Open Access
Grief reactions of potential organ donors' bereaved relatives: an observational study
(American Association of Critical-Care Nurses, 2020-09-01) Soria Oliver, María; Aramayona, Begoña; López Martínez, Jorge S.; Martín, María J.; Martínez, José M.; Sáenz Mendía, Raquel; García Sánchez, Rubén; Ciencias de la Salud; Osasun Zientziak
Background: most family members of potential organ donors experience the death of their relative in an intensive care unit. While under an emotional burden, bereaved relatives must make a decision that will affect the life of other patients. A better understanding of grief within the context of organ donation will help intensive care unit staff better support families during this process. Objectives: to empirically describe the emotional reactions of potential organ donors' family members facing a loved one's death and analyze the relationship of these reactions to factors that occur in the process of illness and death. Methods: a prospective observational study was conducted in 16 Spanish hospitals for 36 months. Data of 421 relatives of potential organ donors, collected through a previously validated instrument, included relatives' emotional responses, deceased's and relatives' characteristics, circumstances of death, and behavior of health care staff. Results: unexpected deaths were linked to more intense emotional reactions and less acceptance of death than were anticipated deaths. Additional stressors, such as perception of poor treatment by hospital staff, perception of deficient medical care, and poor relationships among family members, were associated with stronger reactions. Conclusions: observation and analysis of the factors studied may help hospital staff members anticipate bereaved relatives' emotional reactions and provide better support during the grieving process, increasing family members¿ well-being and facilitating a better-informed organ donation decision.
Open Access
An Integrated Psychosocial Model of Relatives' Organ Donation (IMROD): joining pieces of the puzzle
(Frontiers Media, 2018) López Martínez, Jorge S.; Soria Oliver, María; Aramayona, Begoña; García Sánchez, Rubén; Martínez, José M.; Ciencias de la Salud; Osasun Zientziak
Organ transplantation remains currently limited because the demand for organs far exceeds the supply. Though organ procurement is a complex process involving social, organizational, and clinical factors, one of the most relevant limitations of organ availability is family refusal to donate organs of a deceased relative. In the past decades, a remarkable corpus of evidence about the factors conditioning relatives' consent has been generated. However, research in the field has been carried out mainly by means of merely empirical approaches, and only partial attempts have been made to integrate the existing empirical evidence within conceptual and theoretically based frameworks. Accordingly, this work articulates the proposal of an Integrated Psychosocial Model of Relatives' Organ Donation (IMROD) which offers a systematic view of the factors and psychosocial processes involved in family decision and their interrelations. Relatives' experience is conceptualized as a decision process about the possibility of vicariously performing an altruistic behavior that takes place under one of the most stressful experiences of one's lifetime and in the context of interaction with different healthcare professionals. Drawing on this, in the proposed model, the influence of the implied factors and their interrelations/interactions are structured and interpreted according to their theoretically based relation with processes like rational/heuristic decision-making, uncertainty, stress, bereavement, emotional reactions, sense of reciprocity, sense of freedom to decide, and attitudes/intentions toward one's own and the deceased's organ donation. Our model also develops a processual perspective and suggests different decisional scenarios that may be reached as a result of the combinations of the considered factors. Each of these scenarios may imply different balances between factors that enhance or hinder donation, such as different levels of uncertainty and potential decisional conflict. Throughout our work, current controversial or inconsistent results are discussed and interpreted on the basis of the relationships that are posited in the proposed model. Finally, we suggest that the structure of the relationships and interactions contained in our model can be used by future research to guide the formulation of hypotheses and the interpretation of results. In this sense, specific guidelines and research questions are also proposed.

Soria Oliver, María

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