Abstract
The purpose of the study was to provide insight to the decision making process that Japanese patients and their families undergo when considering heart transplants in the US(via travel for transplantation)and to illustrate the interactions and decision making patterns between the patient and his or her family. The study used a grounded theory approach. Participants were interviewed in an unstructured environment, using semi-structural interview and monitoring techniques to collect data.
The participants observed consisted of six families:five patients and ten family members. Our study revealed that there were two patterns revealed in the four steps decision-making process during the interactions between the patient and his or her family, and six influencing factors. The first pattern showed where only the family made the decision. The second pattern was where the patient and family arrive at a decision together;these decisions were not always reached in the same fashion. The interactions between the family and patient revealed the following:a. Both the patient and family agree to move forward with the transplant;b. The family reaches a decision to move forward with the transplant before the patient decides to do the same;c. The patient reaches a decision to move forward with the transplant, and persuades the family to support him or her in that decision. Understanding how patients and families reach these decisions at each step will help organize a supporting structure.
