title: Caring dilemmas and coping strategies for organ transplant recipients and their families: perspective of health professionals in Taiwan.
abstract: BACKGROUND
  Organ transplant health professionals (OTHP) are challenged by more and more sophisticated caring dilemmas raised by organ transplant recipients (OTR) and their families. The purposes of this study were to explore caring dilemmas and the reliable coping strategies applied by OTHPs in Taiwan.
  
  
  METHODS
  A qualitative design was used with a purposive sample of OT surgeons and nurses. Data were collected by face-to-face in-depth interviews and analyzed by content analysis.
  
  
  RESULTS
  Sixty subjects (43 females, 17 male) participated in this project. They were 16 OT surgeons and 44 nurses, including RNs (n = 29), nurse practitioners (NP, n = 6), and assistant/head nurses (n = 9). Their ages ranged from 25 to 66 (mean = 38.2) years old. Their OT careers ranged from 3 to 40 (mean = 24.7) years for OT surgeons and 0.5 to 15 (years = 4.3) years for the nursing group. Five types of coping strategies for caring dilemmas were reported: (1) developing clinical paths for complex multiple-OT cases, (2) developing OT-expert training programs for interdisciplinary team members, (3) integrating acute and long-term care teams for difficult OT cases and families, (4) holding case conferences for successful and failed cases, and (5) implementing humanistic care training programs.
  
  
  CONCLUSIONS
  The findings of this research provide important coping strategies that can help empower OTHPs to care for complex multiple-OT cases with humanitarian expressions. More discussion about cultivation of interdisciplinary OT experts programs, and integration of caring resources are needed in the near future.
authors.affiliation: Department of Nursing, Central Taiwan, University of Science and Technology, Taichung, Taiwan.
authors.forename: F Chi
authors.initials: FC
authors.lastname: Yang
authors.affiliation: Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: P H
authors.initials: PH
authors.lastname: Tseng
authors.affiliation: Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
authors.forename: F Jong
authors.initials: FJ
authors.lastname: Shih
authors.affiliation: Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wangp@ntu.edu.tw.
authors.forename: S-S
authors.initials: SS
authors.lastname: Wang
authors.affiliation: Department of Medical Research & Nursing, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan. Electronic address: ppaul456tw@yahoo.com.tw.
authors.forename: F Jin
authors.initials: FJ
authors.lastname: Shih
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003299:Cooperative Behavior; D019091:Critical Pathways; D019033:Delivery of Health Care, Integrated; D005195:Family Relations; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006301:Health Services Needs and Demand; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology; D016377:Organ Transplantation / Q000009:adverse effects / Q000451:nursing*; D010348:Patient Care Team; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D011368:Professional-Family Relations; D036301:Qualitative Research; D013624:Taiwan; D066027:Transplant Recipients / Q000523:psychology*; D016896:Treatment Outcome