Understanding decision making in organ donation - a national study: Progress update
CCCF ePoster library. Chassé M. 11/11/19; 283458; EP45
Michaël Chassé
Michaël Chassé
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Rate & Comment (0)
Topic: Survey or Interview (quantitative or qualitative)

Chassé, M1,2; Carvalho, LP1; Jordison, K3;  English, SW 4,5; Fergusson, DA 5,6; Lauzier, F7,8,9; Turgeon, AF7,8, Sarti, A4; Martin, C10; D'Aragon, F 11,12; Li, A 14; Knoll, G 5; Ball, I14; Crawshaw, J 15; Brehaut, J 5; Burns, K 16; Fortin, MC 1,2; Weiss, MJ 9;  Meade, M 17; Marsolais, P 18; Shemie, S 19; Zaabat, S 2; Dhanani, S 20;  Kitto, S 21; Van Allen, Z 17; Presseau, J 22; on behalf of the the Canadian Critical Care Trials Groups.
1 Department of Medicine, Critical Care, Université de Montréal, Montreal, QC, Canada;
2 Centre Hospitalier de l'Université de Montréal (CHUM) Research Center, Montreal, QC, Canada;
3 Canadian National Transplant Research Program (CNTRP)
4 Department of Medicine (Critical Care), University of Ottawa, Ottawa, ON, Canada;
5 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;
6 Department of Medicine, University of Ottawa, Ottawa, ON, Canada;
7 Department of Anesthesiology and Critical Care, Division of Critical Care Medicine, Université Laval, Québec City, QC, Canada;
8 Population Health and Optimal Health Practices Unit/Trauma-Emergency-Critical Care Medicine, CHU de Québec-Université Laval Research Center, Québec City, QC, Canada;
9 Department of Medicine, Université Laval, Québec City, QC, Canada;
10 Division of Critical Care Medicine, Western University, Critical Care Trauma Centre, London Health Sciences Centre, London, ON, Canada
11 Department of Anaesthesiology, Université de Sherbrooke, Sherbrooke, QC, Canada;
12 Centre de Recherche du CHU de Sherbrooke, Sherbrooke, QC, Canada;
14 Division of Critical Care Medicine and Department of Epidemiology and Biostatistics, Western University, Critical Care Trauma Centre, London Health Sciences Centre, London, ON, Canada;
15 Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON, Canada;
16 Interdepartmental Division of Critical Care, St Michael's Hospital, Toronto, ON, Canada;
17 Institute for Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada;
18 Hôpital du Sacré-Coeur de Montréal, Service de soins intensifs, Département de Médecine, and Centre de recherche Hôpital du Sacré-Cœur de Montréal, Université de Montréal, Montréal, QC, Canada;
19 Department of Critical Care Medicine, McGill University, Montreal, Qc, Canada
20 Department of Critical Care, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada;
21 Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada
22 School of Epidemiology and Clinical and Public Health, University of Ottawa, Ottawa, ON, Canada

Introduction: Despite the central role of the substitute decision-makers (SDMs) in the process leading to organ donation, very little is known about their decision-making process. Previous studies have explored SDMs characteristics and predictors of providing consent; the consent process itself; and the effect of the decision on subsequent care and on family well-being.  Our understanding of factors, especially modifiable ones, influencing the decision around posthumous organ donation is restricted to few studies that are limited by inappropriate sampling (retrospective design) or lack of appropriate theoretical assumptions (non-structured and validated models). Our study seeks to fill these gaps by proposing an innovative sampling solution that will directly and prospectively identify SDMs who: a) were and were not approached for organ donation; and b) among those who were approached, those who consent or decline organ donation.

Objective: The study's primary objective is to explore the experiences and perspectives of patients' SDMs involved in decisions about organ donation consent. The objective of the current publication is to inform the development phase of the interview guide.

Methods: We will conduct a national multicenter prospective cohort study of SDMs of potential organ donors (ClinicalTrials NCT03850847) in two steps. In step 1 (qualitative phase), semi-structured telephone interviews will be conducted with SDMs of 60 patients 6-8 weeks after the patient's death. The study will include adult SDMs of patients aged ≥18 yrs admitted to one of the 10 participating ICUs with either catastrophic brain injury or for whom an evaluation for deceased organ donation was considered or could have been considered. Interviews will be balanced across different subsample groups: SDMs who were or were not approached for organ donation and provided or declined consent for organ donation. Step 2 (SDMs of 232 patients) will be informed by the results of step 1 and will include a national survey with SDMs (quantitative phase). Our team includes experts in health psychology, medical sociology, qualitative methodology, questionnaire design and survey administration, patient research partner, organ donation and transplantation and critical care research. The collaboration with large Canadian research networks will ensure future knowledge transfer and dissemination to the population.

Results: From November 2018 to July 2019, our research team developed a template interview guide in both English and French. The interview guide was informed by two complementary theoretical frameworks: 1) the Leventhal's Common-Sense Self-Regulation Model (CSSRM) of health and illness that aims to explore how SDMs understand and conceptualize the illness/injury/brain death; 2) the Theoretical Domains Framework that aims to explore views about what may have impacted the decision to consent to organ donation or not. The interview guide was subsequently pilot tested and revised in collaboration with our patient partner knowledge users for clarity, brevity, and sensitivity. Recruitment and Step 1 data collection will take place between August 2019 to January 2020.

Conclusion: Our study seeks to understand the SDM's beliefs and views surrounding organ donation and identify potential reasons for organ donation refusal and potential barriers to obtaining consent so that we may better support SDMs in the future.

No references

    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Save Settings