Dolaşım Ölümü Sonrası Organ Bağışı Tutum Anketinin Türkçe Geçerlilik ve Güvenilirlik Çalışması

Yıl 2023, , 98 - 107, 30.04.2023

Pınar Ayvat

https://doi.org/10.36516/jocass.1230011

Öz

Amaç: Organ bağışı, tüm dünyada olduğu gibi ülkemizde de önemli bir konudur. Beyin ölümü sonrası organ bağışı yapılabildiği gibi, dolaşım ölümü sonrasında da organ bağışı yapılabilmektedir. Bu araştırmanın amacı; Dolaşım Ölümü Sonrası Organ Bağışı Tutum Anketinin (DÖBTA) Türkçe geçerlilik ve güvenilirliğini değerlendirmektir.
Gereç ve Yöntemler: DÖBTA organ bağışı konusunda deneyimli beş anestezi hekimi tarafından Türkçe’ye çevrildi, dil ve anlam bütünlüğü açısından değerlendirildi. Türkçe’ye çevrilen önermeler için, organ bağışı araştırması deneyimi olan 1 psikolog, 1 organ bağış koordinatörü, 2 yoğun bakım hekimi, 2 yoğun bakım hemşiresi ve daha önce bir aile üyesi için organ bağışı kararı almış 1 hasta yakınına danışıldı. Bu uzman paneli tarafından yapılan inceleme ve tartışmaya müteakip, netliği artırmak için bazı maddeler yeniden ifade edildi, Türkçe anlaşılırlığı konusunda hem fikir olundu ve ankete son hali verildi. Toplam 34 maddeden oluşan, her biri 5 yanıt seçeneğine sahip olan bir anket oluşturuldu.
Bulgular: Yaş ortalaması 46,5±11,2 olan 110 katılımcı anketi cevapladı. İlk faktör analizinde 12 madde düşük faktör yükü (<0,40) gösterdiği için nihayi analize dahil edilmemiştir. Geri kalan 22 maddenin doğrulayıcı faktör analizinde, altı faktörlü bir çözümün en uygun model olduğunu gösterildi. Bunlar önyargı, kişisel güven, deneyim eksikliği, aileye güven, sisteme güven ve maneviyat olarak adlandırıldı. Anketin güvenirliği (Cronbach Alpha) iç tutarlılık katsayısı toplam anket için 0,887 olarak bulundu. Tam model, varyansın %66,73'ünü açıklamaktaydı.
Sonuç: Bu çalışmaya göre DÖBTA’nın Türkçe sürümünün geçerli bir test olduğu, iyi tanısal özellik gösterdiği, iç tutarlılığının yüksek olduğu söylenebilir.

Anahtar Kelimeler

Dolaşım Ölümü, Organ Bağışı, Organ Nakli

Turkish Validity and Reliability Study of the Donation after Circulatory Death Attitudes Scale (DCDAS).

Öz

Aim: Organ donation is a critical issue in our country and the rest of the world. Organ donation can be made after brain death, as well as after circulatory death. This research aims to evaluate the Turkish validity and reliability of the Donation After Circulatory Death Attitudes Scale (DCDAS).
Materials and Methods: DCDAS was translated into Turkish by five anesthesiologists experienced in organ donation and evaluated in terms of language and meaning integrity. For the propositions translated into Turkish, 1 psychologist with experience in organ donation research, 1 organ donation coordinator, 2 intensive care physicians, 2 intensive care nurses, and 1 patient's relative who had previously decided to donate organs for a family member were consulted. Following the review and discussion by this expert panel, some items were restated to increase clarity, agreed on Turkish intelligibility, and finalized the questionnaire. A questionnaire was created with a total of 34 items, each with 5 response options.
Results: 110 participants with a mean age of 46.5±11.2 answered the questionnaire. Since 12 items showed a low factor load (<0.40) in the first-factor analysis, they were not included in the final analysis. In the confirmatory factor analysis of the remaining 22 items, it was shown that a six-factor solution was the most appropriate model. These were named prejudice, self-confidence, lack of experience, trust in family, trust in the system, and spirituality. The reliability (Cronbach Alpha) internal consistency coefficient of the questionnaire was found to be 0.887 for the total questionnaire. The full model explained 66.73% of the variance.
Conclusion: According to this study, it can be said that the Turkish version of the DCDAS is a valid test, has good diagnostic properties, and has high internal consistency.

Anahtar Kelimeler

Circulatory Death, Organ Donation, Organ Transplantation

Kaynakça

• 1. Domínguez-Gil B, Mahillo B, Alvarez M, et al. In-ternational figures on organ, tissue & haematopoi¬etıc stem cell donation & transplantation activities. Documents produced by the council of europe eu¬ropean committee (partial agreement) on organ transplantatıon (cd-p-to). EDQM. 2022;27:1-104.
• 2. Neyrinck A, Van Raemdonck D, Monbaliu D. Do¬nation after circulatory death: current status. Curr Opin Anaesthesiol. 2013;26(3):382-90. https://doi.org/10.1097/ACO.0b013e328360dc87
• 3. Murphy P, Boffa C, Manara A, et al. In-hospital logistics: what are the key aspects for succeeding in each of the steps of the process of controlled do¬nation after circulatory death? Transpl Int. 2016;29(7):760-70. https://doi.org/10.1111/tri.12708
• 4. Israni AK, Zaun D, Bolch C,et al. Deceased Organ Donation. Am J Transplant. 2016;16(2):195-215. https://doi.org/10.1111/ajt.13673
• 5. Klassen DK, Edwards LB, Stewart DE, et al. The OPTN Deceased Donor Potential Study: Implica-tions for Policy and Practice. Am J Transplant. 2016;16(6):1707-14. https://doi.org/10.1111/ajt.13731
• 6. Wigfield C. Donation after cardiac death for lung transplantation: a review of current clinical prac-tice. Curr Opin Organ Transplant. 2014;19(5):455-9. https://doi.org/10.1097/MOT.0000000000000115
• 7. Shahrestani S, Webster AC, Lam VWT, et al. Out-comes From Pancreatic Transplantation in Dona-tion After Cardiac Death: A Systematic Review and Meta-Analysis. Transplantation. 2017;101(1):122-30. https://doi.org/10.1097/TP.0000000000001084
• 8. Koscik R, Ngai J. Donation After Circulatory Death: Expanding Heart Transplants. J Cardiotho¬rac Vasc Anesth. 2022;36(10):3867-76. https://doi.org/10.1053/j.jvca.2022.05.025
• 9. Siminoff LA, Gordon N, Hewlett J, et al. Factors influencing families' consent for donation of solid organs for transplantation. JAMA. 2001;286(1):71-7. https://doi.org/10.1001/jama.286.1.71
• 10. Rodrigue JR, Cornell DL, Howard RJ. Organ Do-nation Decision: Comparison of Donor and Non-donor Families. American Journal of Transplanta¬tion. 2006;6(1):190-8. https://doi.org/10.1111/j.1600-6143.2005.01130.x
• 11. Mandell MS, Zamudio S, Seem D, et al. National evaluation of healthcare provider attitudes toward organ donation after cardiac death. Crit Care Med. 2006;34(12):2952-8. https://doi.org/10.1097/01.CCM.0000247718.27324.65
• 12. Peltier JW, D'Alessandro AM, Hsu M, et al. A hi-erarchical communication model of the anteced-ents of health care professionals' support for dona¬tions after cardiac death. Am J Transplant. 2011;11(3):591-8. https://doi.org/10.1111/j.1600-6143.2010.03433.x
• 13. Bastami S, Matthes O, Krones T, et al. Systematic review of attitudes toward donation after cardiac death among healthcare providers and the general public. Crit Care Med. 2013;41(3):897-905. https://doi.org/10.1097/CCM.0b013e31827585fe
• 14. Rodríguez-Arias D, Tortosa JC, Burant CJ, et al. One or two types of death? Attitudes of health pro¬fessionals towards brain death and donation after circulatory death in three countries. Med Health Care Philos. 2013;16(3):457-67. https://doi.org/10.1007/s11019-011-9369-1
• 15. D'Alessandro AM, Peltier JW, Phelps JE. An em-pirical examination of the antecedents of the ac-ceptance of donation after cardiac death by health care professionals. Am J Transplant. 2008;8(1):193-200. https://doi.org/10.1111/j.1600-6143.2007.02019.x
• 16. Rodrigue JR, Luskin R, Nelson H, et al. Measuring Critical Care Providers' Attitudes About Con¬trolled Donation After Circulatory Death. Progress in Transplantation. 2018;28(2):142-50. https://doi.org/10.1177/1526924818765821
• 17. DuBois JM, Anderson EE. Attitudes toward death criteria and organ donation among healthcare per¬sonnel and the general public. Progress in Trans¬plantation. 2006;16(1):65-73. https://doi.org/10.1177/152692480601600113
• 18. Wind J, van Mook W, Dhanani S, van Heurn E. Determination of death after circulatory arrest by intensive care physicians: A survey of current practice in the Netherlands. J Crit Care. 2016;31(1):2-6. https://doi.org/10.1016/j.jcrc.2015.09.006
• 19. Aulisio MP, DeVita M, Luebke D. Taking values seriously: Ethical challenges in organ donation and transplantation for critical care professionals. Crit Care Med. 2007;35(2):95-101. https://doi.org/10.1097/01.CCM.0000252915.76019.19
• 20. DeVeaux TE. Non-heart-beating organ donation: Issues and ethics for the critical care nurse. J Vasc Nurs. 2006;24(1):17-21. https://doi.org/10.1016/j.jvn.2005.11.004
• 21. Kong AP, Barrios C, Salim A, et al. A multidisci-plinary organ donor council and performance im-provement initiative can improve donation out-comes. Am Surg. 2010;76(10):1059-62. https://doi.org/10.1177/000313481007601007
• 22. Garrison R, Bentley F, Raque G, et al. There is an answer to the shortage of organ donors. Surg Gy-necol Obstet. 1991;173(5):391-6.
• 23. Fugate JE, Stadtler M, Rabinstein AA, Wijdicks EFM. Variability in donation after cardiac death protocols: a national survey. Transplantation. 2011;91(4):386-9. https://doi.org/10.1097/TP.0b013e318204ee96
• 24. Morrissey PE, Monaco AP. Donation after circu-latory death: current practices, ongoing challenges, and potential improvements. Transplantation. 2014;97(3):258-64. https://doi.org/10.1097/01.TP.0000437178.48174.db