京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19226号 / 医博第4025号 / 新制||医||1011(附属図書館) / 32225 / 京都大学大学院医学研究科医学専攻 / (主査)教授 福田 和彦, 教授 木村 剛, 教授 三嶋 理晃 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19556号 / 医博第4063号 / 新制||医||1012(附属図書館) / 32592 / 京都大学大学院医学研究科医学専攻 / (主査)教授 小池 薫, 教授 福田 和彦, 教授 三嶋 理晃 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Denna studie ämnade att undersöka hur en webbapplikation för välgörenhetsdonationer, kunde utformas så att en användare upplever den som intresseväckande, lättnavigerad och tillförlitlig. Utvecklingen av denna webbapplikation delades upp i två iterationer med två användartest och resultaten jämfördes. De tre fokusområdena fick alla goda resultat i användartest 1 och resultatet förbättrades ytterligare till det andra användartestet. Det mest intressanta resultatet var den upplevda tillförlitlighetens stora positiva förändring. Studien kom fram till att det är viktigt att användaren ”vet vart de kan gå” för att uppnågod navigerbarhet på webbapplikationer avsedda för att skänka pengar till välgörenhetsorganisationer. Det är dessutom viktigt för den här typen av webbapplikation att ge ett gott första intryck och att den innehåller flera unika funktioner för att den ska ses som intresseväckande. Att betalningsprocessen är väl utformad och att webbapplikationen använder kända logotyper är viktigt för att den ska upplevas som tillförlitlig. / This study aimed to examine how a web application for charity donations can be designed in such a way that a user would assess the application as being navigable and trustworthy, as well as having an interesting design. The development process was split into two iterations with two user tests and the results were compared. The three focus areas all received good results in the first user test and all of them improved their results in the second user test. The most interesting result was the major increase of the perceived trustworthiness. The study concluded that it is important, for the user, to ”know where they can go” to achieve good navigability on web applications meant for donating money to charities. To be considered interesting, it is also important for this type of web application to make a good first impression and that it contains many unique functions. That the payment process is well designed and for the web application to use known logos are important for it to appear trustworthy.

Donating to charity is a phenomenon found in cultures and religions worldwide. Studies have examined how to attract donors, get them to engage, and eventually make a donation. But what happens after? The post-donation part of the process is less explored and often lacking in transparency toward the donor; where did the donation go, and how can the donors make sure it reaches the intended beneficiaries? This study investigated how post-donation transparency can enhance the user experience of donating money by identifying the donor’s needs and desires post-donation and fulfilling them in a design proposal. The Double Diamond model of design and its four phases were chosen to achieve this. In the first two phases, Discover and Define, the problem space was explored and defined through a literature study and initial interviews. The interview data was analyzed through the Affinity Diagram method resulting in two ”How might we”-questions. The needs and desires of users were also identified at this stage. A brainstorming session based on the ”How might we”-questions initiated the following, and last phases Develop and Deliver. Prototypes of different levels of fidelity were then created and tested on both users and experts before finally landing in a design proposal. Results showed that the elements added for creating post-donation transparency were appreciated by users and experts alike. A high score from a UMUX-LITE usability test suggested that the prototype was usable, elements in the prototype were pointed out for achieving transparency, and all participants expressed positive feelings after using the prototype. Therefore, the prototype was concluded to have achieved post-donation transparency within the frames of this study. Further studies are recommended as the final prototype was never tested on users. The hope is that more tests would give a better understanding of how user needs and desires could be achieved post-donation. / Att donera till välgörenhet är ett fenomen som hittas i kulturer och religioner över hela världen. Studier har undersökt hur man kan rekrytera donatorer, få dem att engagera sig och så småningom göra en donation. Men vad händer sen? Tiden efter donation är mindre utforskad och saknar ofta transparens gentemotgivaren; vart tog donationen vägen och hur kan givarna ta reda på om pengarna når fram? Denna studie har undersökt hur transparens i processen efter genomförd donation kan förbättra användarupplevelsen av att donera pengar genom att identifiera givares behov och önskemål och uppfylla dem i ett designförslag. Metoden Double Diamond med dess fyra faser valdes för att uppnå detta. I de två första faserna Discover och Define utforskades och definierades problemområdet genom en litteraturstudie och intervjuer. Intervjudatan analyserades med Affinity Diagram-metoden vilket slutligen landade i två ”How might we”-frågor. Användarnas behov och önskemål identifierades också i det här stadiet. En brainstorming-session baserad på ”How might we”-frågorna initierade de två sista faserna Develop och Deliver. Prototyper med olika detaljnivå skapades sedan och testades på både användare och experter innan ett designförslag slutligen kunde tas fram. Resultaten visade att de element som adderats för att skapa transparens efter donation uppskattades av både användare och experter. En hög poäng från ett UMUX-LITE användbarhetstest antydde att prototypen var användbar, element i prototypen pekades ut för att inge en känsla av transparens och alla deltagare uttryckte positiva känslor efter att ha använt prototypen. Därför ansågs prototypen att ha uppnått transparens efter genomförd donation inom ramarna för denna studie. Ytterligare studier bör genomföras då den slutliga prototypen aldrig testades på användare. Förhoppningarna är att fler tester skulle ge en bättre förståelse för hur användarnas behov och önskemål skulle kunna förverkligas i processen efter en genomförd donation.

Syftet med denna litteraturstudie är att belysa sjuksköterskors upplevelser av och attityder till organdonation. En donationsprocess börjar med ett dödsfall och slutar med en transplantation och förhoppningsvis en chans till nytt liv. Många anhöriga kan känna det som en tröst i sorgen att deras anhörige har hjälpt till att ge liv åt någon annan människa. Sverige har låga siffror av tillgängliga medicinskt lämpliga donatorer. Under 2005 avled 128 donatorer i Sverige och i september 2006 väntade 571 personer på ett eller flera organ. Sjuksköterskan är en kritisk länk mellan familjen och transplantationsteamet med möjlighet att identifiera potentiella organdonatorer. Sjuksköterskor kan känna en olust inför att närma sig anhöriga till avlidna, vilket kan bero på att man tror att detta tillför mer sorg i den ofta krisfyllda och chockartade situationen. För att sjuksköterskor som arbetar med dessa frågor skall känna sig bekväma i situationen och våga ta frågan till de anhöriga så måste det finnas support för dem. / The aim of this literature review is to highlight nurse’s experience of and attitudes towards organ donation. A donation process starts with bereavement and ends with transplantation and hopefully a chance to a new life. Several relatives can find comfort in knowing that their loved one has helped give life to another human being. Sweden has a low rate of available medically suited donors. During 2005, 128 donors died in Sweden and in September 2006 a total of 571 patients were waiting for one or several organs for transplant. The nurse is a critical link between the family and the transplant team with the ability to identify potential donors. Nurse’s can feel a discomfort when approaching families in grief, which can be because they believe that they add to the distress. To make nurses feel comfortable in the stressful situation and to give them the needed tools to approach families with the question about donation, there must be support and education for them.

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Background: Organ donation is crucial for the survival of many patients that are waiting for a transplant. Considering that the need for organs is often greater than the supply, it is important that the intensive care providers identify and diagnose potential donors. The intensive care nurse has a central role in the donation process. Caring for a potential donor involves respecting the donor's will and preserving the dignity that the body possesses. It is of great importance that the intensive care nurse feels familiar with the donation process and feels secure in their professional role.  Purpose: The purpose of this study was to describe the nurses' experiences of caring for a potential organ donor in an intensive care unit.  Method: A literature review with a qualitative approach is conducted. 13 scientific articles from two different databases were reviewed and analyzed. The data was analyzed according to Bettany-Saltikov and McSherry's (2016) model in nine steps.  Results: The results show that caring for a potential organ donor can result in experiences of emotional stress. Emotions such as sadness, anxiety, stress, fear, anger and hopelessness arise in connection with caring for a potential organ donor. Trusting the diagnosis brain death was very difficult for the intensive care nurses, this made the work more difficult and ethically challenging. In addition, interprofessional collaboration and training around (donation after brain death) DBD were essential in care. Although the donation process could be experienced as emotionally stressful, the intensive care nurse can experience feelings of meaning.  Conclusion: From the results of this study it can be concluded that the donation process is perceived as complex. The intensive care nurses describe the donation process as a stressful task that challenges their professional role and competence. Despite care in this capacity being characterized by emotional and existential challenges, the nurses care for the donor's body and preserve its dignity.

Background: The demand for organ donation is increasing but there is always a lack of organ donor supply. To receive an organ donation, specific criteria must be met. Matching criteria between the donor and the recipient is critically important. The likelihood of having a capable organ increases when the donors and recipients have the same ethnicity. However, the number of organ donors differ significantly based on ethnicity. Purpose: The purpose of this literature review was to explore the impact of cultural background and education among the Asian and non-Hispanic White population on organ donation and how it impacts individuals' decisions on becoming organ donators. Methods: To explore the impact of cultural background and education on the Asian and non-Hispanic White population regarding organ donation, a literature review was conducted. The databases including, CINAHL Plus with Full Text and MEDLINE were utilized. Google Scholar was used for additional articles related to the topic. The time frame of the articles was from January 2012 to January 2022, a ten-year frame. Results: Overall, the Asian population had a lower deceased organ donation rate and registration rate in comparison to the non-Hispanic White population. The factors that contributed to low organ donation and registration include traditional religion, lack of knowledge, miscommunication, mistrust in the healthcare system, and consideration of family members' attitudes. Conclusion: Organ donation and registration rates remain low in the Asian population in comparison to the non-Hispanic White population due to several barriers related to their cultural background. Thus, it is critical to educate the patients and their family members regarding organ donation to increase the organ donation and registration rate.

Bakgrund: Patienter som utvecklar en total hjärninfarkt kan bli aktuella för organdonation. Organdonationsprocessen ställer krav på intensivvårdssjuksköterskan som innefattar att vårda organen och möta närstående i sorg. Att samverka i team är grundläggande för organdonationsprocessen. Syfte: Syftet med studien var att beskriva intensivvårdssjuksköterskornas erfarenhet av att vårda en patient som sedan blir en organdonator.  Metod: En kvalitativ studie där tio intensivvårdssjuksköterskor intervjuades. Datamaterialet analyserades med en kvalitativ innehållsanalys. Resultat: Intensivvårdssjuksköterskorna arbetar aktivt med att finna potentiella organdonatorer. Det praktiska vårdandet innefattar provtagningar och undersökningar, vilket ska ske inom en begränsad tidsram. Teamarbetet beskrivs av intensivvårdssjuksköterskorna som betydelsefullt och transplantationskoordinatorn beskrivs som en expert gällande organdonation. En utmaning under organdonationsprocessen är att få närstående att acceptera och förstå att patenten är avliden.  Konklusion: Potentiella organdonatorer identifieras snabbt inom intensivvården. Organdonationsprocessen sker dock sällan och intensivvårdssjuksköterskorna har svårt att få en rutin i processen. Närstående ska få vara delaktiga i diagnostik och vårdandet. Intensivvårdssjuksköterskorna vill inte skilja på vården av organdonatorer från andra patienter och ser organdonation som positivt. / Background: Patients who develop a total cerebral infarction may be candidates for organ donation. The organ donation process places demands on the intensive care nurse, which includes caring for the organs and meeting relatives in grief. Collaboration in teams is fundamental to the organ donation process. Purpose: The purpose of the study was to describe intensive care nurses' experiences of caring for a patient who then becomes an organ donor. Method: A qualitative study in which ten intensive care nurses were interviewed. The sample were analyzed with a qualitative content analysis. Results: The intensive care nurses work actively to find potential organ donors. The practical care includes sampling and examinations, which must take place within a limited time frame. Teamwork is described by intensive care nurses as important, and the transplant coordinatoris described as an expert in organ donation. A challenge during the organ donation process is getting relatives to accept and understand that the patient is deceased. Conclusion: Potential organ donors are quickly identified within intensive care. However, the organ donation process rarely occurs and the intensive care nurses’ have difficulty establishing a routine in the process. Relatives should be involved to participate in diagnostics and care. The intensive care nurses do not want to differentiate between the care of organ donors and from other patients and see organ donation as positive.