Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor - Editora MPM Comunicação
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Oliveira, F.F.; Honorato, A.K.; Oliveira, L.S.G.;
Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor brain death
DOI: https://doi.org/10.36489/nursing.2021v24i280p6157-6168
Fragilities and experiences of nurses in the
approach to the family of the organ and
tissue donor
ABSTRACT | Objective: To unveil the weaknesses and the experience of nurses in approaching the organ and tissue donor family.
Method: Qualitative research with content analysis by Bardin, carried out with seven nurses in a medium-sized hospital in the
interior of São Paulo, Brazil. Results: The data obtained were grouped into three central categories: Nurses' knowledge in the
context of the family approach to the potential organ and tissue donor; Weaknesses experienced by nurses in the context of
communicating bad news to family members of the potential organ and tissue donor and Nurses' experiences in the face of
brain death diagnosis and the determining factors for obtaining organs and tissues. Conclusion: The nurses' experiences in face
of the weaknesses found and experienced in the family approach of potential organ donors, are characterized by conflicts and
situations that expose the professional to an atmosphere of feelings of welcome and empathy.
Keywords: Organ and tissue donation; Nurses; Role of the Nursing Professional; Family; Brain Death.
RESUMEN | Objetivo: Dar a conocer las debilidades y la experiencia de las enfermeras en el acercamiento a la familia del donante
de órganos y tejidos. Método: Investigación cualitativa con análisis de contenido de Bardin, realizada con siete enfermeras
en un hospital de mediano tamaño del interior de São Paulo, Brasil. Resultado: Los datos obtenidos se agruparon en tres
categorías centrales: Conocimiento del enfermero en el contexto del abordaje familiar del potencial donante de órganos y
tejidos; Debilidades vividas por enfermeras en el contexto de comunicar malas noticias a familiares del potencial donante de
órganos y tejidos y Experiencias de enfermeras ante el diagnóstico de muerte encefálica y los determinantes para la obtención de
órganos y tejidos. Conclusión: Las vivencias de las enfermeras ante las debilidades encontradas y vividas en el abordaje familiar
de los potenciales donantes de órganos, se caracterizan por conflictos y situaciones que exponen al profesional a un clima de
sentimientos de acogida y empatía.
Palabras claves: Donación de órganos y tejidos; Enfermeras; Rol del profesional de enfermería; Familia; Muerte cerebral.
RESUMO | Objetivo: Desvelar as fragilidades e a vivência de enfermeiros na abordagem de família do doador de órgãos e tecidos.
Método: Pesquisa de abordagem qualitativa com análise de conteúdo de Bardin, realizada com sete enfermeiros em um hospital
de médio porte no interior de São Paulo, Brasil. Resultado: Os dados obtidos foram agrupados em três categorias centrais:
Conhecimento dos enfermeiros no contexto da abordagem familiar do potencial doador de órgãos e tecidos; Fragilidades
vivenciadas por enfermeiros no contexto da comunicação de más notícias para familiares do potencial doador de órgãos e
tecidos e Experiências de enfermeiros diante do diagnóstico de morte encefálica e dos fatores determinantes para obtenção de
órgãos e tecidos. Conclusão: As experiências dos enfermeiros frente, às fragilidades encontradas e vivenciadas na abordagem
familiar de potencial doador de órgãos, são caracterizadas por conflitos e situações que expõem o profissional a uma atmosfera
de sentimentos de acolhimento e de empatia.
Palavras-chaves: Doação de Órgãos e tecidos; Enfermeiros; Papel do Profissional de Enfermagem; Família; Morte Encefálica.
Fabiano Fernandes de Oliveira Leticia dos Santos Goulart Oliveira tem (SUS). As a result, it is considered
Nurse graduated from the Teresa D’Ávila Nurse graduated from Escola Superior de one of the most outstanding countries
University Center – UNIFATEA - Lorena - Cruzeiro. Cruzeiro - ESC, Cruzeiro - São Pau- in the world, losing only to the United
São Paulo. Professor at the Undergraduate lo - Brazil. States in absolute numbers according to
Nursing Course at Escola Superior de Cru- ORCID: 0000-0002-7923-6141
the Brazilian Association of Organ Trans-
zeiro - ESC - Cruzeiro - São Paulo and at
the Nursing Course at Centro Paula Souza Received on: 06/01/2021 plantation (ABTO - Associação Brasileira
- São Paulo. Master and Doctoral Student Approved on: 06/14/2021 de Transplante de Órgãos). (1) There is an
in Nursing by the Post-Graduate Program, immeasurable spirit in all political, ega-
INTRODUCTION
Academic Doctoral Course, at Universidade litarian, governmental and non-govern-
Estadual Paulista – Júlio de Mesquita Filho - mental spheres in an attempt to increase
B
UNESP- Botucatu, São Paulo - Brazil.
razil has one of the largest pu- the number of donations made and of
ORCID: 0000-0001-6768-4257
blic programs for the donation, transplant patients. (2)
Adaíza Kelly Honorato capture and transplantation of It is known that organ donors can
organs, tissues and cells, with funding be classified into two divisions: living
Nurse graduated from Escola Superior de
Cruzeiro. Cruzeiro - ESC, Cruzeiro - São for more than 95% of the procedures, donor, person who consents to the do-
Paulo - Brazil. which is made available to the entire po- nation in such a way that there is no
ORCID: 0000-0002-1844-5070 pulation through the Unified Health Sys- harm to their own health, and can do-
Revista Nursing, 2021; 24 (280): 6163-6168 6163brain death Oliveira, F.F.; Honorato, A.K.; Oliveira, L.S.G.;
Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor
nate one of the kidneys, liver element, in the moment of imprecision and am- The study was conducted in a me-
bone marrow or lung lobe. These can biguity when caring for patients with dium-sized hospital located in the in-
be relatives up to the fourth degree and brain death, considered as a possible terior of the state of São Paulo, Brazil,
consorts of the recipient, while in ca- organ donor. There are weaknesses in in a region known as Vale do Paraíba.
ses of non-consanguine donors, there the diagnosis of BD, to the point of ha- This hospital is linked to the Central
must be a judicial license. In the second ving hope in reversing the case. It's like Notification, Capture and Distribution
class, there are non-living donors, who waiting for a miracle. of Organs of the state. It is a partner
are patients diagnosed with Brain Death Thus, the research problem was institution in the activities of the Na-
(BD), who, in most cases, are victims of delimited from the following question: tional Transplant System (SNT - Sistema
Traumatic Brain Injury (TBI) or cerebro- What weaknesses do nurses experience Nacional de Transplante) at a regional
vascular accident (CVA). (3) at the time of diagnosis of brain death level, following the national policy for
In this scenario of non-living donors, and when approaching families of pa- capturing and transplanting organs and
the awareness of family members is as tients with the potential to donate or- tissues.
valuable as all other hospital actions. gans and tissues? As inclusion criteria in the research,
The nurse is a respected and strategic For these reasons, this study sought nurses who provided assistance directly
figure in this system, as he maintains to fill this knowledge gap, seeking to in the organ harvesting procedure and
with the patient and their families a cover the weaknesses and experiences who had at least six months of expe-
shortened relationship and connection of the family of the brain-dead patient rience were established.
created from the proximity established and possible donor. Based on this un- As exclusion for participation, there
during the patient's hospitalization. In derstanding, the aim was to provide were nurses away from the service for
order for the potential donation to be evidence and support for the imple- reasons of vacation, maternity or medi-
successful and the family/nurse rela- mentation of strategies that improve, cal leave and absent at the time of data
tionship closer, principles, skills and naturalize, optimize and smooth the collection.
abilities must be developed to guide the family approach method with regard to Data were collected by the resear-
eligible donor's relatives in an ethical organ and tissue donation, since, in this chers themselves at a previously sche-
and assertive way. (4) investigation, we sought to scientifically duled time in a reserved and confiden-
Considering the family approach anchor the actions of nurses with regard tial environment, which favored the
of potential donors, it is also necessary to the theme. interviewees' privacy and anonymity.
to consider the involvement and per- As a result, this study aimed to re- Such collection took place between Au-
formance of the nurse, as it is a mul- veal the weaknesses and experiences gust and September 2019.
tiprofessional approach. This issue is of nurses in approaching the family of The semi-structured interview tech-
one of the most crucial in the donation organ and tissue donors. nique guided by an instrument (script)
process, given the great hurdle brought developed by the authors was used. This
by relatives. Working with the family, METHOD script included sociodemographic cha-
respecting its limits, is effective for the racteristics, such as gender, age, average
successful completion of the transplant. Article extracted from the Course time in the profession and religion, and
It is a complex moment for the family to Completion Paper (TCC - Trabalho de was followed by the following guiding
see their loved one with a heartbeat and Conclusão de Curso) entitled: “Nurse's questions: What was the experience like
not assimilate the death, so the family's Approach to the Family in the Organ for you in approaching family members
wishes must always be respected, main- Procurement Process through a Proto- about organ donation? What frailties or
taining ethical and legal principles.(5,6) col”, presented to the Department of difficulties do you face or have you faced
It is at this moment that the nurse Undergraduate Nursing at Escola Su- with the family approach?
faces conflicts as a result of the situation perior de Cruzeiro - ESC, Cruzeiro, São The testimonies were transcribed
of pain experienced by family members, Paulo Brazil. 2019. and analyzed and, soon after collec-
due to the patient's BD, but at the same It was characterized as an inves- tion, these data were grouped accor-
time having to request the donation of tigation of an exploratory, descriptive ding to the nuclei of meaning compo-
organs, since they consider the request and qualitative approach. The tool for sed in the communication, considering
for donation, at that time, very distres- reporting the data collection COREQ (9) the presence and thematic frequency
sing to the family. (7) was used, which used content analysis significant for the analyzed object.
About this, a study carried out in based on the theoretical framework pro- Thus, the appreciation of the con-
Iran (8) shows that nurses are involved posed by Bardin.(10) tent consisted of three fundamental pe-
6164 Revista Nursing, 2021; 24 (280): 6163-6168Oliveira, F.F.; Honorato, A.K.; Oliveira, L.S.G.;
Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor
riods for data analysis, and in the pre-a- in Cardiology, Stomatherapy, Nephrolo- “[...] When organ harvesting be-
nalysis, there was a questioning of the gy and Urology. gan at our institution, we recei-
aspects related to the object of study, With regard to religiosity, six ved training from a nurse, it was
the relevant theories, the methodology (85,7%) of the nurses were Catholic and amazing, because I was able
and the necessary operational issues to one (14,2%) was Evangelical. All revea- to open my mind about taking
trigger the search; in the material ex- led to be practitioners of the belief. care of the body after harves-
ploration phase, a cut was made based Regarding the temporal analysis, re- ting, the respect that the entire
on the experience of the theoretical ferring to the experience of exercising nursing and medical team has
construction elaborated so far; finally, the profession, five (71,4%) of the inter- with the body and also the fa-
in the material treatment phase, which viewees performed the function for be- mily and it was a matter of fin-
leads the researcher to theorize about tween 5 to 10 years and two (28,5%) for ding a moment of my own “in
the data, the link between the available more than 10 years. Six (85,7%) worked the BDissue” of the doctor and
reality and the data collected through at the hospital for between 5 to 10 ye- family, and knowing the right
the research was produced. We sought, ars and one (14,2%) for between 1 to time to address the fundraising
then, to explain the results in light of 5 years. is still not easy, but the training
the existing literature, leading to the As for the weekly workload, six nur- helped a lot so that I could ex-
identification of central categories. (10) ses (85,7) reported working for 30 hours plain for the whole family of
To ensure the anonymity of the par- a week and one (14,2), 20 hours a week. care, respect they would have
ticipants, they were referenced using All nurses participated in courses on for the body”. E2
an association of letters and numbers, transplantation and organ harvesting in-
using the letter E for Nurse, followed by side and outside the hospital. In view of the answers presented, it
an Arabic numeral from 1 to 7 accor- In evaluating the qualitative data, was found that the nurses' knowledge
ding to the order of the interviews. after assessing the speeches obtained, about the topic, according to the majo-
The research followed all ethical pre- the information was aggregated into rity of respondents, even though the ter-
cepts as per the recommendations esta- three central categories and their the- ms were not very clearly used in some
blished by resolution 510/16 of the Na- matic units, namely: answers, it is clear that the professionals
tional Health Council for studies carried are prepared about communication and
out with human beings and appreciated Category 1: Knowledge of nurses in the approach to the scenario of the brain
by the board of the researched health context of family approach to potential death process, followed by communi-
institution. The project was also valida- organ and tissue donors. cation to the family about the potential
ted by the Ethics and Research Commit- Regarding the knowledge of respon- uptake of organs.
tee under opinion No. 3.257.576 and dents on the theme of approaching the
CAAE 11227319.9.0000.5431, of April family at the time of communication of Category 2: Weaknesses experienced
10th, 2019. the BDand the possibility of organ do- by nurses in the context of communi-
nation, there was a predominance of cating bad news to family members of
RESULTS responses regarding subsidies or classes potential organ and tissue donors.
that addressed the donation and cap- In this study, it was noticed that the
Seven nurses who worked at the ture of organs, during the graduation approach and communication shared
institution chosen for data collection period or graduate school. All (100%) between nurses and physicians allow
participated in this research, all (100%) nurses revealed that they did not obtain the exchange of information related to
being female, even though, a priori, this sufficient theoretical framework during the client's health/disease conditions,
was not an inclusion criterion. Among the undergraduate or specialization pe- for decision-making and correct con-
these participants, the age group betwe- riod, which can be seen in the following duct and concordance with each iden-
en 31 and 40 years old prevailed. statements: tified need.
Of the nurses interviewed, in addi- Thus, the nurse actively participates
tion to graduation, all had attended a “[...] I don't remember anything in the conducts together with the multi-
postgraduate course at the lato sensu so specific. During the post-se- disciplinary team, which can be eviden-
level, with four (58%) nurses claiming condary period, we talk about ced in the following statements:
to be specialists in the Intensive Care transplantation as a form of kid-
Unit (ICU), two (28,5%) in Emergency ney treatment and the importan- "[...] Along with the medical
and Emergency and only one (14,2%) ce of donation”. E7 team, talking to all the children,
Revista Nursing, 2021; 24 (280): 6163-6168 6165brain death Oliveira, F.F.; Honorato, A.K.; Oliveira, L.S.G.;
Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor
a delicate moment, the family spend more time with the fa- and the relevance of the nurse's pre-
denying death." E3 mily, even if in silence. Finally, sence in moments of communication of
“[...] Difficult due to the resis- we had a patient that was not bad news was noted, in order to mini-
tance of the family to donate, viable for uptake, however, we mize the impact and anguish of family
even clarifying doubts. The ex- needed to give a diagnosis of members.
perience of approaching the brain death. However, I had a In light of these categories, we fou-
family about ME, for me, is ne- lot of difficulty, as the doctor nd that nurses can act in the possibility
ver easy. First, because I don't was not training to follow the of convincing to obtain organs and tis-
know what will be the family's BDprotocol. The protocol was sues, but it can also be inferred that the
reaction to the loss, in some rare carried out with great difficulty, consent for donation, until the moment
cases the family reacts calmly, finally it was up to me to help of our study, is seen as a process that
but the loss of a loved one can- him, and together with the doc- permeates philosophical, religious, so-
not measure the pain the other tor, inform the family about the cial and moving questions.
is feeling, and in this context it confirmed diagnosis" E5
is difficult to find a time or way “[...] At first it was very difficult, DISCUSSION
to explain the importance of the but with time I gained confiden-
donation.” E1 ce. One approach I performed Faced with such a complex issue
“[...] It was never easy to tell the and marked me was a mother as the donation of organs and tissues,
family that you will never see who had her son in the ICU bed knowing the factors that motivated peo-
your loved one again” E4 in BD due to a serious motorcy- ple to make the grant becomes essential,
cle accident, she was in favor even considering the magnitude of the
Reflecting on the possible weak of the donation, as there was a act of donating unquestionable. (11)
points exposed in the daily lives of nur- cousin in her family who, a few It is noteworthy that the support of-
ses and in view of the numerous care years ago, received a kidney and fered by nurses regarding the emotional
activities that compete, it was obser- he no longer needed to undergo issue of family members and specific
ved that the respondents mentioned hemodialysis." E6 knowledge about the entire procedure
the existence of difficulty in the face of “[...] I remember that, the first to be used in the context of organ har-
family resistance when communicating time I had this experience, it was vesting, can encourage the family mem-
the possibility of organ harvesting. with the parents of a teenager ber to decide and accept the donation.
and they accepted and donated In this perspective, the attitudes that
Category 3: Experiences of nurses fa- their daughter's organs for trans- lead family members to accept the do-
cing the diagnosis of brain death and plant purposes. Even sad for his nation of organs from their loved ones
the determining factors for obtaining loss and grateful for his enor- have features in common: empathy, the
organs and tissues. mous nobility, despite being in desire to help others and, even with de-
When asked about the experiences favor of donation, I don't know ath, the offer of some meaning to life
lived at the time of diagnosis of brain if I could donate. It was a we- from the other. (12,13)
death and the possibility of obtaining ekend and I was on duty. The In this context, the nurse is the pro-
organs and tissues, the participants re- patient already had the clinical fessional who provides patient care by
vealed the presence of feelings and atti- tests ready for ME, but was wai- planning nursing care for 24 hours, alwa-
tudes, such as: being on the side of the ting for the Transcranial Doppler ys being in frequent and direct contact
family, evidencing support and accep- to confirm and precisely on that with family members and caregivers. In
tance; transmit trust, confidence and day the neurologist attended to addition, it has a legal responsibility to
credibility; to remain silent, showing perform and confirm the exam. provide training and qualification to the
sadness but also admiration for the fa- After the realization, it was time team it coordinates, in order to promote
mily member who said yes to donation for the approach.” E7 quality care, based on scientific eviden-
and expressed a noble and generous ce for patient safety. (14)
feeling. The statements below point out Analyzing the context of the reports The importance of training and pre-
these feelings and actions: on the family approach and the em- paring nurses through the managers
bracement performed by the nurse, the responsible for health establishments
“[...] The doctor is usually more interpersonal relationship between the linked to the SNT is also highligh-
technical, and it is up to me to nurse and the family was highlighted, ted. This training is critical in fulfilling
6166 Revista Nursing, 2021; 24 (280): 6163-6168Oliveira, F.F.; Honorato, A.K.; Oliveira, L.S.G.;
Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor
communication requirements and tech- so that there is an improvement in their opportunity to be with the family, giving
nical skills to develop strategies on how attitude and practice through different support, attention, developing empathy
to deal with families who will receive training methods. (19) and active listening in the grieving pro-
bad news. (15) According to the information ob- cess. Caring for the family is a complex
Therefore, the nurse needs to esta- tained in our study, support for the po- stage that requires professionals who can
blish a bond with the patient and their tential donor is indicated by confron- offer elements that guide the donation of
families that is based on mutual trust and tation and disorder, leading nurses to organs and tissues. The nurse must be,
has a humanistic character, in order to experience various ambivalent feelings. therefore, willing and prepared to clarify
carry out the essential care to alleviate Linked to the change in the perception all the doubts of the family members in a
the patient's anguish and, if possible, of the being facing brain death, the ex- clear and objective way, ensuring the un-
to overcome their moment of affliction. perience of the family approach, in this derstanding of the real situation of their
This feature was evidenced by the study, context, is permeated by the technical- loved one and thus respecting ethical
(16)
who observed nurses who offered a -scientific and human dimensions, whi- and legal principles. (22)
welcoming and differentiated commu- ch, in the nurses' view, is constituted by Positively, the nurse, who works with
nication with the deceased's relatives the skills, protocols and technologies patients considered as potential donors,
and generated an affective connection, added to the care of the patient and in gives a new meaning to their own life,
which motivated opportunities to obtain communicating difficult news. (20) undergoing a personal and professio-
assent to capture organs and tissues. nal transformation, as they work with a
The scarcity of information to relati- view to life and see the process of de-
ves about what is happening with the pa- ath as a natural part of this process. In
tient, together with the lack of knowled- this way, they adopt zealous attitudes,
ge about brain failure, allow erroneous which result in humanized and sincere
assumptions about the activities for the care, minimizing professional suffering
extraction of tissues and organs. (17) and, consequently, expanding their per-
Regarding the knowledge coefficient
of the analyzed nurses, the results are in
Thus, nurses sonal growth. (23)
In our study, limitations were con-
line with the literature (18) which found assume the full role sidered to be the scarcity of references,
in order to optimize
a low to moderate level in the results the absence of the theme of nurses' fee-
which indicate that, generally, doctors lings towards the family approach, and
and nurses do not have sufficient know-
ledge about the organ donation process
the relationship the fact that the research was carried out
with a small number of participants. The
in patients with brain death, as well as between the team, results found may support the conduct of
the lack of affinity in communicating other studies that broaden the discussion
bad news. family and patient. about these weaknesses, experiences
It is noteworthy, on the other hand, and experiences on the performance of
that there remain numerous shortages in nurses in communicating bad news to
the training of nurses with regard to the capture organs and tissues, not only in
areas of transplantation, especially with the transplant service but also in other
regard to patients with brain death, both fields of action of that professional.
in universities and in hospitals. As a re- What was evident was that the nurse
sult, nurses do not have satisfactorily is presented as a key element for the esta-
adequate knowledge, attitude and prac- Thus, nurses assume the full role blishment of successful family approach
tice. Therefore, it is suggested to include in order to optimize the relationship programs. However, to do so, he needs
the expansion of the discussion in dis- between the team, family and patient. to develop essential skills to act in the di-
ciplines on this theme in the curriculum However, it is essential to provide time fferent phases of the period of communi-
of nursing courses, as well as the im- to be with the family, understand the cation of bad news. Thus, it is considered
plementation of educational campaigns mourning situation and not just offer relevant to know the weaknesses and ex-
for family mobilization, in addition to protocoled information, as each indivi- periences experienced by nurses involved
conducting permanent and continuing dual has their time and uniqueness to in this care, seeking to offer subsidies so
education programs, to accompany the assimilate the new fact. (21) that these professionals can seek recog-
nurse with their role in the care process, In this sense, the nurse may have the nition from the multidisciplinary team
Revista Nursing, 2021; 24 (280): 6163-6168 6167brain death Oliveira, F.F.; Honorato, A.K.; Oliveira, L.S.G.;
Fragilities and experiences of nurses in the approach to the family of the organ and tissue donor
working in the complex area of tissue and news was evident that, in most cases, it tions that expose the professional to an
organ transplantation and give greater vi- is done by the physician, however the atmosphere of feelings, mainly of wel-
sibility to your clinical practice. presence of the nurse is essential throu- coming and empathy, which directly
ghout the communication process. influences in your personal and profes-
CONCLUSION Given the reports, it was possible sional life.
to see that, despite the reality in which Finally, nurses' lack of training from
According to the data obtained in nurses are inserted, this type of commu- graduation to professional life was evi-
the investigation, it was concluded that nication is always difficult and at each denced. Therefore, it is understood that
the nurse is directly linked not only to moment there is a particularity. a closer look at these professionals is
the service of keeping the potential do- It was also observed that the expe- necessary to ensure significant expe-
nor fit for uptake, but also actively parti- riences of nurses facing the weaknesses riences and enrichment of the quality of
cipates in the entire diagnosis and even found and experienced in the family care in the context of approaching the
a little after the approach made with approach of potential organ donors are family of the imminent organ and tissue
the family. The communication of bad characterized by conflicts and situa- donor.
References
1. Teixeira NC. Zaganelli MV. Salardi S. Transplante de órgãos e tecidos: desa- doação de órgãos. Nursing Säo Paulo. 2019;22(254):3047-51.
fios no processo de doação post mortem. Derecho y Cambio Social [Internet]. 13. Nascimento Rodrigues AL, Silva ER, Costa F, Salvático GV, Santos Figueiroa
2020 Jul/Set [cited 2021 May 2];(61):202-22. Available from: https://www. J, Moraes LB, et al. Doação de órgãos: o posicionamento familiar em relação
derechoycambiosocial.com/ aos aspectos da doação. Braz J Develop. 2020; 6(11):91832-50. doi: 10.34117/
2. Silva ALB, Silva MNP, Santana RS, Pereira Ribeiro IA, Rocha MO, Cunha DCL, bjdv6n11-552.
et al. Visão dos enfermeiros sobre suas atribuições no setor de organização 14. Araújo C, Santos JAV, Rodrigues RAP, Guidi Júnior LR. O papel do profis-
de procura de órgãos. Res Soc Dev. 2020;9(8):e879986613. doi: http://dx.doi. sional de enfermagem na doação de órgãos. Rev Saúde Foco. 2017;(9):533-47.
org/10.33448/rsd-v9i8.6613 15. Costa IFD, Mourão Netto JJ, Brito MDCC, Goyanna NF, Santos TCD, Santos
3. Furtado LBS, Moraes Filho IM, Sousa TV, Roure JGR, Lima TP, Arantes AA, SDS. Fragilidades na atenção ao potencial doador de órgãos: percepção de
et al. The role of the nurse in front of cases of brain death and donation of enfermeiros. Rev Bioét. 2017;25(1):130-7.
organs and tissues. Res Soc Dev. [Internet]. 2021 Feb.13 [cited 2021 May 16. Amazonas MAM, Santos JS, Araujo JC, Souza ATAC, Coelho MB, Santos JPS,
2];10(2):e0110212422. Available from: https://rsdjournal.org/index.php/rsd/ et al. Doação de órgãos: dilemas dos familiares na doação de órgãos. REAS
article/view/12422/11186. doiorg/10.33448/rsd-v10i2.12422 [Internet]. 2021 [citado 2021 Maio 30];13(1):e5871. Disponível em: https://
4. Coelho GHF, Bonella AE. Doação de órgãos e tecidos humanos: a trans- acervomais.com.br/index.php/saude/article/view/5871
plantação na Espanha e no Brasil. Rev Bioét. 2019;27(3):419-29. doi: 17. Pereira KGB, Souza VS, Spigolon DN, Teston EF, Oliveira JLC, Moreira FG.
10.1590/1983-80422019273325 Doação de órgãos em serviço hospitalar: principais motivos à negativa na au-
5. Alcântara Sindeaux AC, Vieira do Nascimento AM, Campos JRE, Campos JBR, torização. Rev Enferm UFSM. 2020;10(e4):1-14. doi: 10.5902/2179769236087.
Brito Barros A, Rodrigues Pereira Luz DC. Cuidados de enfermagem dispensa- 18. Cavalcanti NB, Silva ACM, Nascimento JWA. Morte encefálica: conhe-
dos ao potencial doador de órgãos em morte encefálica: uma revisão integra- cimentos e obstáculos de enfermeiros acerca do cuidar. Braz J Health Rev.
tiva. Nursing [Internet]. 2021 [citado 2021 Maio 08];24(272):5128-47. Dispo- 2021;4(1):2586-99. doi:10.34119/bjhrv4n1-208
nível em: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1148453. doi: 19. Costa JR, Angelim CG, Lira GG, Marinho CLA, Fernandes FECV. Intenção de
https://doi.org/10.36489/nursing.2021v24i272p5128-5147 doar órgãos em estudantes de enfermagem: influência do conhecimento na
6. Fonseca EOD, Fernandes FECV, Lira GG, Marinho CLA, Moura KDO, Melo decisão. Nursing São Paulo. 2018:2104-9.
RA. Percepção de enfermeiros sobre os cuidados aos potenciais doadores de 20. Dopson S, Long-Sutehall T. Exploring nurses’ knowledge, attitudes and
órgãos. Enferm Brasil. 2021;20(1):68-81. doi: 10.33233/eb.v20i1.4498. feelings towards organ and tissue donation after circulatory death within the
7. Magalhães ALP, Erdmann AL, Sousa FGM, Lanzoni GMM, Silva EL, Mello paediatric intensive care setting in the United Kingdom: A qualitative con-
ALSF. Significados do cuidado de enfermagem ao paciente em morte encefáli- tent analysis study. Intensive Crit Care Nurs. 2019;54:71-8. doi: 10.1016/j.
ca potencial doador. Rev Gaúcha Enferm. 2018;39:e2017-0274. doi: https:/doi. iccn.2019.07.004.
org/10.1590/1983-1447.2018.2017-0274. 21. Downar J, Shemie S, Gillrie C, Fortin MC, Appleb A, Buchman DZ, et
8. Keshtkaran Z, Sharif F, Navab E, Gholamzadeh S. Lived Experiences of Ira- al. Deceased organ and tissue donation after-medical assistance in dying
nian nurses caring for brain death organ donor patients: caring as “Halo of and other conscious and competent donors: guidance for policy. CMAJ.
Ambiguity and Doubt”. Glob J Health Sci. 2016;8(7):281-92. doi: https://doi. 2019;191(22):E604-13. doi: https://doi.org/10.1503/cmaj.181648
org/10.33233/eb.v20i1.4498. 22. Knihs NS, Santos ACB, Magalhães AP, Barbosa SFF, Schuantes-Paim SM,
9. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative Santos J. Gerenciamento do cuidado do enfermeiro no processo de doação
research (COREQ): a 32-item checklist for interviews and focus groups. Int J de órgãos e tecidos. Texto Contexto Enferm [Internet]. 2020 [acesso 2021
Qual Health Care [Internet]. 2007 [cited 2021 May 2];19(6):349-57. Available Maio 20];29:e20180445. Disponível em: https://www.scielo.br/j/tce/a/xX-
from: https://academic.oup.com/intqhc/ article/19/6/349/1791966. ShM6zWdpSsTvxBkXvkwCK/abstract/?lang=pt. doi: https://doi.org/10.1590/
10. Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011. p.85-103. 1980-265X-TCE-2018-0445
11. Correia WLB, Alencar SRM, Coutinho DTR, Gondim MM, Almeida PC, 23. Ribeiro OAP, Ferreira LP, Quadros A, Fernandes MTC, Dellanhese APF. Sen-
Freitas MC. Potencial doador cadáver: causas da não doação de órgãos. En- timentos de enfermeiros na assistência ao paciente em cuidados paliativos:
ferm Foco. 2018;9(3):120-25. doi: https://doi.org/10.21675/2357-707X.2018. uma revisão integrativa. Braz J Develop. 2020;6(8):63874-90. doi: https://doi.
v9.n3.1150 org/10.34117/bjdv6n8-715
12. Sandri AJV, Kuse AE. O significado do sim para a família no processo de
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