朝居 朋子

OBJECTIVES: The gap between the numbers of organ donors and recipients is a common problem worldwide. This study was designed to investigate the importance of 'individual readiness', a here introduced novel concept in transplantation medicine and a measure of positive attitudes towards organ donation and transplantation. DESIGN: A cross-sectional online survey was used to collect the research data. PARTICIPANTS: The participants were recruited by a Japanese research company and affiliates in South Korea and Taiwan and fulfilled the following criteria: (1) laypersons aged 18-75 years, (2) residents of the countries and (3) understood the questions in their native languages. PRIMARY OUTCOME MEASURES: The survey investigated the interest and attitude of individuals regarding transplantation medicine by asking multiple choice questions. Based on answers concerning attitude, a positive group was identified as willing to be organ donors and recipients, and a non-positive group was identified as unwilling to be donors and recipients. The ratio between the positive and non-positive group, the P/N ratio, was introduced as an index of individual readiness. RESULTS: 1500 samples were included in this analysis. Individuals with interest agreed more with statements on organ donation than those without interest, and the P/N ratio per country was compatible with the actual deceased organ donors rate per million population (ADODR). CONCLUSIONS: Interest in transplantation medicine was associated with positive attitudes, and positive attitudes were associated with a higher ADODR. These results support that individual readiness is an important determinant for the number of donors. The P/N ratio can be used as an index to assess individual readiness in organ transplantation, at least in countries with minor to moderate popularisation. Further studies of individual readiness using the P/N ratio should be undertaken to develop policies and initiatives for increasing organ donations.

【目的】日本の在留外国人数は280万人を超え、本院でも外国人患者の受診者数は増加傾向にある。外国人ドナーが発生した場合の対応における課題を抽出し、解決策を検討することを目的とした。【方法】本院の外国人患者対応プログラムの現状を検証し、外国人ドナー対応の問題点を検討した。【結果】本院では2014年から外国人患者対応プログラムを準備し、院内表示の多言語化、常駐の医療通訳やタブレット型翻訳機の採用、外国人専用病棟設置・外国人スタッフ配置、クレジットカード・電子マネーの導入などを実施、国際規格の認証も取得した。しかし、臓器・組織提供の説明書や同意書は多言語化されておらず、外国人ドナー対応のマニュアルも作成されていなかった。【考察・結論】外国人患者受診者数が多い医療機関においては、一般診療の対応に加え、外国人ドナーに対応できるような書類の多言語化、文化的背景に配慮したマニュアルの作成などの体制整備が急務である。(著者抄録)