本文選題：器官捐獻(xiàn) + 文化心理��； 參考：《廣州中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：器官移植供體器官短缺、供需矛盾突出是世界各國(guó)器官移植領(lǐng)域共同面對(duì)的問(wèn)題,積極倡導(dǎo)以自愿無(wú)償為核心的公民逝世后器官捐獻(xiàn)模式對(duì)于器官移植技術(shù)的健康開(kāi)展具有決定性意義。本研究旨在立足于我國(guó)文化背景,對(duì)我國(guó)公民的器官捐獻(xiàn)意愿的文化心理因素進(jìn)行整體性探究,了解公民志愿捐獻(xiàn)狀況,呈現(xiàn)器官捐獻(xiàn)所涉及到的文化心理主題,分析捐獻(xiàn)意愿產(chǎn)生的原因、影響因素及決定作用因素,歸納文化心理對(duì)公民器官捐獻(xiàn)意愿的作用機(jī)制,構(gòu)建器官捐獻(xiàn)志愿者的捐獻(xiàn)心理模型；并嘗試從東西方視角對(duì)有關(guān)捐獻(xiàn)的文化心理影響進(jìn)行理論解讀；為建立具有本土化屬性的科學(xué)器官捐獻(xiàn)體系提供理論和現(xiàn)實(shí)依據(jù),為器官捐獻(xiàn)工作的進(jìn)一步開(kāi)展提出具有針對(duì)性的對(duì)策與建議。方法：本研究以文化心理為研究視角,以建構(gòu)主義認(rèn)識(shí)論為理論基礎(chǔ),以質(zhì)性研究為方法論基礎(chǔ)。采用現(xiàn)象學(xué)研究方法通過(guò)器官捐獻(xiàn)兩難情境故事呈現(xiàn)探究器官捐獻(xiàn)意愿的文化心理主題,運(yùn)用描述性統(tǒng)計(jì)分析呈現(xiàn)器官捐獻(xiàn)志愿者的基本狀況,并應(yīng)用扎根理論的研究方法通過(guò)半結(jié)構(gòu)化問(wèn)卷進(jìn)行深入訪談。研究對(duì)象主要采用目的性抽樣策略選取,采用“信息飽和法”確定樣本量。研究工具包括器官捐獻(xiàn)兩難情境故事、半結(jié)構(gòu)訪談提綱、錄音工具等。整個(gè)質(zhì)性研究的觀察、訪談、資料分析等均由研究者獨(dú)立完成。在研究過(guò)程中,通過(guò)完善收集資料的過(guò)程、三角檢驗(yàn)法、專(zhuān)家反饋法、參與者檢驗(yàn)法等手段以保障研究符合描述型效度、解釋型效度、推論型效度、理論型效度以及評(píng)價(jià)型效度。結(jié)果：1、針對(duì)廣東省戶(hù)籍的器官捐獻(xiàn)志愿者群體的統(tǒng)計(jì)結(jié)果顯示：器官捐獻(xiàn)志愿者群體中女性比例高于男性,年齡以20-40歲的青年群體為主,文化程度以專(zhuān)科及本科學(xué)歷者居多,有宗教信仰的人占一定比例(13.26%),志愿登記的地區(qū)間差異與該地區(qū)經(jīng)濟(jì)發(fā)展水平趨于一致,職業(yè)方面以企事業(yè)員工和學(xué)生居多；電視、報(bào)紙、廣播、雜志等主流媒體仍是人們了解器官捐獻(xiàn)的主要方式,絕大部分人同意捐獻(xiàn)全部器官,個(gè)別人對(duì)捐獻(xiàn)某個(gè)器官有要求；超過(guò)半數(shù)的人征得了父母或其他親屬的同意,但仍有40.51%未得到家人的支持。2、通過(guò)對(duì)器官捐獻(xiàn)志愿者捐獻(xiàn)意愿的扎根理論研究顯示：死亡態(tài)度與身體觀對(duì)捐獻(xiàn)意愿的作用是雙向的；平靜接納的死亡態(tài)度、身體獨(dú)立與我之外的身體觀對(duì)捐獻(xiàn)有促進(jìn)作用；恐懼焦慮的死亡態(tài)度、身體即是我的身體觀會(huì)妨礙捐獻(xiàn)；但焦慮恐懼又會(huì)觸發(fā)存在的思考,身我合一的存在使命與生命意義的啟迪又反過(guò)來(lái)可以促進(jìn)捐獻(xiàn)。器官捐獻(xiàn)意愿的文化心理機(jī)制是：個(gè)體利用器官捐獻(xiàn)實(shí)現(xiàn)身體存在或精神意義從而克服死亡恐懼,達(dá)到自身對(duì)生的訴求,進(jìn)而構(gòu)建了“實(shí)現(xiàn)于存在的生命延續(xù)”這一器官捐獻(xiàn)志愿者的心理模型。3、圍繞公民器官捐獻(xiàn)提煉出與中國(guó)文化心理相關(guān)的死亡、意義、喪失、避諱和尊重五個(gè)文化主題；以及死亡恐懼、死亡焦慮等情緒因素。其中,對(duì)于器官捐獻(xiàn)具有促進(jìn)作用的有：持自然接受和趨近導(dǎo)向的死亡態(tài)度,能夠賦予器官捐獻(xiàn)以意義(有利于個(gè)人、他人、社會(huì)等)；對(duì)器官捐獻(xiàn)具有阻礙作用的有：對(duì)死亡持逃避、恐懼態(tài)度,擔(dān)心喪失,擔(dān)心不吉利而避諱等；在行為決定前人們渴求更多的社會(huì)支持,并希望自己的決定能夠得到家人的尊重,尤其是重要親人的理解與支持；并發(fā)現(xiàn)附加利益可能會(huì)使器官捐獻(xiàn)意義本質(zhì)發(fā)生改變,進(jìn)而影響捐獻(xiàn)意愿。4、通過(guò)對(duì)影響器官捐獻(xiàn)文化心理因素的理論分析發(fā)現(xiàn)：首先,中國(guó)人對(duì)于器官捐獻(xiàn)表現(xiàn)出避諱和禁忌的現(xiàn)象其實(shí)質(zhì)是死亡恐懼,但死亡恐懼也會(huì)成為觸發(fā)人類(lèi)主動(dòng)找尋精神棲居地的內(nèi)在心理動(dòng)因；其次,身心二元論和身心合一的本體論作為東西方不同的身體觀會(huì)導(dǎo)致人們對(duì)身體器官的不同態(tài)度,需要注意分辨可以加以利用；第三,向死而生的存在意義為我們提供一種超越死亡恐懼的新的存在方式,對(duì)此,中國(guó)傳統(tǒng)文化中儒釋道不同的人生意境和存在主義心理學(xué)的意義療法都提供存在意義的找尋提供了頗具可能的操作范式,值得借鑒。5、通過(guò)理論聯(lián)系實(shí)際提出我國(guó)器官捐獻(xiàn)工作的對(duì)策和建議：認(rèn)為加強(qiáng)公民生命教育,促進(jìn)積極死亡態(tài)度；重視個(gè)人存在體驗(yàn),強(qiáng)化個(gè)體存在意義以及注重營(yíng)造全社會(huì)支持的氛圍,促進(jìn)家庭的理解和尊重是我國(guó)文化背景下器官捐獻(xiàn)需要重視加強(qiáng)的方面,建議在公共部門(mén)管理層面：依托中國(guó)文化背景,尊重公民心理需求,針對(duì)性開(kāi)展公眾宣傳,完善器官捐獻(xiàn)體系建設(shè)；在相關(guān)工作人員層面：熟悉中國(guó)不同地域民眾的風(fēng)俗及文化習(xí)慣,注重了解不同個(gè)體的身體觀認(rèn)識(shí),尊重個(gè)體差異,個(gè)性化開(kāi)展工作；在公民個(gè)體層面：提早思考衰老和死亡,更好地完善當(dāng)下的人生。結(jié)論：1.年齡及文化程度因素與公民捐獻(xiàn)意愿相關(guān),但作用機(jī)制仍需進(jìn)一步了解；家庭是器官捐獻(xiàn)志愿者的重要社會(huì)支持力量,家人同意率不高應(yīng)引起重視；器官捐獻(xiàn)宣傳力度仍需進(jìn)一步加大,尤應(yīng)重視加強(qiáng)網(wǎng)絡(luò)及新媒體的宣傳作用；器官捐獻(xiàn)志愿者的個(gè)人需求應(yīng)予以重視和尊重,特殊個(gè)案值得進(jìn)一步研究。2、器官捐獻(xiàn)志愿者作為生命意義的踐行者,利用器官捐獻(xiàn)實(shí)現(xiàn)身體存在或精神意義從而克服死亡恐懼,達(dá)到自身對(duì)生的訴求,進(jìn)而完成了“實(shí)現(xiàn)于存在的生命延續(xù)”這一心理路徑。其中對(duì)生死的思考會(huì)觸發(fā)器官捐獻(xiàn)意愿；生命的延續(xù)是捐獻(xiàn)意愿最大的原動(dòng)力；實(shí)現(xiàn)生命存在的意義是器官捐獻(xiàn)意愿的決定因素；3、由于我國(guó)的傳統(tǒng)文化背景,會(huì)因死亡恐懼導(dǎo)致的避諱、身體完整性喪失引發(fā)焦慮情緒而影響捐獻(xiàn)意愿；公民個(gè)體對(duì)器官捐獻(xiàn)進(jìn)行意義的賦予則可以使捐獻(xiàn)意愿獲得心理支持,從而戰(zhàn)勝恐懼和焦慮情緒；4、死亡態(tài)度和身心關(guān)系是影響器官捐獻(xiàn)態(tài)度的重要文化心理因素,持有或積極或自然的死亡態(tài)度、身心二元的身心觀對(duì)器官捐獻(xiàn)有促進(jìn)作用,而持有消極死亡態(tài)度和身心一元論雖然對(duì)器官捐獻(xiàn)有阻礙作用,但可以通過(guò)生命價(jià)值的追問(wèn)和德性身體的實(shí)現(xiàn),最終實(shí)現(xiàn)對(duì)存在意義的追尋。5、中國(guó)傳統(tǒng)文化中對(duì)生命意義的關(guān)照,尤其是傳統(tǒng)儒釋道文化中有益的生死價(jià)值理念,對(duì)中國(guó)人沖破生死和身體限制達(dá)到追求存在意義的自由境界,提供了很多路徑選擇的可能。6、充分了解中國(guó)公民文化心理特點(diǎn),點(diǎn)面結(jié)合,既重視開(kāi)展大眾教育,又尊重理解個(gè)體差異,并針對(duì)性進(jìn)行宣教,調(diào)動(dòng)公民個(gè)體對(duì)自我存在意義實(shí)現(xiàn)的動(dòng)力,是提高我國(guó)公民逝世后自愿捐獻(xiàn)率的重要路徑。具體可以從公共管理層面、相關(guān)工作人員層面及公民個(gè)體層面等三個(gè)層面分別開(kāi)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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R193.3

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6 記者 呂sァ⊥ㄑ對(duì)，

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