principally, those within a 50 km radius of the centre were compared with those from regional areas within the state and those from interstate donors within Australia. Organ donors were categorised according to distance from National Pancreas Transplant Unit Westmead (NPTU). Donor characteristics were analysed statistically against islet isolation outcomes. These were age, BMI, cause and mechanism of death, days in ICU, gender, inotrope and steroid use, cold ischemia time (CIT) and retrieval surgical team. Between March 2007 and December 2020, 297 islet isolations were performed at our centre. A total of 149 donor pancreata were local area, and 148 non-local regions. Mean distance from the isolation facility was 780.05 km. Mean pancreas CIT was 401.07 ± 137.71 min and was significantly different between local and non-local groups (297.2 vs. 487.5 min, p < 0.01). Mean age of donors was 45.22 years, mean BMI was 28.82, sex ratio was 48:52 F:M and mean time in ICU was 3.07 days. There was no significant difference between local and non-local for these characteristics. The mean CIT resulting in islet transplantation was 297.1 ± 91.5 min and longest CIT resulting in transplantation was 676 min. There was no significant difference in islet isolation outcomes between local and non-local donors for characteristics other than CIT. There was also no significant effect of distance from the isolation facility on positive islet transplant outcomes (C-peptide > 0.2 at 1 month post-transplant). Conclusions: Distance from the isolation centre did not impact on isolation or transplant outcomes supporting the ongoing nationwide use of shipping pancreata for islet isolation and transplantation.

Objectives & background Anonymous live organ donors or unspecified donors are individuals willing to be organ donors for any transplant recipient with whom they have no biological or antecedent emotional relationship. Despite excellent recipient outcomes and the potential to help address organ scarcity, controversy surrounds the unconditional act of gifting one’s organs to an unrelated recipient. This qualitative systematic review provides insights into the first-hand experiences, motivations, and challenges that unspecified donors face. Methods A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, and Web of Science database for qualitative literature regarding unspecified living donors’ motivations and experiences in liver and kidney transplantation. An inductive thematic analysis was conducted to generate themes and supportive subthemes. Results 12 studies were included. The four major themes were (i) motivations, (ii) perception of risks, (iii) donor support, and (iv) benefits of donation. Unspecified donors demonstrated a deep sense of social responsibility but tended to underestimate health risks in favour of benefits for recipients. Despite the lack of emotional support from family and friends, the decision to donate was a resolute personal decision for donors. Majority benefitted emotionally and did not express regret. Conclusion This qualitative review bridges the gap in literature on unspecified living donor psychology and provides a comprehensive understanding of the decision-making matrix and experiences of donors.

Multi-organ procurement surgical procedures are undertaken on donors who have consented at the time of their death to donate multiple organs, body parts or tissues. These donors fulfil the criteria for donation by either being certified as brain dead as a result of an injury or via a donation after cardiac death (DCD) pathway. Worldwide multi-organ procurement surgery has made a huge impact in both extending and enhancing the quality of life for recipient patients who have received organs from donors. Perioperative nurses working in surgical teams play a vital role in procuring organs from both paediatric and adult cadaver organ donors. The nature of the surgical procedure used for procuring organs, the urgency of coordinating surgical procurement teams and the removal of organs for urgent transplantation to awaiting recipients is fast paced and technical. The experience has been reported to evoke emotions which traumatically impact on perioperative nurses when assisting in these surgical procedures. There is currently a dearth of research examining the experiences of Australian perioperative nurses assisting within multi-organ procurement surgery.The objective of this study was to describe and gain a greater understanding of the personal experiences nurses encountered as part of their professional roles when involved in these surgical procedures. This thesis presents the substantive theory which has used a grounded theory methodology to describe the experiences of 35 perioperative nurses working within multi-organ procurement surgical teams from metropolitan, regional and rural hospitals in both New South Wales and Western Australia. The qualitative data from in-depth interviews were simultaneously collected and analysed to develop the substantive theory. The study findings draw attention to the complexities that exist for perioperative nurses to participate in these surgical procedures.The basic social psychological problem of hiding behind a mask was found to be a fundamental shared concern that the majority of perioperative nurses in this study faced when participating in multi-organ procurement surgery. The problem of hiding behind a mask was comprised of three stages: being unprepared, being overwhelmed and hiding the burden. The first stage, conceptualised as being unprepared, consisted of not knowing what to expect during the surgical procedure when they lacked prior knowledge and experience and felt unprepared for being exposed to death by operating on a cadaver donor and managing DCD donors within the operating room. Moreover participants were unprepared for witnessing the circumstances of each donor patient in addition to dealing with the grieving family.During the second stage participants described being overwhelmed with fears of facilitating death of the donor when they lacked understanding of the process of brain death diagnosis. They reported being overwhelmed at also having to witness the graphic nature of the procurement process and feeling overwhelmed by their own emotional responses to the donor’s death which they tried to hide and contain from their work colleagues through hiding behind a mask. Lastly the third stage of hiding behind a mask was identified as hiding the burden where participants were forced to contain their own personal beliefs and attitudes towards these surgical procedures whilst undertaking their professional roles. They reported hiding behind a mask when suppressing personal beliefs, hiding an objection to participate, not disclosing their own views or attitudes on death and spiritual ‘afterlife’ beliefs and lastly hiding not being able to cope when participating in these surgical procedures. The majority of the participants in this study articulated that various conditions influenced and directly contributed towards their experiences of hiding behind a mask. Three conditions were identified and these were reported as: work conditions, levels of knowledge and experience and levels of support.In an attempt to overcome the problem of hiding behind a mask, the data revealed that participants had to reach a turning point which was labelled as taking control. The turning point of taking control was described by participants as taking control of their own internal turmoil and rationalising the situation they were placed in whilst also changing their attitudes and thoughts towards their participation in the procedure. Once they had passed through the turning point of taking control participants were able to move beyond this point into the basic social psychological process of finding meaning.The basic social psychological process of finding meaning comprised of three stages: pushing through; preserving self and coming to terms. The first stage of finding meaning was conceptualised as pushing through. For many of the study participants in pushing through they dissociated themselves from their internal feelings and conflicts by focusing on the importance of their role and professional contributions towards the surgical procedure. The second stage of the basic social psychological process of finding meaning was conceptualised as preserving self, this saw participants implement strategies to protect themselves from both the traumatic experiences of procurement surgery and the tragic circumstances of the donors they came in contact with. Three aspects of preserving self were identified: being resilient; nurse self care and seeking personal support. The third and final stage of the basic social psychological process of finding meaning was conceptualised as coming to terms. During this stage participants were able to gain some understanding from their experiences by placing their participation role into perspective, honouring the donation wish and assisting in preserving life for the greater good when focusing on the needs of recipient patients requiring the organs they were assisting to procure. Conditions influencing the basic social psychological process of finding meaning encompassed: work conditions, levels of knowledge and experience and levels of support. Participants articulated these as positive influencing conditions such as a changing work environment, feeling less isolated and being supported by their work organisations.Throughout this thesis pertinent scientific literature has been woven into the research findings to illustrate the relevance of the newly developed theory and to place the substantive theory within the context of other findings and related theories to further support the trustworthiness of the current study data and the newly developed theory. The findings detailed in the substantive theory illustrate new contributions to the knowledge and understanding of the Australian perioperative nurses experiences when undertaking multi-organ procurement surgical procedures which will have relevance both nationally and internationally. The findings have implications and recommendations directed towards perioperative nurses, health services, perioperative organisations, government and policy makers.

Thesis (M.A.)--Georgia State University, 2007.
Title from file title page. Cynthia Hoffner, committee chair; Yuki Fujioka, Holley Wilkin, committee members. Electronic text ( 81 p.) : digital, PDF file. Description based on contents viewed Nov. 8, 2007. Includes bibliographical references (p. 57-65).

The use of quality-of-life as an outcome measure provides detailed information about the effectiveness of medical treatments than morbidity or mortality rates alone. The use of quality-of-life data in the clinical setting can inform patients regarding treatment options, treatment benefits and costs. In competing health care markets, outcome measurement is regarded as important as it is concerned with the impact of health care practice and affects health policy decisions. Doessel (1978) conducted the first Australian study on the cost-effectiveness analysis of renal replacement therapies. The study was based on Klarman, Francis & Rosenthal's (1968) the study, where the output was measured in terms of the number of life years gained from kidney transplantation, and a twenty-five percent weight was allocated in an attempt to capture quality-of-life from kidney transplantation. Doessel (1978) used two sources of data: Australian data (Disney 1974) and European data (Gurland et al. 1973; Shiel et al. 1974). The study measured life years gained, and agreed with the Klarman et al. (1974) findings that transplantation is the most effective way to increase life expectancy of persons with chronic renal disease (Butler & Doessel 1989). The outputs of the alternative treatments were not reported in monetary terms; the study focused on life years gained as the output measure. Hence the importance of this current study, which includes a cost-effectiveness analysis for cadaver liver, and living kidney transplantation for end-stage liver and kidney disease patients. Calls to respect patient autonomy and to produce patient-centered outcomes have recently brought the patient’s point of view back into the center of clinical medicine (Sullivan 2003). Survival rates indicate one measure of outcome however they do not reflect patients’ perceptions of health benefit or experiences. Noting that patients’ psychosocial effect on functioning is of more concern to them than their physical Thesis Preamble iii ability, that more accurate knowledge of patients’ conditions be measured prior to transplantation (Tarter et al. 1991). Recently researchers advocated investigating transplant patients' states of health to assess the social benefit of these expensive health care services from their perspective (Joralemon & Fujinaga 1997). The current study's mixed method, bridges the gaps in treatment outcome measurements, as the mixed method applied (Creswell 1994; Sim & Sharp 1998) prospectively measured quality-oflife, determined health utility, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The study reported the living donors experience of the donation process, described their needs; expressed using a new psychosocial model supporting future living kidney donor's during the donation process.

By path analysis, it was found that only self-efficacy and subjective norm, but not general attitudes, significantly predicted individuals' BID across all samples. Moreover, in contrast to the hypothesis, results showed that after-death anxiety predicted self-efficacy but not attitudes. Low after-death anxiety, accurate knowledge regarding organ donation, and high subjective norm promoted self-efficacy. Altruism was the main determinant of attitudes but its indirect impact on BID was weak. The applicability of the model on all four samples was acceptably high, and the configural invariance of the model was generally supported across three ethnic groups.
Previous studies have shown that the general public exhibits favorable attitudes toward posthumous organ donation, but a low donor card signing rate. Hence, positive attitudes may not be a good predictor of the behavioral commitment to donate organs. This dissertation was a cross-cultural study on the actual behaviors of signing or taking away the donor card (i.e. b&barbelow;ehavioral i&barbelow;ntentions to d&barbelow;onate organs after death (BID). It aimed at proposing an integrative, content-specific but culture-general model for posthumous organ donation. The model was composed of two levels of influences on BID, namely, the proximal level (including self-efficacy toward signing the donor card, general attitudes toward posthumous organ donation, and subjective norm for posthumous organ donation) as well as the distal level (including knowledge regarding posthumous organ donation, altruism, and after-death anxiety). The model was first tested and refined among 517 Chinese college students (Study 1), and was then further validated with 290 Chinese community adults (Study 2) in Hong Kong. The applicability of the model was also examined with a Western control sample of 217 Caucasian American college students (Study 3) and a non-Chinese Asian sample of 670 Japanese college students (Study 4). Psychosocial characteristics of three college samples were then compared, and ethnic differences on predictive values of psychosocial factors on BID were studied (Study 5).
The ANOVA results challenged the old assumption of underlying similarities in psychosocial characteristics across Asian ethnic groups. As expected, Americans were the most likely to show BID, followed by Chinese, while Japanese had the lowest tendency to show BID. (Abstract shortened by UMI.)
Wu Man Sze Anise.
"May 2005."
Adviser: Catherine S. K. Tang.
Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0604.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2005.
Includes bibliographical references (p. 122-136).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract in English and Chinese.
School code: 1307.