Table 2. Illustration of the relation between main categories, categories and subcategories.
Main categories | Categories | Subcategories | Exemplifying quote |
---|---|---|---|
The occurrence of death | Time point for death according to donor relatives | - Immediately when collapsing - During determination of brain death - Formally informed about death - At donation request - During donor operation - When the heart stopped beating |
“. . .I sat there by the ambulance and then I kind of understood, oh…is it this bad… Because I saw that it was just, that she wasn’t there so to say. No, I think that she was dead already then.” |
Uncertain / Contradictory: - Staff communication with dying and dead patient - Vague information about death - Psychological difficulties accepting death |
“She didn’t say it explicitly–dead–but that there was no reaction up here in the brain. And then one can figure out that it must be something like that.” | ||
Mistrust regarding declaration of death | - Insufficient skills | “…what if they didn’t do it correctly. One has read, sometimes one reads about things…” | |
From life sustaining to organ preserving interventions | Ventilator treatment after death | - Kept patient alive - Maintained though no hope - Maintained even though dead - Maintained after death for the sake of the organs - Maintained to provide oxygen to the organs - Prolonged to enable organ donation |
“He was alive thanks to the machines, so without the machines he would have died and then they cannot pick anything from him.” |
Other medical interventions given and preparations made in order to maintain organ viability | - Plenty of preparations - Fluids |
“…they give fluids and various other things to keep the organs fresh”. | |
Suspicion of less good medical treatment | - Now we have a chance - Did not give 100 percent - A done deal |
“Look, here we have a chance, we might not be able to save him…” | |
The donor operation | Information about the operation beforehand | Unspecific information: - Vague information from staff - Received no information - Cannot recall any information - Were informed but remember little - Didn’t want information - Reluctance to discuss- Specific surgeons |
“No they did not tell me anything, I mean, it is their thing…” |
Specific information: - Related to the organs - Specific surgeons - Logistic planning |
“Well, she told us which organs one can use, cornea and…” | ||
The surgical procedure | - Positive/Respectful - Neutral/Distanced - Negative/Uneasiness |
“It is just like a, ehh, surgery. So they treat you like in any surgery… well like in any operation. With respect as well…” | |
The state of the body after the operation | - Positive - Neutral - Negative |
“… that they were going to use the eyes sounded a bit nasty. But when we later took farewell of her one could not notice it at all. She looked so nice…”“… that they were going to use the eyes sounded a bit nasty. But when we later took farewell of her one could not notice it at all. She looked so nice…” | |
The donor relatives’ own decision-making process | Directly affected by their dead family member’s donation | Positively influenced: - Gained knowledge - Inspired by outcome of the donation - Proud of deceased family members’ donation |
And then they told me that they make a decision on a case-by-case basis. So, you don’t have to be too old at all, but that was what I thought before.” |
Negatively influenced: - Treatment mistakes - Media exposure |
”…It was a young doctor and he fiddled with the drainage so… No there were so many mistakes…” | ||
Mind made up long time ago | Willing: - Willingness to help others - Right thing to do - Organ shortage - Employment in medical health care |
“Well, I want to help if I can…” | |
Unwilling: - Fear not dead - Buried according to old traditions |
“I’m too old you know, and I come from the country side… I just want to be buried whole according to old traditions.” |