医院住院患者对器官移植与捐献的意愿调查

目的了解医院住院患者对器官移植与捐献相关领域的认知情况和态度。方法通过自编调查问卷形式,以医院住院患者为对象进行问卷调查。内容包括一般信息、对器官移植与捐献的认知和态度,并分析影响器官移植和捐献、对移植和捐献关注的问题以及捐献方式的影响因素。数据结果以SPSS 18.0进行分析。结果本次调查共发放问卷1 000份,回收973份,有效问卷906份,有效率为93.1%。906份有效问卷中,788例(87.0%)患者听过器官移植,118例(13.0%)未听过器官移植;189例(20.9%)有移植亲属,717例(79.1%)无移植亲属;511例(56.4%)愿意接受器官移植,226例(24.9%)不愿意,169例(18.7%)不知道;490例(54.1%)同意器官捐献,173例(19.1%)不同意,243例(26.8%)不知道。性别因素对器官移植(P=0.299)和捐献(P=0.327)的意愿均无影响,年龄、学历、职业、是否听过器官移植及是否有移植亲属对器官移植和捐献的意愿均有影响(P<0.01)。性别因素对关于器官移植(P=0.727)和器官捐献(P=0.935)关注问题均无影响,年龄、学历、是否听过器官移植、是否有移植亲属对器官移植和捐献后关注的问题均有影响(P<0.01)。对器官移植手术最关注的问题依次为:是否有可供移植的器官占28.7%(260/906),术后生活质量占23.0%(208/906),手术风险占21.5%(195/906),手术费用占19.5%(177/906),术后排斥反应占7.3%(66/906)。器官捐献后最关注的问题依次为:捐献器官的合理应用占57.4%(520/906),亲属的态度占23.8%(216/906),捐献补偿占17.6%(159/906),其他占1.2%(11/906)。捐献方式上,403例(44.4%)愿意接受心脏死亡器官捐献(DCD),257例(28.4%)愿意接受脑死亡器官捐献,246例(27.2%)愿意接受活体器官捐献。性别、学历和职业对捐献方式有影响(P<0.05),而年龄、是否听过器官移植和是否有移植亲属对捐献方式无影响(P>0.05)。结论对器官移植宣传的不足和高昂的移植费用是制约器官移植接受率的主要因素,随着时间推移、全民教育水平的不断提高和加强对器官移植的广泛宣传,器官移植的接受率将呈现不断增高的趋势。目前医院患者普遍接受的器官捐献方式仍然是DCD。建立一个合理运作的捐献器官分配体系和适当的捐献补偿机制是促进器官捐献事业发展的关键。

Questionnaire Analysis of Attitude Towards Organ Transplantation and Donation in Inpatients

Objective To get the information about the cognition and attitude towards organ transplantation and donation in inpatients.Methods The inpatients were investigated by using a self-designed questionnaire,including general data,cognition and attitude towards organ transplantation and donation.The influence factors of organ transplantation and donation were analyzed by SPSS 18.0.Results A total of 1 000 questionnaires were delivered,973 returned,the effective questionnaire was 906,and the effective rate was 93.1%.In 906 valid questionnaires,788(87.0%)patients knew organ transplantation;189(20.9%)patients had transplanted relatives;511(56.4%)patients were willing to accept the organ transplant surgery,226(24.9%)patients did not want,169(18.7%)patients did not know;490(54.1%)patients agreed to donate organ,173(19.1%)patients disagreed,243(26.8%)patients did not know.The age,education,occupation,knowing organ transplants,and with organ transplanted relatives or not had significant influences to the willingness towards organ transplantation and donation(P<0.01).The gender had no effect on organ transplantation(P=0.727)and donation(P=0.935)concerned issues,but the age,education,knowing organ transplantation,and with organ transplanted relatives or not had significant influences on it(P<0.01).Most concerned factors about organ transplantation were as follows:with an available organ for transplantation〔28.7%(260/906)〕,postoperative quality of life〔23.0%(208/906)〕,risk of surgery〔21.5%(195/906)〕,surgery costs〔19.5%(177/906)〕,and postoperative rejection〔7.3%(66/906)〕.Most concerned factors about organ donation were as follows:the reasonable usage of donated organs〔57.4%(520/906)〕,attitude of relatives〔23.8%(216/906)〕,and donation compensation〔17.6%(159/906)〕,and others〔1.2%(11/906)〕.According to the way of organ donation,403(44.4%)patients were willing to accept donation after cardiac death(DCD),257(28.4%)patients accept donation after brain death,246(27.2%)patients accept living organ donation.The gender,education,and occupation had significant influences on the way of organ donation(P<0.05),but age,knowing organ transplantation,and with organ transplanted relatives or not had no effects on it(P>0.05).Conclusions The lack of propaganda and the high costs of transplantation surgery are the main factors restricting the acceptance rate of organ transplantation.Over time,with continuous improvement of universal education and strengthening the publicity of organ transplantation,the acceptance rate will show a constant increase in the trend.By now,the most accepted way of organ donation is DCD in inpatients.The establishment of a reasonable organ allocation and compensation system is a corner stone to promote organ donation.