Facilitating aspects and barriers in the effectiveness of donation of organs and tissues

Freire, Izaura Luzia Silvério; Vasconcelos, Quinídia Lúcia Duarte de Almeida Quithé de; Melo, Gabriela de Sousa Martins; Torres, Gilson de Vasconcelos; Araújo, Ednaldo Cavalcante de; Miranda, Francisco Arnoldo Nunes de

doi:10.1590/0104-07072014002350013

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Original Article • Texto contexto - enferm. 23 (4) • Dec 2014 • https://doi.org/10.1590/0104-07072014002350013 copy

Facilitating aspects and barriers in the effectiveness of donation of organs and tissues¹ 1 Extract from thesis - Factors associated with the effectiveness of donation of organs and tissues for transplantation. Postgraduate Program in Nursing, Universidade Federal do Rio Grande do Norte (UFRN), 2013.

Facilitadores y barreras en la eficacia de la donación de órganos y tejidos

Authorship SCIMAGO INSTITUTIONS RANKINGS

This study aims to ascertain the influence of the structure and process on the effectiveness of donation of organs and tissues. It is an evaluative, longitudinal study, with a quantitative approach, undertaken in six hospitals of Natal-RN, with 65 potential donors. The data collection instrument was a structured script of non-participant observation. The data were analyzed using descriptive statistics and the application of the Chi-squared, Fisher, and Mann Whitney tests. The effectiveness of donation was 27.7%. No significant difference occurred between structure and effectiveness of donation, however, inadequacies were observed in the physical resources (36.9%), material resources (30.8%), organizational structure (29.2%), and human resources (18.5%). In the process, the phases of maintenance (p=0.004), diagnosis of brain death (p=0.032), family interview (p≤0.001) and documentation (p=0.001) presented significant differences with effectiveness. The adequacy of the factors related to the structure and process is associated with the effectiveness of the donation. Improvement of these indices depends on the speed with which the process is conducted, in addition to the adequate structure.

Nursing; Health services evaluation; Effectiveness; Tissue and organ procurement

Structure of the hospital units		Effectiveness of the donation
		Donor		Non-donor		Total		χ2 p
		n	%	n	%	n	%	χ2 p
Physical resources	Adequate	12	18.5	29	44.6	41	63.1	0.711
Physical resources	Inadequate	6	9.2	18	27.7	24	36.9	0.711
Material resources	Adequate	13	20.0	32	49.2	45	69.2	0.746
Material resources	Inadequate	5	7.7	15	23.1	20	30.8	0.746
Human resources	Adequate	14	21.5	39	60.0	53	81.5	0.436^*
Human resources	Inadequate	4	6.2	8	12.3	12	18.5	0.436^*
Organizational structure	Adequate	13	20.0	33	50.8	46	70.8	0.873
Organizational structure	Inadequate	5	7.7	14	21.5	19	29.2	0.873

Process of donation		Effectiveness of the donation						χ2 p	OR
		Donor		Non-donor		Total
		n	%	n	%	n	%
Identification and notification	Adequate	12	18.5	30	46.2	42	64.6	0.831	-
Identification and notification	Inadequate	6	9.2	17	26.2	23	35.4	0.831	-
Evaluation	Adequate	10	15.4	21	40.0	31	52.3	0.986	-
Evaluation	Inadequate	8	12.3	26	32.3	34	47.7	0.986	-
Maintenance	Adequate	12	18.5	13	20.0	25	38.5	0.004	1.6
Maintenance	Inadequate	6	9.2	34	52.3	40	61.5	0.004	1.6
Diagnosis of brain death	Adequate	11	16.9	15	23.1	26	40.0	0.032	1.4
Diagnosis of brain death	Inadequate	7	10.8	32	49.2	39	60.0	0.032	1.4
Family interview	Adequate	17	26.2	17	26.2	34	52.4	≤0.001^*	1.9
Family interview	Inadequate	1	1.4	30	46.2	31	47.6	≤0.001^*	1.9
Documentation of brain death	Adequate	05	7.7	01	1.5	06	9.2	≤0.001^*	11.5
Documentation of brain death	Inadequate	13	20.0	46	70.8	59	90.8	≤0.001^*	11.5

Factors		Effectiveness of the donation						χ2 p	OR
		Donor		Non-donor		Total
		n	%	n	%	n	%
Structure	Adequate	12	18.5	29	44.6	41	63.1	0.711	-
Structure	Inadequate	6	9.2	18	27.7	24	36.9	0.711	-
Process	Adequate	6	9.2	1	1.5	7	10.8	0.001^*	5.5
Process	Inadequate	12	18.5	46	70.5	58	89.2	0.001^*	5.5

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] Correspondence: Izaura Luzia Silvério Freire Rua São João, 1233, ap. 601, bloco A 59022-390 - Natal, RN, Brazil E-mail: izaurafreire@hotmail.com