To achieve effective communication with organ donor family: Key points from the Chinese expert consensus working group
Wenshi Jiang1,6, Wujun Xue2, Qifa Ye3, Zhonghua Chen4, Qiang Fang5, Xiaotong Wu6, Yue Wang7, Xiao Xu8, Haifeng Wang9, Xuyong Sun1, Li Li10, Min Gu11.
1The Second Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China; 2The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China; 3Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China; 4Tongji Hospital Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People's Republic of China; 5The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China; 6Shanxi Provincial Organ Procurement and Allocation Center, Taiyuan, People's Republic of China; 7Peking University, Beijing, People's Republic of China; 8Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China; 9The First Bethune Hospital of Jilin University, Changchun, People's Republic of China; 10The First Hospital of Kunming, Kunming, People's Republic of China; 11The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
Working Group of Consensus on Communication with Families of Organ and Tissue Donors.
Introduction: It has been a decade since China launched the national program for voluntary deceased organ donation (OD). While progress has been observed, the OD rate (donors per million population, DPMP) remains relatively low at only 3.73 in 2021, indicating that there is much room for improvement. Communication is a continuous action that is vital throughout the organ and tissue donation process. This study aims to explore both theoretical and practical measures to enhance effective communication with the family members of potential organ and tissue donors to increase the OD rate so as to achieve self-sufficiency for organ transplantation (OT) in China.
Method: Professionals with multidisciplinary backgrounds, representatives from the Red Cross Society, and representatives of donor’s families jointly conducted literature reviews, expert consultations, and comprehensive discussions regarding the identification of issues and solutions for achieving effective communication with the family of potential organ and tissue donors. The consensus was reached through three rounds of Delphi voting, and recommendation grade of each element was determined through the GRADE method.
Results: Firstly, the progress of the deceased organ donation program in China was reviewed, current problems of family communication were summarized. Then, a consensus was developed, which includes 18 key elements for facilitating effective communication. The definition and principles of effective communication and suggestions on the preparation before communication, the best timing and environment for communication were given. Additionally, guidance on the attitude, manner and content of communication, as well as corresponding suggestions in the face of family objection were included. We also weigh the influences of Chinese traditional culture and religion on families’ opinions. In terms of the professionalism, contents about training for practitioners, metrics to measure effective communication, as well as topics of suggested scientific research were added. Moreover, recommendations for care and service for the donor family reflect the humanistic concern.
Conclusion: This expert consensus is the first guideline focusing on the communication issues with the families of potential donors in China. The consensus aims at improving awareness of organ donation among the public and medical professionals. Through providing recommendations for clinical practice can be developed towards standardization and scientization with high quality.
