中国公民器官捐献意愿的文化心理研究

发布时间：2018-06-24 01:53

本文选题：器官捐献 + 文化心理　；参考：《广州中医药大学》2016年博士论文

【摘要】：目的：器官移植供体器官短缺、供需矛盾突出是世界各国器官移植领域共同面对的问题,积极倡导以自愿无偿为核心的公民逝世后器官捐献模式对于器官移植技术的健康开展具有决定性意义。本研究旨在立足于我国文化背景,对我国公民的器官捐献意愿的文化心理因素进行整体性探究,了解公民志愿捐献状况,呈现器官捐献所涉及到的文化心理主题,分析捐献意愿产生的原因、影响因素及决定作用因素,归纳文化心理对公民器官捐献意愿的作用机制,构建器官捐献志愿者的捐献心理模型；并尝试从东西方视角对有关捐献的文化心理影响进行理论解读；为建立具有本土化属性的科学器官捐献体系提供理论和现实依据,为器官捐献工作的进一步开展提出具有针对性的对策与建议。方法：本研究以文化心理为研究视角,以建构主义认识论为理论基础,以质性研究为方法论基础。采用现象学研究方法通过器官捐献两难情境故事呈现探究器官捐献意愿的文化心理主题,运用描述性统计分析呈现器官捐献志愿者的基本状况,并应用扎根理论的研究方法通过半结构化问卷进行深入访谈。研究对象主要采用目的性抽样策略选取,采用“信息饱和法”确定样本量。研究工具包括器官捐献两难情境故事、半结构访谈提纲、录音工具等。整个质性研究的观察、访谈、资料分析等均由研究者独立完成。在研究过程中,通过完善收集资料的过程、三角检验法、专家反馈法、参与者检验法等手段以保障研究符合描述型效度、解释型效度、推论型效度、理论型效度以及评价型效度。结果：1、针对广东省户籍的器官捐献志愿者群体的统计结果显示：器官捐献志愿者群体中女性比例高于男性,年龄以20-40岁的青年群体为主,文化程度以专科及本科学历者居多,有宗教信仰的人占一定比例(13.26%),志愿登记的地区间差异与该地区经济发展水平趋于一致,职业方面以企事业员工和学生居多；电视、报纸、广播、杂志等主流媒体仍是人们了解器官捐献的主要方式,绝大部分人同意捐献全部器官,个别人对捐献某个器官有要求；超过半数的人征得了父母或其他亲属的同意,但仍有40.51%未得到家人的支持。2、通过对器官捐献志愿者捐献意愿的扎根理论研究显示：死亡态度与身体观对捐献意愿的作用是双向的；平静接纳的死亡态度、身体独立与我之外的身体观对捐献有促进作用；恐惧焦虑的死亡态度、身体即是我的身体观会妨碍捐献；但焦虑恐惧又会触发存在的思考,身我合一的存在使命与生命意义的启迪又反过来可以促进捐献。器官捐献意愿的文化心理机制是：个体利用器官捐献实现身体存在或精神意义从而克服死亡恐惧,达到自身对生的诉求,进而构建了“实现于存在的生命延续”这一器官捐献志愿者的心理模型。3、围绕公民器官捐献提炼出与中国文化心理相关的死亡、意义、丧失、避讳和尊重五个文化主题；以及死亡恐惧、死亡焦虑等情绪因素。其中,对于器官捐献具有促进作用的有：持自然接受和趋近导向的死亡态度,能够赋予器官捐献以意义(有利于个人、他人、社会等)；对器官捐献具有阻碍作用的有：对死亡持逃避、恐惧态度,担心丧失,担心不吉利而避讳等；在行为决定前人们渴求更多的社会支持,并希望自己的决定能够得到家人的尊重,尤其是重要亲人的理解与支持；并发现附加利益可能会使器官捐献意义本质发生改变,进而影响捐献意愿。4、通过对影响器官捐献文化心理因素的理论分析发现：首先,中国人对于器官捐献表现出避讳和禁忌的现象其实质是死亡恐惧,但死亡恐惧也会成为触发人类主动找寻精神栖居地的内在心理动因；其次,身心二元论和身心合一的本体论作为东西方不同的身体观会导致人们对身体器官的不同态度,需要注意分辨可以加以利用；第三,向死而生的存在意义为我们提供一种超越死亡恐惧的新的存在方式,对此,中国传统文化中儒释道不同的人生意境和存在主义心理学的意义疗法都提供存在意义的找寻提供了颇具可能的操作范式,值得借鉴。5、通过理论联系实际提出我国器官捐献工作的对策和建议：认为加强公民生命教育,促进积极死亡态度；重视个人存在体验,强化个体存在意义以及注重营造全社会支持的氛围,促进家庭的理解和尊重是我国文化背景下器官捐献需要重视加强的方面,建议在公共部门管理层面：依托中国文化背景,尊重公民心理需求,针对性开展公众宣传,完善器官捐献体系建设；在相关工作人员层面：熟悉中国不同地域民众的风俗及文化习惯,注重了解不同个体的身体观认识,尊重个体差异,个性化开展工作；在公民个体层面：提早思考衰老和死亡,更好地完善当下的人生。结论：1.年龄及文化程度因素与公民捐献意愿相关,但作用机制仍需进一步了解；家庭是器官捐献志愿者的重要社会支持力量,家人同意率不高应引起重视；器官捐献宣传力度仍需进一步加大,尤应重视加强网络及新媒体的宣传作用；器官捐献志愿者的个人需求应予以重视和尊重,特殊个案值得进一步研究。2、器官捐献志愿者作为生命意义的践行者,利用器官捐献实现身体存在或精神意义从而克服死亡恐惧,达到自身对生的诉求,进而完成了“实现于存在的生命延续”这一心理路径。其中对生死的思考会触发器官捐献意愿；生命的延续是捐献意愿最大的原动力；实现生命存在的意义是器官捐献意愿的决定因素；3、由于我国的传统文化背景,会因死亡恐惧导致的避讳、身体完整性丧失引发焦虑情绪而影响捐献意愿；公民个体对器官捐献进行意义的赋予则可以使捐献意愿获得心理支持,从而战胜恐惧和焦虑情绪；4、死亡态度和身心关系是影响器官捐献态度的重要文化心理因素,持有或积极或自然的死亡态度、身心二元的身心观对器官捐献有促进作用,而持有消极死亡态度和身心一元论虽然对器官捐献有阻碍作用,但可以通过生命价值的追问和德性身体的实现,最终实现对存在意义的追寻。5、中国传统文化中对生命意义的关照,尤其是传统儒释道文化中有益的生死价值理念,对中国人冲破生死和身体限制达到追求存在意义的自由境界,提供了很多路径选择的可能。6、充分了解中国公民文化心理特点,点面结合,既重视开展大众教育,又尊重理解个体差异,并针对性进行宣教,调动公民个体对自我存在意义实现的动力,是提高我国公民逝世后自愿捐献率的重要路径。具体可以从公共管理层面、相关工作人员层面及公民个体层面等三个层面分别开展工作。
[Abstract]:Objective: the shortage of organ donor organs, the prominent contradiction between supply and demand is a common problem in the field of organ transplantation in the world. The cultural psychological factors of citizen's organ donation will be taken as a whole, to understand the status of citizen voluntary donation, to present the cultural and psychological themes involved in organ donation, to analyze the causes of the donation will, to influence factors and to determine the factors of action, to sum up the mechanism of the cultural psychology to the willingness of the public to donate, and to construct the organ donation. In order to provide theoretical and practical basis for the establishment of a scientific organ donation system with localization property, this paper provides a theoretical and practical basis for the establishment of a scientific organ donation system with localization attributes, and provides some pertinent countermeasures and suggestions for the further development of organ donation. We take the cultural psychology as the research perspective, take the constructivist epistemology as the theoretical basis, and take the qualitative research as the methodology basis. The phenomenological research method is used to present the cultural and psychological themes of the organ donation will through the story of the organ donation, and the descriptive statistics and analysis are used to present the basic situation of the organ donation volunteers. Through the semi structured questionnaire, the paper uses the semi structured questionnaire to conduct in-depth interviews. The object of the study is to select the target sampling strategy and use the "information saturation method" to determine the sample size. The research tools include the story of the dilemma of organ donation, the outline of the semi structure interview, the recording tool and so on. In the course of the study, by improving the process of collecting data, triangulation test, expert feedback, and participant inspection, the research is in accordance with descriptive validity, explanatory validity, inferential validity, theoretical validity and evaluation type validity. Results: 1, organ donation to the household registration of Guangdong province. The statistical results of the volunteer group showed that the proportion of women in the volunteer group was higher than that of the male group, the majority of the young people aged 20-40 years, the majority of the students with professional and undergraduate education, and the proportion of the people with religious belief (13.26%). The regional differences in voluntary registration were consistent with the level of economic development in the region. The mainstream media, such as television, newspapers, radio, magazines, and other mainstream media, is still the main way of understanding organ donation. Most people agree to donate all organs, others are required to donate an organ; more than half of them have the consent of parents or other relatives, but 40.51% still have not. To the support of family support.2, a grounded theory study of the willingness to donate volunteers showed that the attitude of death and the body view played a two-way role in the willingness to donate; the calm and accepted attitude of death, the physical independence and the physical view outside of me promoted the donation; the fear of anxiety and the death attitude of anxiety, the body was my body. View will impede the donation; but anxiety and fear will trigger the thought of existence. The Enlightenment of the mission and the meaning of life in one of the body and I can contribute to the donation. The cultural psychological mechanism of the intention of organ donation is that the individual use organ donation to achieve physical existence or spiritual meaning from the fear of death, and to achieve its own right to life. And then, we build a psychological model.3 of an organ donation volunteer that is "the existence of life continuity", and extracts five cultural themes related to Chinese cultural psychology, such as death, meaning, loss, taboo and respect around Chinese cultural psychology, as well as emotional factors such as death fear and death and anxiety. The promotion is: natural acceptance and approach oriented death attitude, which can give meaning to organ donation (beneficial to individuals, other people, society, etc.); there are obstacles to organ donation: death evasion, fear, fear of loss, fear of unlucky and taboo; people craving more society before behavior decision. Support, and hope that their decisions can be respected by the family, especially the understanding and support of important relatives, and that additional benefits may change the essence of the meaning of organ donation, and then affect the willingness to donate.4. Through theoretical analysis of cultural psychological factors affecting organ donation, first, Chinese people donate to organs. The essence of the taboo and taboo is the fear of death, but the fear of death will also become the inner psychological cause that triggers the human initiative to find the spiritual habitat. Secondly, the body and body theory of physical and mental dualism and physical and mental unity will lead to people's different attitudes towards the body organs as the different physical views of the East and the west, and need to be distinguished. Third, the existence meaning to death provides us with a new way of existence beyond the fear of death. In the traditional culture of Chinese traditional culture, the different life conception of Confucianism, the meaning therapy of existentialism and the meaning of existentialism provide the possible operational paradigm, which is worthy of reference to.5. The countermeasures and suggestions of organ donation work in China are put forward through theory and practice. It is considered that strengthening citizen life education and promoting positive death attitude, paying attention to personal existence experience, strengthening the significance of individual existence and emphasizing the atmosphere of building all social support, and promoting family understanding and respect are the need of organ donation under the cultural background of our country. On the aspect of strengthening, it is suggested that in the management level of the public sector, we should rely on the cultural background of China, respect the psychological needs of the citizens, carry out public propaganda and improve the construction of organ donation system, and be familiar with the customs and culture habits of the people of different regions in China, and pay attention to understanding the physical concept of different individuals, and respect the understanding of the body view of different individuals. Individual differences and individualized work; at the individual level of citizens: thinking about senility and death early and improving the present life better. Conclusion: the 1. age and the cultural degree are related to the willingness of the citizen to contribute, but the mechanism of action still needs to be further understood; the family is an important social support force for the volunteers of organ donation, and the family agrees. Not high rate should be paid attention to; the publicity of organ donation needs to be further strengthened, especially to strengthen the propaganda role of the network and the new media; the individual needs of the volunteers of organ donation should be paid attention and respect. The special cases deserve further study of.2, organ donation volunteers as a person of life significance, and the use of organ donation. There is physical existence or spiritual significance to overcome the fear of death, to achieve their own demands for life, and then to complete the psychological path of "realizing the existence of life". Among them, the thinking of life and death triggers the willingness of organ donation; the continuation of life is the greatest motive force of the willingness to donate; the significance of realizing life is organ donation. The determinants of the willingness to offer; 3, due to the traditional cultural background of our country, the fear of death caused by the fear of death, the loss of physical integrity causing anxiety and the influence of the willingness to donate; the individual's individual to the meaning of organ donation can make the desire of the donation psychological support, thus defeating the fear and anxiety; 4, the death state. The relationship between degree and body and mind is an important cultural and psychological factor affecting the attitude of organ donation. Holding or positive or natural death attitude, physical and mental outlook of two yuan in body and mind can promote organ donation, while holding negative death attitude and physical and mental monism can be hindered by organ donation, but it can be passed through the pursuit of life value and virtue. The realization of the body, finally to the pursuit of the meaning of the existence of.5, the Chinese traditional culture of the meaning of life, especially the traditional Confucian and Taoist culture of the beneficial concept of life and death, to the Chinese people to break through life and death and body restrictions to achieve the pursuit of the existence of a sense of freedom, provides a number of possible paths to choose the possible.6, fully understand the Chinese public The psychological characteristics of the people and the combination of point to surface, not only pay attention to the development of public education, but also respect the understanding of individual differences, and to promote the motivation of the individual to realize the meaning of self existence. It is an important way to improve the voluntary donation rate after the death of the citizens of our country. It can be taken from the public management level, the related staff level and the citizens. Three levels, such as the individual level, are carried out respectively.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R193.3

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