Thesis (D. Min.)--Ashland Theological Seminary, 2006. / Abstract. Includes bibliographical references (leaves 157-162, 222-226).

Made available in DSpace on 2016-08-18T17:27:37Z (GMT). No. of bitstreams: 1 DISSERTACAO HELOISA ROSARIO.pdf: 8090200 bytes, checksum: 47b52c85281674379ce0ebaca4796683 (MD5) Previous issue date: 2015-07-13 / FUNDAÇÃO DE AMPARO À PESQUISA E AO DESENVOLVIMENTO CIENTIFICO E TECNOLÓGICO DO MARANHÃO / In Maranhao, donation, organs and tissues transplatation process began in 2000 with the creation of Transplant Center and the execution of the first kidney and cornea transplant. However, organization, operation and evolution of this service needs new perspectives and practices to raise the number of organs and tissues donations. Before that, we asked: which instruments, tools and strategies can be used to increase the number of potential and effective donors of organs and tissues in Maranhão? The research objective was building innovative measures aimed at increasing notifications, donations and transplants in Maranhão from the active participation of the actors involved in the donation, capture and organ transplantation process. The investigation was guided by Convergent Care Research, with a qualitative approach, and it involved 50 participants between five hospitals technicians (03 public and 02 private) from services related to donation and organ transplantation process (Intra-Hospital Transplant Commissions, Eye Bank, Transplantation Center, Intensive Care and Urgent and Emergency Services). It also involved managers of these hospitals and from Secretaria Municipal de Saúde de São Luís MA (health's secretary, control superintendent, beds evaluation, audit and regulation, beds Regulation Center coordinator) and Prosecutor's Office. Wheel conversations, focus groups and individual meetings were strategies to data collection, and it had identified limitations and build strategies and interventions to donation and organ transplantation process. Interventions were product of participant s collective work and it has been organized in three dimensions: institutional; technical-professional and social mobilization. As a result of interventions, we had the following changes in organ and tissue donation s process from Maranhão: increase in deaths and brain death notifications; more hospitals closing brain death protocol; increase in closed brain death protocols; completion time s reduction in brain death protocol; greater interaction between Transplantation Center and notifiers hospitals; Intra-Hospital Transplant Commissions implementation and reactivation; cooperative and collaborative work between Central, Eye Bank and the Intra-Hospital Transplant Commission; increase in donations and transplants. The interventions produced positive results in donation and cornea and kidney s transplants. From 2013 to 2014, Maranhão occupied the 19th position in kidney transplant and 21th position in cornea transplant. Advances were achieved by research in May 2015, so the state began occupying the 17th position in the kidney transplant and the 18th position in cornea transplant. It focused effectively on Maranhão performance in national ranking of kidney and cornea transplant. The disruption of institutional borders via interventions in the process of donation and transplant of organs and tissues by social mobilization represented a significant evolution in the increase in the number of donations and, consequentely, of transplants of organs and tissues. / No Maranhão o processo de doação e transplante de órgãos e tecidos foi iniciado em 2000 com a criação da Central de Transplante e a realização do primeiro transplante de rim e córnea. Porém no ranking Nacional até 2014 o Maranhão ocupava a penúltima posição com relação ao número de transplante de córnea e o último lugar em transplante de rim. Evidenciando que a organização e a operacionalização desse serviço carece de novas perspectivas e práticas para evoluir e elevar o número de doações de órgãos e tecidos. Em face disso questionou-se: que instrumentos, recursos e estratégias podem ser utilizados para aumentar o número de doadores possíveis e efetivos de órgãos e tecidos no Maranhão? O objetivo da pesquisa foi construir, a partir da ativa participação dos atores envolvidos no processo de doação, captação e transplante de órgãos, medidas inovadoras visando o aumento das notificações, doações e transplantes no Maranhão. Guiada pela Pesquisa Convergente Assistencial com abordagem qualitativa a investigação envolveu 50 participantes entre técnicos de cinco hospitais (03 públicos e 02 privados) dos serviços ligados com o processo de doação e transplante de órgãos (Comissão Intra-hospitalar de Transplante, Banco de Olhos, Central de Transplante, terapia intensiva e serviços de urgência e emergência) assim como gestores dessas instituições hospitalares e da Secretaria Municipal de Saúde de São Luís MA (Secretária de Saúde, Superintendente de Controle Avaliação, Auditoria e Regulação de Leitos, Coordenadora da Central de Regulação de Leitos) e Promotoria da Justiça. Rodas de conversas, grupos focais e encontros individuais foram estratégias utilizadas para a coleta de dados que permitiram identificar limitações e construir estratégias e intervenções para o processo de doação e transplantes de órgãos. As intervenções foram produto do trabalho coletivo dos atores e foram organizadas sob três dimensões: institucional; técnica-profissional e de mobilização social. Como resultado das intervenções ocorreu as seguintes mudanças no processo de doação de órgãos e tecidos do Estado do Maranhão: aumento das notificações de óbitos e de morte encefálica; maior número de hospitais concluindo protocolo de morte encefálica; aumento no número de protocolos de morte encefálica concluídos; redução no tempo de conclusão de protocolo de morte encefálica; maior interação da Central de Transplante com hospitais notificadores; implantação e reativação de Comissões Intra-hospitalares de Transplantes; trabalho cooperativo e colaborativo entre a Central, o Banco de Olhos e as Comissões Intra-hospitalares de Transplantes; aumento do número de doações e transplantes. As intervenções produziram resultados positivos na doação e transplantes de córneas e rim. De 2013 a 2014 o Maranhão ocupava a 19ª posição em transplante de rim e a 21ª no transplante de córneas. Com os avanços decorridos pela pesquisa em maio de 2015 o Estado passou a ocupar a 17ª posição no transplante de rim e 18ª em transplante de córneas incidindo eficazmente no desempenho do Maranhão no ranking Nacional de transplante de rim e córnea. O rompimento das fronteiras institucionais por meio de intervenções no processo de doação e transplante de órgãos e tecidos pela mobilização social representou uma evolução significativa no crescimento dos números de doações e, consequentemente, transplantes de órgãos e tecidos.

Bakgrund: Anledningen till att en individ kan ha ett behov av en ny njure är att individen lider av någon form av kronisk njursvikt. Patienter som idag har ett behov av njurtransplantation får patienten oftast vänta mellan ett till tre år på att få en ny njure. Syfte: Syftet med denna studie är att sammanställa forskning om individens upplevelser i samband med njurdonation. Metod: En litteraturstudie baserad med 14 vetenskapliga artiklar av både kvantitativ och kvalitativ ansats hämtade från databaserna CINAHL och PubMed. Resultat: Presentation av de åtta kategorier av upplevelser inför och efter en njurdonation. Dessa var: Upplevelser av ambivalens och behov av stöd kring beslut att donera Behov av information inför beslut att donera, Att fatta ett beslut om donation, Att se sin närstående lida, Oro och stress inför operation, Smärta, Individuella upplevelser efter donation och Missnöje med uppföljningen. Slutsats: Donation beskrivs vara en handling som leder till en känsla av lycka och stolthet hos individen som donerat sin ena njure. Det fanns i vissa fall en viss oro för den egna hälsan och smärta efter operationen, men trots detta har erfarenheten att donera varit positiv. De som donerat har inte ångrat sig och kan tänka sig att donera igen om de skulle få frågan en gång till. / Background: The reason why a person may need a new kidney is that the person suffers from some form of chronic renal failure. Patients who currently have a need for kidney transplantation the patient usually have to wait between one to three years to get at a new kidney. Aim: The aim of the study is to compile research on the individual´s experiences in connection with renal donation. Method: A literature review based on 14 scientific articles with both quantitative and qualitative approach found in the databases CINAHL and PubMed. Result: Presentation of the eight categories of experiences before and after renal donation. These were: experiences of ambivalence and the need for support for decision making, need for information prior to decision to donate, to make a decision on donation, to see your relatives suffering, anxiety and stress before surgery, pain, individual experiences after donation and dissatisfaction with the follow-up. Conclusion: Donation seems to be an act that donor´s leads to a sense of happiness and proudly to help a close relative. In some cases there was anxiety about one´s own health and pain after surgery, but despite that, the experience of donating has been positive. Donors have not in their decision to donate not regret it and many would make the same decision again if they were asked.

Thesis (M. A. (Clinical Psychology)) -- University of Limpopo, 2019 / Demographical factors affect the way people perceive, conceptualise and make meaning of their daily living experiences, which in turn influence their decision-making abilities in certain situations. Therefore, perceptions and conceptualisations, together with the associated attitudes to organ donation, were defined and understood in participants’ socio-cultural context. A qualitative study was conducted among the African elderly community members of Madibaneng Village (Sekhukhune District), Limpopo Province (South Africa) to explore perceptions of organ donation. African elderly community members were selected using purposive sampling, after ethical clearance from the University and gate-keepers’ permission from the Tswako-Lekentle traditional council had been obtained. Six (6) males and six (6) females were interviewed. Data was collected using semi-structured interviews and analysed using the thematic analysis method. The following psychological themes and subthemes emerged from the study: African elderly community members’ understanding and knowledge about organ donation (inadequate knowledge and lack of awareness); community members’ feelings about organ donation; African elderly community members attitudes to organ donation (family dynamics relating to organ donation, culture and organ donation and psychological aspects of organ donation), and participants’ perceptions of those living with donated organs. The findings revealed that multiple demographical factors affect and influence people’s perceptions of organ donation. The study revealed that 80% of the elderly community members expressed some positive perceptions about the process of organ donation; however, some of the participants expressed conflicting factors that might affect their ultimate decision about becoming donors, such as associated psychological aspects. Other participants portrayed a negative perception that was more likely to have been affected by cultural factors, their family dynamics, belief systems and other social factors in their context. The findings from the current study emphasise that there is a need for effective awareness campaigns to curb the levels of illiteracy and inadequacy in knowledge concerning the subject of organ donation and to incorporate the demographical factors of particular social contexts in the healthcare system and related policies.

Bakgrund: Varje år dör folk i väntan på organ- och vävnadsdonation. När en person avlider av total hjärninfarkt blir denne under rätt förutsättningar en möjlig donator. Organ- och vävnadsdonationsprocessen är en process som oftast ses som plötslig och främmande för de närstående. Närstående är involverade under hela donationsprocessen och de blir en del av omvårdnaden, något sjuksköterskan måste ta i beaktande. Syfte: Att belysa närståendes upplevelser av donationsprocessen. Metod: En litteraturöversikt baserad på kvalitativa artiklar där tio vetenskapliga originalartiklar analyserades. Resultat: Resultatet presenteras i två huvudteman: Yttre faktorer och Inre faktorer med två subteman tillhörande vardera huvudtema: vårdmiljö och tid, socialt stöd, bristande förståelse och att känna sig bortglömd. Konklusion: Närstående upplevde donationsprocessen som en svår tid med både positiva och negativa känslor. Yttre och inre faktorer präglar de närståendes upplevelser. Behovet av utveckling av vårdandet för de närstående kvarstår och behöver förbättras. / Background: Every year people die waiting for organ and tissue donation. When a person dies of a total cerebral infarction, he becomes a possible donor under the right conditions. The organ and tissue donation process is a process that often is seen as sudden and foreign to the relatives. Relatives are involved throughout the donation process and they become part of the care, something the nurses must take into account. Aim: To shed light on relatives’ experiences of the donation process. Method: A literature review based on ten qualitative original articles were analysed. Findings: The results revealed two main themes: External factors and Internal factors with two subthemes belonging to each main theme: care environment and time, social support, lack of understanding and to feel forgotten. Conclusion: Relatives experienced the donation process as a difficult time with both positive and negative emotions. External and internal factors shape the experiences of those close to you. The need for development of care for the next of kin remains and needs to be improved.

The post-donation process has long lacked attention, and the majority of users experience little to no personal updates after donating. Studies regarding the subject often tend to focus on attracting donors and keeping them interested in the charity, but rarely does it seem like the researchers study possible solutions for the post-donation process. This thesis aims to do that and investigate how an alternative to the process can be presented. Additionally, the aim is to explore if it is possible for a community feeling to arise when using the prototype and if the sharing aspect affects the perception of being part of a community. The thesis was split up into several different phases based on a human-centered design method called the Double Diamond. In the beginning, a literature study and qualitative interviews were executed to understand the problem area further. These interviews brought forward intriguing aspects, such as that users enjoy seeing others sharing donation information but avoid doing so themselves. The project continued with brainstorming to bring forward ideas. These ideas were then visualized in prototypes, iterated, and tested with the help of users and usability experts. Finally, after four iterations, a concluding design proposal was presented, which envisioned an alternative to a donation process. From the usability tests, users expressed an appreciation for the prototype and that the concept delivered a new aspect to donating. The users also stated that some elements in the prototype conveyed a sense of community. These elements were primarily the ability to participate in donation groups and the comment sections within posts and groups. Regarding the sharing aspect, the users mentioned that if the alternatives to interact and share thoughts with other users were removed, the community feeling would decline. Therefore, it was concluded that sharing affects the perceived sense of a community and that a community feeling can be present in a donation service. A disclaimer is that these conclusions are made within the study and apply to the users participating, and it is not certain that they can be applied to others. / Processen efter en donation har länge saknat uppmärksamhet, och majoriteten av dem som donerar erhåller få till inga personliga uppdateringar efteråt. Studier om ämnet i sig tenderar ofta att fokusera på att fånga nya donatorer och att bibehålla deras intresse av välgörenhetsorganisationen, men sällan verkar det som att forskarna studerar möjliga förbättringar för processen efter en donation. Det här examensarbetet ämnar till att utforska processen och undersöker hur ett alternativ kan presenteras. Dessutom syftar arbetet till att undersöka om det är möjligt för en känsla av gemenskap att uppstå när prototypen används och om en delningsaspekt kommer påverka denna känsla. Projektet delades up i ett flertal olika faser baserat på en metod vid namn Double Diamond som kan nyttjas när det är användaren som befinner sig i fokus. Till en början utfördes en litteraturstudie tillsammans med kvalitativa intervjuer för att skapa en förståelse för ämnet. Dessa intervjuer förde med sig intressanta insikter såsom att användare uppskattar när andra delar donationsinformation på sociala medier, men att de själva drar sig för att utföra samma sak. Arbetet fortsatte med en brainstormingssession med syftet att få fram många olika idéer. Idéerna blev sedan visualiserade i prototyper som itererades och testades med hjälp av användare och användbarhetsexperter. Efter fyra iterationer presenterades ett slutgiltigt designförslag som åskådliggjorde ett alternativ till donationsprocessen. Under testerna uttryckte användarna en uppskattning för prototypen och det nämndes att konceptet levererade en ny synvinkel till en donationstjänst. Användarna yttrade även att ett par av elementen inom prototypen förmedlade en känsla av gemenskap. Dessa element var främst möjligheten att delta i donationsgrupper och kommentarssektionerna inom inlägg och grupper. Angående delningsaspekten så nämnde användarna att om möjligheterna till interaktion med övriga användare försvann så skulle gemenskapskänslan minska. En slutsats blev därmed att delning troligen påverkar gemenskapen och att en känsla av en gemenskap kan uppstå i en donationstjänst. En begränsning kopplad till slutsatserna är däremot att de utgår från studiens deltagare och det kan därmed inte bekräftas att resultaten är representiva för alla användare.

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Fifty percent of the Swedish population is not aware of their relatives’ wishes on organ donation. It happens that some family members use their veto when they are asked to confirm their dead family member’s wish on organ donation and thereby preventing a potential transplant. If more people would be aware of this issue and tell each other what their standpoint is, we could help the health care to identify more organ donors and thus help more people to a better life. The project lead to an educational and physical exercise based application for tablets aimed for sixteen years old pupils where they by walking around in the physical space, learn about the organs and get physical exercise at the same time. The app is meant for schools since the school has the responsible to educate the pupils about different types of physical exercise and lifestyle. Moreover, tablets are becoming increasingly common in the schools. I was influenced by an application called Zombies Run that focuses on creating a story by collecting virtual supplies while being running outside. Some statements from the research influenced me. A lady stated that she used to take her daughter out to walk the dog as much as possible because her daughter was at risk of becoming overweight. A Donor Coordinating Doctor stated a thoughtful sentence during a workshop “Would you be willing to receive an organ if you needed a transplant? Donate your organs after death so it is possible” The Virtual Donation Challenge is an application aimed at sixteen year old pupils for educational purposes. The school is responsible for giving the students education about lifestyles, different types of exercises and CPR education, I found it most appropriate to link the application to the Physical Education subject or even Natural Science subject. The application is a quiz and the questions are linked to local GPS coordinates which the users have to visit in order to answer the questions about organ donation and how the interdisciplinary processes in the body work.

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