Abstract
Purpose: :
Consent for cornea donation from non heart-beating donors is often requested by means of telephone interviews. The outcomes seem to be largely predetermined by values and opinions as well as the momentary situation of the consulted family members, but experience indicates that some influence of the interviewer may exist. The purpose of this study was to identify factors which may influence the outcome of consent requests.
Methods: :
A retrospective analysis of consent requests made by the Aachen Cornea Bank over consecutive 8 years was performed, based on written consent protocols. All interviews were conducted via telephone by 22 ophthalmic residents and fellows based on standard protocols in accordance with German and EU laws and guidelines. Logistic regression analysis was employed to identify factors influencing the odds for the graft to be granted or denied, with focus on factors related to the interviewer and the consulted family member. P-values < 0.05 were considered significant. Results were expressed as odds ratios (95% confidence interval, Wald p-value). Data analysis was performed using SAS.
Results: :
1388 interviews fulfilled inclusion criteria. The overall consent rate was 49.14%. Male interviewers were 1.488 times more likely to obtain consent than female interviewers (CI 1.155 - 1.918, p=0.0021). The consulted family member was 0.896 times less likely to grant consent for donation with each increase in degree of blood relation (CI 0.847 - 0.947, p=0.0001). The odds for consent decreased by a factor of 0.898 per year of clinical experience of the interviewer (CI 0.840 - 0.960, p=0.0016). The completion of a specific communication training seminar increased the odds of consent by 1.343 (CI 1.062 - 1.699, p=0.0137). Other factors did not display a statistically significant influence.
Conclusions: :
A telephone interview is an effective method for obtaining consent for cornea donation. Our study shows that the consent decision may be associated with factors related to the interviewer as well as the consulted family member, and that specific training and support for cornea bank staff may increase the odds of obtaining consent.
Keywords: cornea: storage • clinical (human) or epidemiologic studies: health care delivery/economics/manpower • transplantation