ORGAN VE DOKU BAĞIŞI KOORDİNATÖRLERİNİN COVİD-19 DÖNEMİNDE DENEYİMLERİ: NİTEL BİR ÇALIŞMA
Yıl 2024,
, 19 - 27, 27.03.2024
Ufuk Akkurt
,
İsa Çelik
,
Seçil Duran
,
Murat Bektaş
,
Dilek Çilingir
Öz
Bu çalışmanın amacı, Türkiye'deki Organ ve Doku Bağışı Koordinatörleri (OTDC)’nin, COVID-19 salgını sırasında kadavra donör sürecindeki deneyimlerini incelemektir. Bu, Türkiye'nin dokuz farklı bölgesinde çalışan 12 OTDC ile yürütülen tanımlayıcı nitel bir çalışmadır. Şeffaflığı sağlamak için nitel araştırmaların raporlanmasına yönelik birleştirilmiş kriterler (COREQ) kılavuzları kullanıldı. OTDC'lerin deneyimlerine ilişkin altı tema ortaya çıktı: 1) yoğun bakım ünitelerindeki yoğunluk, 2) COVID-19 salgınının OTDC'ler üzerindeki olumsuz etkileri, 3) donör teşhis sürecindeki değişiklikler, 4) aileyle iletişim zorlukları, 5) potansiyel donörlerin azalması ve 6) OTDC'lerin organ bağışı faaliyetlerinde azalma. Bulgular, yoğun bakım ünitelerinde hasta yoğunluğunun artması nedeniyle koordinasyon sürecinde uzama ve değişikliklerin yaşandığını ve bu durumun OTDC'leri olumsuz etkilediğini gösterdi. Ayrıca tanı sürecindeki değişikliklerin, aile bireyleri ile iletişim zorluklarının ve potansiyel donör sayısının azalmasının kadavra donör sayısında azalmaya yol açtığı vurgulandı. Bu çalışma, Türkiye'deki OTDC'lerin COVID-19 salgını sırasında yaşadığı önemli sorunları vurgulamaktadır. Bulgular aynı zamanda pandemi sırasında organ bağışçılarının azalmasını da açıklamaktadır. Çalışmamız bu dönemde kadavra bağışı sürecine ilişkin eylem planlarının, yönergelerin ve iletişim araçlarının yetersiz olduğunu ortaya çıkardı.
Kaynakça
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- 3. Fang, X, Li, S, Yu, H, Wang, P, Zhang, Y, Chen, Z, Li, Y, Cheng, L, Li, W, Jia, H. and Ma, X. (2020). “Epidemiological, Comorbidity Factors With Severity and Prognosis Of COVID-19: A Systematic Review and Meta-Analysis”. Aging, 12 (13), 12493–12503. https://doi.org/10.18632/aging.103579
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- 10. Health Resources & Services Administration (HRSA). (2023). Erişim adresi: https://www.organdonor.gov/learn/organ-donation-statistics. (Erişim tarihi: 16.09.2023).
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- 17. Anthony, S.J, Lin, J, Pol, S.J, Wright, L. and Dhanani, S. (2021). “Family Veto in Organ Donation: The Experiences of Organ And Tissue Donation Coordinators İn Ontario. Veto Familial Au Don D’organes: Expériences Des Coordonnateurs En Don D’organes Et De Tissus En Ontario”. Canadian Journal of Anaesthesia, 68 (1), 611–21. https://doi.org/10.1007/s12630-021-01928-0
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- 21. Saglik Bakanligi Organ ve Doku Nakli Koordinatörlüğü Eğitim Yönergesi. (2023). Erişim adresi: https://www.saglik.gov.tr/TR,11251/organ-ve-doku-nakli-koordinatorlugu-egitim-yonergesi.html (Erişim tarihi: 16.09.2023).
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EXPERIENCES OF ORGAN AND TISSUE DONATION COORDINATORS DURING COVID-19: A QUALITATIVE STUDY
Yıl 2024,
, 19 - 27, 27.03.2024
Ufuk Akkurt
,
İsa Çelik
,
Seçil Duran
,
Murat Bektaş
,
Dilek Çilingir
Öz
This study was intended to examine the experiences of Organ and Tissue Donation Coordinators (OTDCs) in Turkey involved in the cadaveric donor process during the COVID-19 pandemic. This was a descriptive qualitative study conducted with 12 OTDCs working in nine different regions in Turkey. Consolidated criteria for reporting qualitative research (COREQ) guidelines were used to ensure transparency. Six themes emerged regarding the experiences of OTDCs: 1) intensity in intensive care units, 2) negative effects of the COVID-19 pandemic on OTDCs, 3) changes in the donor diagnostic process, 4) communication difficulties with family, 5) the reduction in potential donors, and 6) a decrease in organ donation activities of OTDCs. The findings emphasized that there were prolongations and changes in the coordination process due to increased patient density in intensive care units, which negatively affected the OTDCs. In addition, it was emphasized that the changes in the diagnostic process, communication difficulties with family members, and fewer potential donors led to a decrease in the number of cadaveric donors. This study highlights important issues experienced by OTDCs in Turkey during the COVID-19 pandemic. The findings also explain the decrease in organ donors during the pandemic. Our study revealed insufficient action plans, guidelines, and communication tools regarding the cadaveric donation process during this time.
Etik Beyan
Approval numbered 14.04.2021 2021/3
from GümüĢhane University Ethics
Committee, and research permission dated
23.05.2021 from the Ministry of Health were
obtained. No personal data was used in the
research. Participation was dependent on the
consent of the participants.
Kaynakça
- 1. Pollard, C.A, Morran, M.P. and Nestor-Kalinoski, A.L. (2020). “The COVID-19 Pandemic: A Global Health crisis”. Physiological Genomics, 52 (11), 549–57. https://doi.org/10.1152/physiolgenomics.00089
- 2. Haleem, A, Javaid, M. and Vaishya, R. (2020). “Effects of COVID-19 Pandemic in Daily Life”. Current Medicine Research and Practice, 10 (2), 78–79. https://doi.org/10.1016/j.cmrp.2020.03.011
- 3. Fang, X, Li, S, Yu, H, Wang, P, Zhang, Y, Chen, Z, Li, Y, Cheng, L, Li, W, Jia, H. and Ma, X. (2020). “Epidemiological, Comorbidity Factors With Severity and Prognosis Of COVID-19: A Systematic Review and Meta-Analysis”. Aging, 12 (13), 12493–12503. https://doi.org/10.18632/aging.103579
- 4. Centers for Disease Control and Prevention (CDC). (2023). Erişim adresi: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html (Erişim tarihi: 16.09.2023).
- 5. Cleve Clinic. Organ failure. (2023). Erişim adresi: https://my.clevelandclinic.org/health/diseases/24679-organ-failure (Erişim tarihi: 16.09.2023).
- 6. Citerio, G, Cypel, M, Dobb, G.J, Dominguez-Gil, B, Frontera, J.A, Greer, D.M, Manara, A.R, Shemie, S.D, Smith, M, Valenza, F. and Wijdicks, E. (2016). “Organ Donation in Adults: A Critical Care Perspective”. Intensive Care Medicine, 42, 305–315. https://doi.org/10.1007/s00134-015-4191-5
- 7. Bezinover, D. and Saner, F. (2019). “Organ Transplantation in the Modern Era”. BMC Anesthesiology, 19, 32. https://doi.org/10.1186/s12871-019-0704-z
- 8. International Registry on Organ Donation and Transplantation. (IRODaT). (2023). Erişim adresi: https://www.irodat.org/?p=database&c=TR&year=2021 (Erişim tarihi: 16.09.2023).
- 9. Lentine, K.L, Lam, N.N. and Segev D.L. (2019). “Risks of Living Kidney Donation: Current State of Knowledge on Outcomes Important to Donors”. Clinical Journal of the American Society of Nephrology, 14 (4), 597-608. https://doi.org/10.2215/CJN.11220918
- 10. Health Resources & Services Administration (HRSA). (2023). Erişim adresi: https://www.organdonor.gov/learn/organ-donation-statistics. (Erişim tarihi: 16.09.2023).
- 11. de Jonge, J, Kalisvaart, M, van der Hoeven, M, Epker, J, de Haan, J, IJzermans, J.N. and Grüne, F. (2016). “Organspende Nach Herz-Und Kreislauftod [Organ Donation After Circulatory Death]”. Der Nervenarzt, 87, 150–160. https://doi.org/10.1007/s00115-015-0066-9
- 12. Bendorf, A, Kelly, P.J, Kerridge, I.H, McCaughan, G.W, Myerson, B, Stewart, C. and Pussell, B.A. (2013). “An İnternational Comparison Of The Effect Of Policy Shifts to Organ Donation Following Cardiocirculatory Death (DCD) on Donation Rates After Brain Death (DBD) And Transplantation Rates”. PloS One, 8 (5), e62010. https://doi.org/10.1371/journal.pone.0062010
- 13. Domínguez-Gil, B, Delmonico, F.L, Shaheen, F.A, Matesanz, R, O'Connor, K, Minina, M, Muller, E, Young, K, Manyalich, M, Chapman, J, Kirste, G, Al-Mousawi, M, Coene L, García, V.D, Gautier, S, Hasegawa, T, Jha, V, Kwek, TK, Chen, Z.K, Loty, B. and Noël, L. (2011). “The Critical Pathway For Deceased Donation: Reportable Uniformity in the Approach to Deceased Donation”. Transplant Internatıonal, 24 (4), 373–78. https://doi.org/10.1111/j.1432-2277.2011.01243.x
- 14. Kalson, S. (1983). “A Link To Life: Coordinators As of Organ Procument Programs and Transplantation’s “Unsung Heroes”. New York Time Magazine, 6, 20.
- 15. Teixeira, J.F, Maio, R, Immer, F, Dominguez, J.M, Papalois, V, Mihály, S. and Paredes, D. (2014). “The Certification of Transplant Coordinators in Europe”. In Transplantation Proceedings, 46 (5), 1265-1273. Elsevier.
- 16. Sağlık Bakanlığı Organ Nakli Hizmetleri Yönetmeliği. (2023). Erişim adresi:https://www.resmigazete.gov.tr/eskiler/2022/12/20221209-3.htm. (Erişim tarihi: 16.09.2023).
- 17. Anthony, S.J, Lin, J, Pol, S.J, Wright, L. and Dhanani, S. (2021). “Family Veto in Organ Donation: The Experiences of Organ And Tissue Donation Coordinators İn Ontario. Veto Familial Au Don D’organes: Expériences Des Coordonnateurs En Don D’organes Et De Tissus En Ontario”. Canadian Journal of Anaesthesia, 68 (1), 611–21. https://doi.org/10.1007/s12630-021-01928-0
- 18. Mengi, T, Şirin, H, Yaka, E, Özdemir, A.Ö, Arsava, E.M. and Topçuoğlu, M.A. (2021). “Brain Death Diagnosis and Management in the Pandemic: Expert Opinion of the Turkish Neurological Society Neurological Intensive Care Scientific Working Group”. Turk J Neurol, 27, 1-4. DOI:10.4274/tnd.2021.88785
- 19. Türkiye Organ Nakli Vakfı. İstatistikler. (2023). Erişim adresi: https://www.tonv.org.tr/tr/organ-bagisi/istatistikler/ (Erişim tarihi: 16.09.2023).
- 20. Sandelowski, M. (2010). “What's in a Name? Qualitative Description Revisited”. Research in Nursing Health, 33 (1), 77-84. https://doi.org/10.1002/nur.20362
- 21. Saglik Bakanligi Organ ve Doku Nakli Koordinatörlüğü Eğitim Yönergesi. (2023). Erişim adresi: https://www.saglik.gov.tr/TR,11251/organ-ve-doku-nakli-koordinatorlugu-egitim-yonergesi.html (Erişim tarihi: 16.09.2023).
- 22. Organ Nakli Koordinatörleri Derneği. Bölge Koordinasyon Merkezleri. (2023). Erişim adresi: https://www.onkod.org.tr/sayfa/bolge-koordinasyon-merkezleri-(bkm)/28/9 (Erişim tarihi: 16.09.2023).
- 23. Organ Nakli Koordinatörleri Derneği. Ulusal Organ ve Doku Nakli Koordinasyon Merkezi. (2023). Erişim adresi: https://www.onkod.org.tr/sayfa/ulusal-organ-ve-doku-nakli-koordinasyon-merkezi-(ukm)/27/9 (Erişim tarihi: 16.09.2023).
- 24. Braun, V. and Clarke, V. (2006). “Using Thematic Analysis in Psychology”. Qualitative Research in Psychology, 3, 77-101.
https://doi.org/10.1191/1478088706qp063oa
- 25. Tong, A, Sainsbury, P. and Craig, J. (2007). “Consolidated Criteria For Reporting Qualitative Research (COREQ): A 32-İtem Checklist For İnterviews and Focus Groups”. International Journal For Quality İn Health Care: Journal Of The International Society For Quality İn Health Care, 19 (6), 349–357. https://doi.org/10.1093/intqhc/mzm042
- 26. Domínguez-Gil, B, Fernández-Ruiz, M, Hernández, D, Crespo, M, Colmenero, J. and Coll E. (2021). “Organ Donation and Transplantation During The COVID-19 Pandemic: A Summary of the Spanish Experience”. Transplantation, 105 (1), 29-36. https://doi.org/10.1097/TP.0000000000003528
- 27. Domínguez-Gil, B, Coll, E, Ferrer-Fàbrega, J, Briceño, J. and Ríos, A. (2020). “Dramatic İmpact Of The COVID-19 Outbreak On Donation and Transplantation Activities İn Spain. Drástico İmpacto De La Epidemia De COVID-19 Sobre La Actividad De Donación Y Trasplante En España”. Cirugia Espanola, 98 (7), 412–414. https://doi.org/10.1016/j.ciresp.2020.04.012
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