• 沒有找到結果。

第六章 研究結論與建議

第三節、 研究限制

本研究於進行過程中,遭遇以下三點研究限制:

一、外推性問題:

本研究以北中南醫學中心醫療人員為對象,採取立意取樣方式進 行,但南部醫學中心由於研究者的資源不足,相對問卷回收比例較 少,整體的外推性可能不足。

二、群體壓力:

由於問卷是經由行政部門及人際網絡進行發放,擔心拒絕填答問 卷或受外力壓力介入影響填答結果。

三、研究對象之比例問題:

對於醫療人員比例,本研究護理人員 62﹪、醫師 14﹪、醫事人 員 21﹪,在比例上有些接近醫療機構人力分配,但在器官移植及捐 贈的事件影響力上,其實醫師是扮演較重要的影響人物,所以醫師問 卷部分未能適當比例的增加。

參考文獻 (Reference)

英文

Amaral, Roza, Galvao, Jardim, & Medina-Pestana, (2002). Knowledge of organ donation among one group of Brazilian professors of medicine. Transplantation

Proceedings, 34(2), 449-450.

Basu, Hazariwala, & Chipman, (1989). Public attitudes toward donation of body parts, particularly the eye. Canadian Journal of Ophthalmology, 24(5),216-220.

Beauchamp , & Childress, (2008). Principle of biomedical ethics. Oxford University Press; Sixth edition.

Bosch ,(1999). Spain lead world in organ donation and transplantation. The Journal of

the American Medical Association, 282 (1),17-18.

Botsford, (1995). Review of literature on heart transplant recipients’ return to work:

Predictors and outcomes. Social Work in Health Care, 21(2),19-39.

Bratton, & Griffin, (1994). A kidney donor’s dilemma: The sibling who can donate-but doesn’t. Social Work in Health Care, 20(2),75-96.

Cohen, Ami, Ashkenazi, & Singer, (2008). Attitude of health care professionals to brain death: influence on the organ donation process. Clinical Transplantation, 22(2),211-215.

Conesa, Ríos , Ramírez P, del Mar Rodríguez M, Rivas P,& Parrilla P.

(2004).Socio-personal factors influencing public attitude towards living donation in south-eastern Spain. Nephrol Dial Transplant. Nov;19(11),2874-82.

Conesa, Ríos , Ramírez P, Sánchez J, Sánchez E, Rodríguez MM, Martínez L, &

Ramos F, Parrilla P.(2005).Acceptance level of living liver donation among primary care nursing personnel.Transplant

Proceedings . Nov;37(9),3631-5.

Conesa, Ríos , Ramírez P, Sánchez J, Sánchez E, Rodríguez MM, Martínez L,&

Ramos F, Parrilla P. (2005).Attitude of primary care nurses toward living kidney donation.Transplant Proc. Nov;37(9),3626-30.

Conesa, Ríos, Ramírez, P., Cantéras, M., Rodríguez, M. M., & Parrilla, P. (2006).

Attitudes toward organ donation in rural areas of southeastern Spain.

Transplantation Proceedings, 38 (3),866-868.

Creecy, R. F., & Wright, R. (1990). Correlates of willingness to consider organ donation among blacks. Social Science & Medicine, 31(11) ,1229-1232.

Cunningham, Cass, Anderson, Snelling, Devitt1, Preece , & Eris, J.(2006)Australian nephrologists’ attitudes towards living kidney donation. Nephrol Dial

Transplan, 21,1178-1183

Dejong, W., Drachman, J., & Gortmaker, S. L. (1995). Options for increasing organ

procedures, and public education to promote family discussion. The Milbank

Quarterly, 73(3) ,463-477.

Dhooper, & Wilson, (1989). Social work and organ transplantation. Health and Social

Work, 14(2) ,115-121.

Duarte, P. S., Pericoco, S., Miyazaki, M. C., Ramalho, H. J., & Abbud-Filho, M.

(2002). Brazilian’s attitudes toward organ donation and transplantation.

Transplantation Proceedings, 34(2) ,458-459.

Geva, J., & Weinman, M. L. (1995). Social work perspectives in organ procurement.

Health & Social Work, 20(4) , 287-293.

Goetzmann, L.(2004) .Is It Me, or Isn't It? -Transplanted Organs and Their Donors as Transitional Objects. American Journal of Psychoanalysis, 64(3),279-289.

Guadagnoli, E., Christiansen, C. L., McNamara, P., Beasley, C., Christiansen, E., &

Evanisko, M. (1999). The public’s willingness to discuss their preference for organ donation with family members. Clinical Transplantation, (13) ,342-348.

Gullede, A. D., Buszta, C., & Montauge, D. K. (1983). Psychosocial aspects of renal transplantation. Urologic Clinics of North America, 10(2) , 327-335.

Horton, R. L., & Horton, P. J. (1991). A model of willingness to become a potential organ donor. Social science and medicine, 33(9), 1037-1051.

Humphry, D., & Wickett, A. (1986). The Right to Die: Understanding Euthanasia.

The Bodley Head: London.

Kiberd, M. C., & Kiberd, B. A. (1992). Nursing attitudes towards organ donation, procurement, and transplantation. Heart Lung,( 21) ,106-111.

Klassen, A. C., & Klassen, D. K. (1996). Who are the donors in organ donation? The family's perspective in mandated choice. Annals of Internal Medicine, 125(1) , 70-73.

Krmar ,R.T., Eymann ,A., Ramirez, J.A., & Ferraris ,JR(1997). Quality of life after kidney transplantation in children, Transplanation, 64(3),540-541.

Manninen, D. L., & Evans, R. W. (1985). Public attitudes and behavior regarding organ donation. The Journal of the American Medical Association, 253(21) , 3111-3115.

Mirand A B , Fernandez L M ,& Fel Ipec , (1999) . Organ donation in Spain . Nephrol

Dial Transplant , (14),15-21.

Morris, P. (2003). Ethical eye: transplants Council of Europe, Publishing, January Mossialos, E., Costa-Font, J., & Rudisill, C. (2008). Does organ donation legislation

affect individuals' willingness to donate their own or their relative's organs?

Evidence from European Union survey data. BioMed Central Health Services

Research, 8(48), http://www.biomedcentral.com/1472-6963/8/48.

Myfanwy Morgan, Richard Hooper, Maya Mayblin, & Roger Jones(2006) . Attitudes

to kidney donation and registering as a donor among ethnic groups in the UK.

Journal of Public Health,.28(3) ,226-234.

Nalon, B. E., & Spanos, N. P. (1989). Psychosocial variables associated with willingness to donate organs. Canadian Medical Association Journal. (141), 27-32.

Popp, F C; Eggert, N; Hoy, L; Lang, S A ; Obed, A ; Piso, P; Schlitt, H J ;& Dahlke, M H. (2006).Who is willing to take the risk? Assessing the readiness for living liver donation in the general German population .Journal of Medical

Ethics;32,389-894

Rene, A. A., Viera, E., & Daniels, D. E. (1995). Organ donation awareness:

Knowledge, attitudes and beliefs in a Puerto Rican population. Transplantation

Proceedings, 27(2), 1893-1896.

Ríos A, Conesa C, Ramírez P, Sanmartín A, & Parrilla. P (2004) .Socio-personal profile of teenagers opposed to organ donation .Nephrol Dial

Transplant,19,1269-1275.

Ríos A, Ramírez P, Galindo PJ, Sánchez J, Sánchez E, Martínez-Alarcón L, & Parrilla P. (2008).Primary health care personnel faced with cadaveric organ donation: a multicenter study in south-eastern Spain. Clin Transplant, 22, 657-663.

Ríos, A., Conesa, C., Ramírez, P., Galindo, P. J., Martínez, L., Montoya, M. J., Pons, J. A., Rodríguez, M. M.,& Parrilla, P. (2005). Attitude toward deceased organ donation and transplantation among the workers in the surgical services in a hospital with a transplant program. Transplantation Proceedings, 37(9), 3603-3608.

Ríos, A., Conesa, C., Ramírez, P., Sánchez, J., Sánchez, E., Ramos, F., & Parrilla, P.

(2006). Information requested about organ donation in primary health care centers. Transplantation Proceedings, 38 (8),2367-2370.

Ríos, A., Ramírez, P., del mar Rodríguez, M., Martínez-Alarcón, L., Lucas, D., Alcaraz, J., Montoya, M., & Parrilla, P. (2007a). Benefit of a hospital course about organ donation and transplantation: An evaluation by Spanish hospital transplant personnel. Transplantation Proceedings, 39 (5),1310-1313.

Ríos, A., Ramírez, P., Martínez-Alarcón, L., Galindo, P., Montoya, M., Rodríguez, M., Cascales, P., Pons, J., & Parrilla, P. (2007b). Hospital Personnel in Surgical Services in a Transplant Hospital Faced With Living Liver Donation: An Attitudinal Survey. Transplantation Proceedings, 39(7),2079-2082.

Scanner, M. A. (1994). A comparison of public attitude toward autopsy, organ donation, and anatomic dissection. The Journal of the American Medical

Association, 271(4) ,284-288.

Scanner, M. A. (1998). Giving and taking ─ to whom and from whom? People’

attitude toward transplantation of organs and tissue from different sources.

Clinical Transplantation,(12), 530-537.

Spital, A. (1996). Mandated choice for organ donation: Time to give it a try. Annals of

Internal Medicine, 125(1),66-69.

Spital, Aaron and Taylor,& James Stacey (2007). Living Organ Donation: Always Ethically Complex.Clinical Journal America Society Nephrol ,2, 203–204.

Stark, J. L., Reiley, P., Osiecki, A., & Cook, L. (1984). Attitudes affecting organ donation in the intensive care unit. Heart Lung, 13(4), 400-404.

Starzomski ,& Hilton,(2002) .Patient and family adjustment to kidney transplantation with and without an interim period of dialysis. Nephrology Nursing Journal.

27(1),17-31.

Steele, C. I., & Altholz, J. A. (1987). Donor ambivalence:A key issues in families of children with end-stage renal disease. Social Work in Health Care, 13(2) ,47-57.

Walter, Bronner, Steinmuller, Klapp, & Danzer (2002). Psychosocial data of potential living donors before living donor liver transplantation,Clinical Transplantation,:

16(1), 55-59.

Younger, S. J., Landefld, C. S., Coulton, C. J., Juknialis, B. W., & Leary, M. (1989).

Brain death’ and organ retrieval – a cross-sectional survey of knowledge and concepts among health professionals. The Journal of the American Medical

Association, 261(15),205-2210.

中文

李伯璋 (2001)。

一步一腳印。

台南:成功大學。

臺灣醫學人文學刊

;6(1&2):143-155。

林忠義 (2003)。

從多元觀點省思器官捐贈制度的應有走向-以屍體器官捐贈為

其相關因素之探討。

慈濟醫學

,14(2):87-96。

植聲明」

健康世界

;(231):61-66。

http://health.chinanews.cn/jk/kong/news/2008/06-15/1282064.shtml

「中華民國器官捐贈協會」。最後擷取日期:2008/10/21。網址:

http://www.organ.org.tw/

「中國肝移植註冊(China Liver Transplant Registry, CLTR)」。最後擷取日期:

2008/6/21。網址:

「財團法人器官捐贈移植登錄中心(TORSC)」。最後擷取日期:2009/4/13。網址:

http://www.torsc.org.tw/home/index.htm

「益思科技法律事務所」。最後擷取日期:2008/9/13。網址:

http://www.is-law.com/news/Home001.htm

「衛生署」。最後擷取日期:2009/4/12。網址:

http://www.doh.gov.tw/cht2006/index_populace.aspx

「立法院全球法律資訊網」。最後擷取日期:2008/8/28。網址:

http://glin.ly.gov.tw/web/index.do

「中央研究院醫學研究倫理委員會」。最後擷取日期:2008/8/25。網址:

http://proj1.sinica.edu.tw/~irb/

「UNOS(United Network for Organ Sharing)」。最後擷取日期:2008/8/27。網址:

http://www.unos.org/

「Canadian Blood Services Launches Living Donor Paired Exchange Registry」。最後 擷取日期:2008/6/27。網址:

http://www.ccdt.ca/

「transplant-observatory」。最後擷取日期:2008/8/21。網址:

http://www.transplant-observatory.org/C18/National%20Transplant%20Organiza ti/default.aspx.

「Japan Organ Transplant Network(JOTN)」。最後擷取日期:2008/8/28。網址:

http://www.jotnw.or.jp/english/index.html

「Ministry of Health, Singapore,」。最後擷取日期:2008/8/28。網址:

http://www.moh.gov.sg/mohcorp/legislations.aspx?id=1672

「ONT (Organización Nacional de Trasplantes)」。最後擷取日期:2008/8/28。網址::

http://www.ont.es

「HRSA (Health Resources and Services Administration)」。最後擷取日期:

2008/8/21。網址:

http://www.hrsa.gov/

「The Canadian Association of Transplantation」。最後擷取日期:2008/8/27。網址::

http://www.transplant.ca/

「UK Transplant」。最後擷取日期:2008/11/21。網址:

http://www.uktransplant.org.uk/ukt/

附錄一 (Appendix I) 世界各國器官移植組織

(National Transplant Organizations)

歐洲地區 (Europe)

Austria: Austrotransplant: http://www.austrotransplant.at Croatia : Donor Network of Croatia : http://www.hdm.hr/

Czech Republic : Czech Transplantation Coordinating Centre (KST):

http://www.kst.cz/web/home-en.php

Estonia : Tartu Hospital University : http://www.kliinikum.ee

France : Agence de la biomédecine: http://www.agence-biomedecine.fr/fr/index.asp Germany : Deutsche Stiftung Organtransplantation (DSO): http://www.dso.de/

Greece : Hellenic National Transplant Organization: http://www.eom.gr Hungary : HungaroTransplant: http://www.htp.hu/

Israel : Israel Transplant. http://www.health.gov.il/transplant/eng1.htm

Italy : Centro Nazionale Trapianti (CNT): http://www.trapianti.ministerosalute.it/

Lithuania : Lithuanian Bureau on Organ Transplantation:

http://www.transplantacija.lt/content/nuorodos/lietuvoje.en.html Netherlands : Nederlandse Transplantatie Vereniging:

http://www.transplantatievereniging.nl/

Norway : Rikshospitalet / Radium Hospitalet: http://www.rikshospitalet.no Poland : Poltransplant: http://www.poltransplant.org.pl/

Romania : National Transplant Agency: http://www.transplant.ro/

Slovakia : Slovaq Centre on Organ Transplantation: http://www.ncot.sk

Slovenia : Institute of the Republic of Slovenia for the Transplant of Organs and Tissues: Slovenija Transplant: http://www.slovenija-transplant.si

Spain : Organización Nacional de Trasplantes (ONT): http://www.ont.es Sweeden: Swedish Council for Organ and Tissue Donation:

http://www.donationsradet.se

Switzerland : Swisstransplant for Solid Organ and Partial Tissue:

http://www.swisstransplant.org/ .

Swiss Blood Stem Cells for cells: http://www.bloodstemcells.ch United Kingdom : UKTransplant: http://www.uktransplant.org.uk/ukt/

美洲地區 (Americas)

Argentina : Instituto Nacional Central Único Coordinador de Ablación e Implante:

http://www.incucai.gov.ar/

Bolivia : Comisión Coordinadora Nacional de Trasplantes de Órganos y Tejidos de Bolivia: http://www.trasplantesorganos-bo.org/

Brazil : Coordenaçao –Geral do Sistema Nacional de Transplantes:

http://www.abto.com.br/

Canadá : The Canadian Association of Transplantation: http://www.transplant.ca/

Chile : Corporación Nacional de Trasplantes de Chile: http://www.trasplante.cl Colombia : Red de Donación y Trasplante: Instituto Nacional de Salud:

http://www.ins.gov.co

Cuba : Grupo de Coordinación Nacional de Trasplantes:

http://www.sld.cu/sitios/trasplante/

México : Centro Nacional de Trasplantes (CENATRA): http://www.rnt.gob.mx/

United States of America : United Network for Organ Sharing: http://www.unos.org/

Uruguay : Instituto Nacional de Donación y Trasplante de Células, Tejidos y Órganos (INDT): http://www.indt.hc.edu.uy/

Venezuela : Sistema de Procura de Órganos y Tejidos : http://www.ontv-venezuela.org 亞洲地區 ( Asia)

Egypt : Directorate of Specialized Medical Committee Curative Care Sector MOH and Population. Egyptian Medical Syndicate: http://www.mohp.gov.eg Indian : Directorate General of Health Services : http://mohfw.nic.in/dghsindex.htm Japan : Japan Organ Transplant Network:

http://www.jotnw.or.jp/english_top/englishtop.html

Korea : Konos Korean Network for Organ Sharing: http://www.konos.go.kr

Lebanon: National Organization for Organs and Tissues Donation and Transplantation (NOOTDT): http://nootdt.org/en/index.en.htm

Malaysia : National Transplant Procurement Management: http://www.hkl.gov.my Myanmar : Department of Health: http://www.moh.gov.mm

Pakistan : Sindh Institute of Urology and Transplantation: http://www.siut.org Saudi Arabia : Saudi Centre for Organ Transplantation:

http://www.scot.org.sa/eng-index.html

Taiwan : Taiwan Organ Registry and Sharing Center : http://www.torsc.org.tw/

附錄二 (Appendix II)問卷

(3)您自己或家人/親友是否曾經是器官受贈者嗎?