title: Motivations and decision-making dilemmas of overseas liver transplantation: Taiwan recipients' perspectives.
abstract: OBJECTIVE
  This study sought to explore the motivation and dilemmas in the decision-making process encountered by Taiwan overseas orthotopic liver transplant (OLT) recipients.
  
  
  METHODS
  We used an exploratory qualitative research method on a sample of transplant recipients. Face-to-face in-depth interviews were performed with a semistructured interview guide. Data were evaluated by qualitative content analysis.
  
  
  RESULTS
  We interviewed 15 patients including 11 males and 4 females aged between 41 and 68 years (mean = 57.3) including 14 who received OLT in China and one in the United States. The most important motivations were saving lives from end-stage liver disease and avoiding a hopeless sense of their residual lives with the psychological torture of a waiting death. Their decision-making process leading to overseas OLT could be divided into several phases among which the phase of transplant data evaluation and decision was the most critical one. Nevertheless, every stage and phase had its unique contents, factors, and dilemmas.
  
  
  CONCLUSIONS
  This study demonstrated that patients encountered various dilemmas at different phases in the decision-making process of considering overseas OLT. This information is important for care providers and policy makers in dealing with patients who consider overseas OLT.
authors.affiliation: Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Huang
authors.forename: R H
authors.initials: RH
authors.lastname: Hu
authors.forename: F J
authors.initials: FJ
authors.lastname: Shih
authors.forename: H M
authors.initials: HM
authors.lastname: Chen
authors.forename: F J
authors.initials: FJ
authors.lastname: Shih
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003657:Decision Making; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D013624:Taiwan; D014195:Travel; D014481:United States