FATORES RELACIONADOS À DECISÃO FAMILIAR SOBRE A DOAÇÃO DE ORGÃOS E TECIDOS PARA TRANSPLANTES

Abstract

With the increase in the number of patients on waiting lists for organ or tissue transplantation, it becomes necessary to analyze the reasons for the non-realization of donations. Studies demonstrate that one of the main reasons is familial refusal. Thus, this research aimed to analyze the factors related to family decision regarding organ and tissue donation for transplantations. This is a two-phase study: the first through an integrative literature review and the other through an observational study with a mixed approach, with a cross-sectional component and a qualitative component. It was carried out at a large hospital in the municipality of Campo Grande, capital of the state of Mato Grosso do Sul/Brazil. Data collection took place from September 2023 to January 2024 and included patients treated by the service studied in the year 2022. The sample for the cross-sectional study consisted of 120 medical records. The variables studied were the potential donor’s age, medical diagnosis, education level, reasons for family refusal, reasons for medical refusal, degree of kinship of the person responsible for the decision and family decision. The chi-square test was applied for inferential analysis, with a significance value of 0.05. For the qualitative study, 20 family members/people responsible for the donation decision were interviewed. Data were collected through semi-structured interviews, prepared based on the Readings in Family Theory. Bardin’s Content Analysis was for data analysis, and data processing was done using the IRaMuTeQ® software. The integrative review identified the family perception about the destination of the organs, the misunderstanding of the diagnosis of brain death (BD) and the lack of knowledge about the position of different religions on donation as the main factors related to the refusal to donate. The main reason for the non-realization of donation was family refusal (58.58%), followed by medical refusal (45.74%). Among the reasons for family refusals, the concern for body integrity (19.19%), the deceased’s wishes during his/her lifetime (14.14%) and the unawareness of the deceased’s wishes (11.11%) were observed. Regarding families that did not authorize donation, most respondents reported that their relatives had communicated the wish not to become donors during their lifetime and preferred to be buried with their intact bodies. Among those who agreed to donate, the desire to help others was the decisive factor. They assumed the perspective that, by consenting to the donation, they would be helping to save lives. This served as a trigger for decision-making, even for some families unaware of the potential donor’s wishes during his/her lifetime. Communication among family members allows knowledge about the position of each relative, facilitating the identification of individual perceptions generated about the topic, since death is still a difficult issue is avoided among family members in most cases.