Journal of Qualitative Research in Health Sciences

Authors

Abstract

Introduction: Brain death is one of the greatest crises experienced by families who are faced with the decision of organ donation. Families of brain dead patients are faced with many psychological problems. Thus, the experiences of intensive care unit (ICU) nurses regarding the psychosocial status of family members of organ donating patients were studied in the present study.

Method: This qualitative study was conducted through phenomenological approach. The study participants consisted of 8 nurses of ICUs in Kerman, Iran, who were selected through purposive sampling. Subjects were assured of confidentiality of data and were able to leave the study any time they wished. Data were collected through open and semi-structured in-depth interviews until data saturation was achieved. All interviews were recorded, transcribed verbatim, and analyzed using Colaizzi's method.

Results: Through analysis and integration of codes, 3 main codes and 13 secondary codes were extracted. The main code of unknowns consisted of the secondary codes of ambiguity, anxiety, unknowns, and the reaction of family members. The main code of understanding the family’s critical situation contained the secondary codes of fear of remorse, the chances of recovery, others’ lack of approval, and obsessive thoughts. Moreover, the main code of understanding the cultural, social, and religious aspects consisted of the secondary codes of altruism, religious beliefs, growing up in difficult circumstances, interests and expectations, and emotional relationships.

Conclusion: The psychological problems of families of brain dead patients can be managed through the elimination of the unknown, understanding the critical situation of the family, and understanding their cultural, social, and religious status. In this way, these difficult stages can be passed in greater psychological tranquility.

Keywords

1-Range L , Rotherham A,. Moral distress among nursing and non-nursing students. Nursing ethics. (2010); 17(2),225-232. 2-Sevim, C. etal . Critical care nurses knowledge aboat the care of deceased adult patient in an intensive care unit . )2006(; 53-58. 3- Irving MJ, Tong A, Jan S, et al. Factors that influence the decision to be an organ donor: a systematic review of the qualitative literature. Nephrol Dial Transplant.( 2012) ;27(6):2526-33. 4-Badger,JM and B.OConnor. Moral discord, cognitive coping strategies, and medicalintensive care unit nurses insights from a focus group study. Critical care nursing quarterly.(2006); 29(2),147-151. 5-Cadge, W., E.Ecklund, and M.ShortReligion and spirituality: A barrier and a bridge in the everyday professional work of pediatric physicians. Social problems. . (2009); 56(4),702-721. 6-Corley M, Minick P, Elswick, R., & Jacobs, M. Nurse moral distress and ethical work environment. Nursing Ethics(2005); 12(4), 381-390. 7-Hosseainrezaei, Hakimeh. et al. Psychological Symptoms in Family Members of Brain Death in Intensive Care Unit in Kerman, Iran. Patients Global Journal of Health Science. (2014).; l. 6) 2(:123-127. 8- Brown H, Edelman R: Project 2000: A study of expected and experienced stressors and support reported by students and qualified nurses. J Adv Nur 2000; 31:857–864 9- Iranmanesh S, HosseinRezaei H, Hossein Rafiei, Hasan Eslami1. Critical care nurses’ moral distress in South-East of Iran Asian J. Nur. Edu. and Research 3(3): July-Sept., 2013; 129-133 10-Mobley M,Rady M, Verheijde J, Patel B, & Larson, J. The relationship between moral distress and perception of futile care in the critical care unit. Intensive and Critical Care Nursing, (2007); 23, 256-263. 11- Jack de G, Myrra VD, Cornelia H, et al. Decision making by relatives about brain death organ donation: an integrative review. Transplantation 2012;93(12):119-211. 12-Patrick, K., & Lavery, J. Burnout in nursing. Australian Journal of Advanced Nursing, (2007); 24(3), 43-49. 13-PaulyB, Varcoe C, Storch J, & Newton, L. Registered Nurses' perceptions of moral distress and ethical climate. Nursing Ethics, . (2009); 16(5), 561-572. 14-Paul eric marik. multyorgano dysfunction syndrome. handbokk evidence based critical care. 2010. ; Part 7,593-597 15 Fumis RR, Deheinzelin D.) (2009Family members of critically ill cancer patients: assessing the symptoms of anxiety and depression. Intensive Care Med. 2009;35(5):899-902 16- Jacoby L,H Breitkopf CR, Pease EA. Aqualitative examination of the needs of families faced with the option of prgan donation . Dimens crit care nurs. (2005); 24 (4) , 183-189 17- Exley M,White N, Martian JH, .Why families say no to organ donation?CritCareNurs(2002): 22 (6).44-5 18-Rice E, Rady M, Hamrick A, Verheijde J., &Pendergast, D. Determinants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital. Journal of Nursing Management.(2008);16, 360-373. 19-Storch J.L, N Kenny. Shared moral work of nurses and physicians. Nursing ethics.(2007);14(4),478-491. 20-Urden l D,stacy k M, lough mE. Critical care nursing:diagnosis and management.2010; 6th ed.st Louis:mosby Elsevier,3-12. 21-. Paparrigopoulos T, Melissaki A, Efthymiou A, et al. Short-term psychological impact on family members of intensive care unit patients. J Psychosom Res. 2006;61(5):719- 722 22- Long T, SqueM and Addington-Hall J. What does a diagnosis of brain death mean to family members approachedabout organ donation? A review of the literature. Prog Transplant 2008; 18(2): 118–126. 23- Siminoff LA, Gordon N, Hewlett RM . Factor in fluencing families consent for donation of solid organ of transplantation . JAMA (2001) ;286(1). 71-77 24-Sque M,Long T,Payne S. Organ Donation : key factors influencing families decision making . Transplatation Proceeding .(2005);.37. 543-546 25--Donald R, Sullivan, Xinggang Liu, D, Douglas S. Corwin, , Avelino C. Verceles, , Michael T. McCurdy. Learned Helplessness Among Families and Surrogate Decision-Makers of Patients Admitted to Medical, Surgical, and Trauma ICUs. Chest. 2012 ;Dec; 142(6): 1440–1446. Published online 2012 May 31. doi: 10.1378/chest.12-0112