Uncertainty expression in surgical patients of organ removal: a cross-sectional study

Introduction: The surgical treatment of organ removal seems to meet a number of pathologies that emerge as health needs of populations. In this context, the state of uncertainty is installed.Objective: To investigate the uncertainty in illness in surgical patients of organ removal.Method: Cross-sectional study developed with patients admitted to the surgical outpatient clinic of a university hospital. Sociodemographic and clinical variables were collected, in addition to applying Mishel uncertainty in illness scale.Results: The profile of medical diagnoses in the 60 participants showed that the most frequent diseases were the neoplasms. As for the scale application, 68% of the participants presented scores greater than or equal to 80 points. The value found for the Cronbach’s Alpha was 0.842. The surgical procedures abdominal hysterectomy and mastectomy, which were the most prevalent for the participants, are associated with uncertainty domains.Conclusions: High levels of uncertainty demonstrated the need for the management of this condition. The psychosocial aspects of surgical treatments are disregarded at the expense of the clinical restoration, circumstances that neglect the patient’s emotional suffering. The improvement of communication between the health professional and the patient can influence to prevent the manifestation of the lack of information, one of the forms of expressing uncertainty. Aspects such as the patient’s socioeconomic profile, educational level and income must be taken into account in the surgical treatment of organ removal. The uncertainty experienced by these patients needs to be better known and widely disseminated to gain prominence in the health care setting. Introducción: El tratamiento quirúrgico de la extirpación de órganos parece satisfacer una serie de patologías que surgen como necesidades de salud de las poblaciones. En este contexto, se instala el estado de incertidumbre.Objetivo: Investigar la incertidumbre de la extracción de un órgano en pacientes quirúrgicos.Método: Estudio transversal realizado con pacientes hospitalizados en la clínica quirúrgica de un hospital universitario. Variables sociodemográficas y clínicas fueron recogidas, además, se aplicó la escala de incertidumbre en la enfermedad de Mishel.Resultados: El perfil de diagnósticos médicos en los 60 participantes mostró que las enfermedades más frecuentes fueron las neoplasias. Con relación a la aplicación de la escala, el 68% de los participantes presentaron puntuaciones mayores o iguales a 80 puntos. El valor hallado para el alfa de Cronbach fue de 0,842. Los procedimientos quirúrgicos histerectomía abdominal y mastectomía, que fueron los más frecuentes para los participantes, están asociados con áreas de incertidumbre.Conclusiones: Los altos niveles de incertidumbre demostraron la necesidad de la gestión de esta condición. Los aspectos psicosociales de los tratamientos quirúrgicos son desconsiderados a expensas de la restauración clínica, circunstancias en que se descuida el sufrimiento emocional del paciente. La mejora de la comunicación entre los profesionales de la salud y el paciente puede influir para prevenir la manifestación de la falta de información, una de las formas de la expresión de la incertidumbre. Aspectos como el perfil socioeconómico del paciente, el nivel educativo y los ingresos deben tenerse en cuenta en el tratamiento quirúrgico de la extracción de órganos. La incertidumbre experimentada por estos pacientes debe conocerse mejor y difundirse ampliamente para que estos aspectos se destaquen en el entorno de la atención médica. Introdução: O tratamento cirúrgico de retirada de órgãos surge para atender a uma diversidade de patologias que emergem como necessidade de saúde apresentadas pelas populações, sendo considerado um procedimento que provoca no paciente sentimentos de incerteza.Objetivo: Investigar a incerteza na doença, em pacientes cirúrgicos submetidos à retirada de órgão.Método: Estudo transversal desenvolvido com pacientes internados na clínica cirúrgica de um hospital universitário. Coletaram-se as variáveis sociodemográficas e clínicas e aplicou-se a escala da incerteza na doença de Mishel (MUIS).Resultados: O perfil de diagnósticos médicos nos 60 participantes revelou que as doenças mais frequentes foram as neoplasias. Quanto a aplicação da escala, 68% dos participantes apresentaram escores maiores ou iguais a 80 pontos. O valor encontrado para o Alpha de Cronbach foi de 0,842. Os procedimentos cirúrgicos, histerectomia via abdominal e mastectomia, os quais foram os mais prevalentes para os participantes, se associam aos domínios da incerteza.Conclusões: Elevados níveis de incerteza evidenciaram a necessidade do manejo dessa condição. Os aspectos psicossociais dos tratamentos cirúrgicos acabam secundarizados em detrimento do reestabelecimento clínico, circunstância em que se negligencia o sofrimento emocional do paciente. A melhora da comunicação entre o profissional da saúde e o paciente pode influenciar para que não ocorra a manifestação da falta de informação, uma das formas de expressão da incerteza. Aspectos como perfil socioeconômico do paciente, escolaridade e renda devem ser levados em consideração no tratamento cirúrgico de retirada de órgãos. A incerteza vivenciada por esses pacientes precisa ser mais conhecida e amplamente disseminada para ganhar destaque no ambiente de saúde.

Determinants of Organ Donation Registration Among University Students in Hong Kong

The present study explored the determinants of registration to facilitate the promotion of posthumous organ donation based on the theory of reasoned actions. A total of 211 university students participated in the study. Logistic regression, multiple regressions, and path analysis were conducted. The logistic regression model correctly predicted nearly 80% of registration status, and a good fit model of registration for posthumous organ donation (MRPOD) was proposed. Findings suggested that affective attitude, subjective norm of family, self-rated knowledge, distance from death, and age were predictors of registration. Worries about organ removal and postmortem mutilation anxiety were also mediated through bodily integrity, which had an indirect effect on the registration through affective attitude. Policymakers are suggested to address the negative emotions associated with challenges towards bodily integrity, encourage parents to initiate discussions with children, instill correct knowledge of brain death, and intervene the bystander effect on organ donation.

Knowledge and societal perceptions regarding autopsy amongst different educational backgrounds in Karachi, Pakistan

Objective: The purpose of this study is to find out awareness levels about legislation/authorization and objectives of autopsy amongst the general public, in addition to their opinions about the topic based on the different levels of education. Methods: A cross-sectional questionnaire-based study design was implemented to collect data on their knowledge, perceptions and concerns regarding autopsy from a sample population of 260 citizens aged 18 and above from all educational backgrounds of District South Karachi, Pakistan. Results: Out of total respondents 47.1% (n=122) fell within the age range of 18-25. Males were 41.7% (n=106) and females were 56.3% (n=143) in the study. Out of the 82% (n=208) who marked “Yes” to knowing the meaning of autopsy, 55.3% (n=115) of the respondents belonged to high educational level, 44.7% (n=93) belonged to low educational level. Only 44.7% (n=93) participants correctly knew the purpose for conducting an autopsy. For concerns regarding autopsy a vast majority of respondents marked “Organ removal” (21.7%, n=135) and “Disfigurement of body” (18.3%, n=114) as the top two concerns across regardless of educational level. Conclusion: Although most people held positive perception of autopsy, in depth questioning revealed a clear lack of correct information amongst the general public regarding autopsies. This has led to many falsely held beliefs including fear of body disfigurement and organ removal and less faith in the medicolegal system, irrespective of educational background. Continuous....

Perceptions of Governmental and Nongovernmental Actors of Human Trafficking Victims: The Case of Vietnam

This article explores how governmental and nongovernmental actors perceive victims of human trafficking in Vietnam. This research utilises a qualitative design, drawing on data from 30 in-depth interviews with police officials from eight study sites and two nongovernmental organisations. Findings identify that some victims of human trafficking do not fit the traditional victim images of this crime, including trafficked men for sex tourism, forced labour, organ removal, sex workers, migrants in search of seasonal employment and girls with high education levels. Implications for policies and practice are suggested from these findings.

Human trafficking, health care systems and sexually transmitted infections

Introduction: Data about the increase in human trafficking around the world are worrisome. Although there is legislation on the subject, its scope does not cover all forms and victims of trafficking. Thus, many women, children and men remain in a vulnerable situation. Objective: The purpose of this paper was to elucidate and understand, based on the literature, the relationship between human trafficking, health care systems and the increase in sexually transmitted diseases, and also to point out what is being done to combat the problem. Methods: A documentary research was conducted through an integrative review for the period from 2010 to 2020. The literature search was carried out on the basis of the CAPES journals portal using the keywords “human trafficking”, “sexually transmitted diseases”, “health care systems” and “education”. Results: The results obtained indicated that the absence of access to information, health care and education are intrinsic to the process of illegal immigration and the destination of women and children for exploitation, whether sexual, for organ removal or forced labor, and that situations of violence, absence of health care or education and coercion, among others, are common both for the conditions of trafficking and for the conditions of the increase in sexually transmitted diseases. Conclusion: Given the information obtained, it is concluded that more research must be carried out together with the agencies that investigate and apply current laws to determine what are the most effective measures to combat human trafficking. Furthermore, we highlight the need for information on policies and projects that are able to reach vulnerable populations, with the promotion of education, health care and better living conditions.

Human Trafficking: Women, Children, and Victim-Offender Overlap

Human trafficking involves exploitation in prostitution and other forms of sexual exploitation, forced labor, domestic service, and for the purpose of organ removal. The dominant narrative in human trafficking discourse on victims is that of “a young woman and naïve innocent lured or deceived into a life of lurid horror from which escape is nearly impossible,” according to Jo Doezema. This conflicts with the reality of victims who may have exercised agency and been voluntarily involved in the initial stages of the process or those agreeing to work in prostitution. Identifying victims of human trafficking is complex when their very existence in a country as undocumented migrants or their forced participation in activities deemed illegal (prostitution, participation in armed conflict or child soldiering, or criminal offenses) results in their being criminalized rather than protected. The existence of prior victims becoming traffickers, particularly in the sexual exploitation of other women, has been documented by numerous researchers. Here, and in other situations where victims are forced to participate in criminal activities, the victim-offender overlap becomes blurred. This presents a number of ethical and operational problems, in terms of how we recognize victims of human trafficking and how we discern them from offenders. Based upon a number of case studies involving women and children forced into prostitution, participation in armed conflict and terrorism, and criminal activities, the reader begins to understand the complexities of the victim-offender overlap and what measures are available to identify and protect victims of human trafficking from criminal prosecution.

Organ Trafficking and Migration: A Bibliometric Analysis of an Untold Story

The debate over trafficking of human beings for the purpose of organ removal (THBOR) remains largely absent from policy debates, as its crime is hardly detected, reported and sparsely researched. However, criminal networks continue to exploit vulnerable populations, particularly migrants. To help bridge this gap in knowledge, we employ a bibliometric analysis to examine whether the nexus between organ removal and migration is being addressed by the current academic literature. Our results indicate that (1) research exploring the link between THBOR and migrants is relatively scarce; (2) organ trafficking literature output is largely clustered in a couple of Western countries, and (3) despite the international nature of the topic, most empirical studies on organ trafficking and migration lack representation within the social sciences and humanities. Taken together, our results point to a huge gap on scientific publications between THBOR and migration. Quantitative data is required to lift the current knowledge constraints and better inform policymakers.