title: A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation.
abstract: OBJECTIVE
  Although existing studies suggest that factors affecting families' decisions regarding pediatric organ donation mirror those for adult patients, health professionals working in this area maintain that pediatric and adult decision-makers differ in significant ways. This study compared the request process, experiences, and authorization decisions between family decision-makers (FDMs) of adult and pediatric donors and nondonors.
  
  
  METHODS
  Perceptions of the donation request were collected via telephone interviews with 1601 FDMs approached by staff from 9 US organ procurement organizations (OPOs). Authorization regarding donation (ie, authorized/refused) was obtained from FDM reports and verified by using OPO records. Tests of association were used to estimate differences between FDMs of adult and pediatric patients. A logistic regression analysis was conducted to identify variables predicting FDM authorization.
  
  
  RESULTS
  FDMs of children were significantly more likely to authorize donation than were FDMs of adults (89.7% vs 83.2%; χ(2) = 6.2, P = .01). Differences were found between pediatric and adult families' initial feelings toward donation, donation-related topics discussed, communication behaviors and techniques used, perceptions of the request, and receipt and preference of grief information. The likelihood of FDM authorization increased with the number of topics discussed and communication skills employed during requests. Authorization was not predicted by patient age (ie, adult versus pediatric).
  
  
  CONCLUSIONS
  FDMs of children are willing to donate and experience no more psychological distress from the request for donation than do FDMs of adults. Communication emerged as a critical factor of family authorization, reinforcing its importance in requests for donation.
authors.affiliation: Department of Public Health, Temple University, Philadelphia, Pennsylvania; and.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Siminoff
authors.affiliation: Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Molisani
authors.affiliation: Department of Public Health, Temple University, Philadelphia, Pennsylvania; and hmtraino@vcu.edu.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Traino
mesh_terms: D000328:Adult; D002648:Child; D003657:Decision Making; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors / Q000523:psychology*; D009927:Tissue and Organ Procurement / Q000379:methods*