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護理人員器官移植倫理與勸募態度之相關性研究

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(1)29. 1. 2,5. 3,4. 5. 1. 2. 6 3. 5. 93. 6. 93. 4 6. 12 887. (presumed consent) 2007;12:29-36. (living donor) 1954. Merril. Murray (cadaver donor). [1] (recipient) [3-5]. 20 [2] (donor). 404. 91. 2006. 2. 14. 2006. 9. 27. 2006. 5. 23.

(2) 30. [6]. (quantitative approach). (operationalization) (structured). (. 92. 1. ) 30 (factor analysis) Cronbach alpha. (teleological theory). (. deontological theory) (. [8] (principle of beneficence). 1. 2). 6) 5). (principle. ( ( (4. of non-maleficence). ) (. (principle of autonomy). (. 11). 3. ( 4. 7 8) 9 (5 ) 9 10) ( 12). (principle of justice) [9] ( 14) 16). (. ). (. ( 13) 15) ( 17). ( 1-6.

(3) 31. alpha 0.72 9-12 alpha 0.80 0.70-0.80. 7-8 alpha 0.84 13-17 alpha. 0.81 alpha. 2.99 2.51(. ). 4.09 4.07. 4.06 3.52(. ) 4.07 4.06. 3.87 93. 6. 93. 950. 3.67 3.38(. 12. 93.3%. (n = 887). 887. / SPSS. ). (10. (%). ( ) 20-25 26-35 36-50. ). 459 (51.7) 365 (41.1) 52 ( 6.0) 11 ( 1.2). t 9 ( 1.0) 489 (55.2) 378 (42.6) 10 ( 1.1) 1 ( 0.1) (. 838 (94.5) 41 ( 4.6) 8 ( 0.9). ) 26-35. (N0 N1 94.5% (AHN) (HN) 4.6%. N2. N3. 3. 10 51.1% 47.7% 14.2% 83.5%. 3.92. 3.73. 472 (53.2) 411 (46.3) 4 ( 0.5). (SV) 1. 5. N4). 1 1 3 5 10. 3 5 10. 122 (13.8) 235 (26.5) 189 (21.3) 229 (25.8) 94 (10.6) 18 ( 2.0) 423 (47.7) 453 (51.1) 11 ( 1.2) 741 (83.5) 126 (14.2) 20 ( 2.3).

(4) 32. (n = 887) (%). (%). (%). (%). (%) 3.9 3.9. 0.7* 0.9. 0.9 1.4. 4.0 3.7 3.8 3.7. 0.7 0.6 0.8 0.8. 10.1. 1.5. 3.8. 0.9. 28.9. 32.7. 4.3. 3.0 3.0. 1.0 1.0. 37.6 36.0. 40.8 40.8. 10.1 10.8. 2.5 2.5 2.5. 0.8 0.8 0.7. 4.1 4.1 4.1 4.1 4.1 3.5 3.5. 0.6* 0.6 0.6 0.6 0.6 0.8 0.8. 3.9 3.9 3.7 3.7 4.1 4.1 4.1 4.1 3.4 3.4. 0.7 0.7 0.8 0.8 0.7 0.7 0.7 0.7 0.9 0.9. 1.. 22.1. 55.1. 12.0. 10.3. 0.5. 2.. 19.5. 62.6. 13.2. 4.8. 0.2. 3. 4.. 13.3 11.0. 57.2 58.5. 21.1 19.1. 7.4 10.0. 5.. 16.7. 55.4. 16.3. 6.. 6.2. 27.9. 7. 8.. 1.2 1.5. 10.3 10.8. (5. ). (4. ). (3. ). (2. ). (1. ). SD. *Mean. (n = 887) (%). (%). (%). (%). (%). 9. 10.. 23.2 28.6. 64.2 54.9. 10.9 12.3. 1.3 3.4. 0.3 0.8. 11.. 21.7. 63.7. 13.7. 0.7. 0.2. 12.. 7.4. 47.1. 36.6. 7.7. 1.3. 13.. 14.0. 60.9. 23.0. 1.7. 0.3. 14.. 12.2. 49.0. 32.9. 5.5. 0.5. 15.. 25.9. 57.3. 14.5. 2.3. 0.0. 16.. 24.7. 57.3. 17.1. 0.8. 0.1. 17.. 10.0. 36.2. 37.9. 14.1. 1.9. (5. ). (4. ). (3. ). (2. ). (1. ). *Mean. SD. 26-35 20-25 26-35. 36-50. 20-25.

(5) 33. (. (. ). ). (. ). (. ). (n = 887) 20-25 (G1). 26-35 (G2). 36-50 (G3). F. 3.8. 0.6*. 3.7. 0.6. 3.4. 0.7. 7.29. 3.1. 1.0. 2.9. 1.0. 2.8. 1.1. 5.67. *Mean. SD. t. G1 > G3 G2 > G3 G1 > G2. p < 0.05. 3.1 2.6. 1.0 0.8. 2.9 2.4. 1.0 0.8. 2.62 3.06. 3.8. 0.7. 3.9. 0.6. 2.17. p < 0.01. (n = 887) t 3.7. 0.6*. 3.5. 0.7. 2.62. 2.5. 0.8. 2.3. 0.9. 1.92. 3.4. 0.9. 3.1. 1.0. t 3.8. 0.6. 3.7. 0.6. 2.65. 3.7 4.1 4.1. 0.7 0.7 0.7. 3.6 4.0 4.0. 0.8 0.7 0.7. 2.90 2.16 2.48. 1.95 *Mean. SD. p < 0.05. p < 0.01. t 3.8 3.1. 0.6 1.0. 3.7 2.9. 0.6 2.09 1.0 2.67.

(6) 34. (n = 887) t 4.0 2.4. 0.7* 0.8. 3.8 2.6. 0.7 0.8. 2.51 2.81. 4.1. 0.6. 4.0. 0.6. 2.84. 3.9 4.1. 0.7 0.7. 3.8 4.0. 0.6 0.7. 2.87 2.03. *Mean. SD. p < 0.05. t. §. 2.2. 0.9. 2.6. 0.8. 4.01. 4.3 4.2. 0.6 0.5. 4.0 4.0. 0.6 0.6. 3.97 § 3.70. 0.7. 4.0. 0.7. 2.72. 4.2. §. §. p < 0.01. p < 0.001. (n = 887) R2 F. t. *p < 0.05. p < 0.01. 0.405. 0.038. 0.336. 0.291 0.168. 0.054 0.056. 0.242 0.133. 5.40 2.98*. 0.260 0.158 0.102. 0.055 0.056 0.038. 0.216 0.125 0.090. 4.74 2.80 2.68. 0.251 0.159 0.098 0.049. 0.055 0.056 0.038 0.024. 0.208 0.126 0.087 0.065. 4.57 2.83 2.59 2.07*. 10.62. R2. 0.113 F = 112.73 0.122 F = 61.307. 0.009. 0.129 F = 43.518. 0.007. 0.133 F = 33.856. 0.004. p < 0.001. (. 11.3% 0.7% 13.3% 0.159 0.049. 0.9% 0.4% Y=1.321 0.251 0.098. [10-11]. ).

(7) 35. DMR-92018 (presumed consent) [1] 1. Siegel Laurel R. Engineering the Laws of Organ Transplantation. 2000;49 Emory L.J. 917. 2005. 2.. 4. http://www.torsc.org.tw/home/index.htm 3.. 2000;4:275-81. 4. 1992 5. Botsford AL. Review of literature on heart transplant. [12]. [13]. return to work: predictors and outcomes. recipients [Review] Soc Work Health Care 1995;21:19-39. 6. Geva J, Weinman ML. Social work perspectives in organ procurement. Health Soc Work 1995;20:287-93.. [14,15]. 7. 2001 8.. 1999;18-20. 9. 2000:36 10. 2000;27:23-34 11. 2001;12:42-51 12. 2003 13. 1996;7:46-56 14. 1992;3:156-65 15. 2001;5:1-7. [16,17]. 16.. 2003; 4. 17. 25. 1999;7:27-8.

(8) 36. A Study of the Attitude Toward Organ Transplant Ethics and Donation Among Nurses 1. 2,5. 3,4. 5. 6. Kuang-Huei Chen , Chi-Hsuan Lung , Mei-Due Yang , Sheng-Rong He , Shih-Chien Chen 1. 2. 3. 4. Department of Nursing, Department of Social Work, Department of Digestive Surgery, Department 5. of Clinical Nutrition, China Medical University Hospital; Department of Health Service Management, 6. Department of Public Health, China Medical University, Taichung, Taiwan.. P u r p o s e . This study aimed to evaluate the attitude of nursing staff toward organ transplant ethics and organ donation practice in task situations, as well as to analyze related influencing factors. Methods. This research was conducted from June to December 2004. Selected interval level structured questionnaires were administered to 887 nurses in order to collect data regarding their attitude toward organ transplant ethics and organ donation. The data were analyzed by t test, ANOVA and step-wise regression. R e s u l t s . We found that the “autonomy principle” was the most important factor, followed by the “family principle” and the “medical purpose principle”. In the crossanalysis, blood donation habits and registered organ transplant cards were important influencing attitude factors for organ transplant ethics (p < 0.05) and donation behavior (p < 0.001); moreover, “support” (p < 0.001), “acceptability” (p < 0.001), “nature principle” (p < 0.001) and “medical purpose principle” (p < 0.05) were the four variables which could predict the willingness of medical teams participating in donation. Conclusions. Nurses in Taiwan regard patients' individual autonomy to be the most important consideration in organ transplant donation. However, nurses also feel that the opinion of the donor's family is an important consideration. The study showed that the majority of nurses consider the donor's wishes to be more important than the patients' needs. We believe that the government should consider amending laws regarding presumed consent and increase promulgation of the organ transplant donation concept. Hospitals should increase education programs to promote organ transplant and donation awareness among nurses. ( Mid Taiwan J Med 2007;12:29-36 ). Key words organ donation, organ transplant, transplant ethics. Received : 14 February 2006.. Revised : 23 May 2006.. Accepted : 27 September 2006. Address reprint requests to : Chi-Hsuan Lung, Department of Health Service Management, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan..

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