Emotional landscape of organ donation: a qualitative study of families' experiences in Spain.

Abstract

To explore families' experiences of deceased organ donation and examine the perceived influence of participation in the donation process on grief and bereavement in Spain. Qualitative study with a phenomenological orientation, conducted as the qualitative component of a broader mixed-method prospective cohort study, using semi-structured interviews and thematic analysis informed by an abductive approach. The study was conducted in Spain with relatives of patients declared dead by neurological or circulatory criteria following potential deceased organ donation processes. 47 relatives were interviewed approximately 1 month after the death of their family member. Interviews explored experiences of end-of-life care, communication with healthcare professionals, the organ donation request process and grief. Participants described organ donation as a meaningful experience that, in many cases, contributed to consolation, emotional well-being and a more adaptive grieving process. Trust in healthcare professionals, clear and compassionate communication, understanding of death determination and knowledge of the deceased person's wishes emerged as important facilitating factors. However, some participants also reported ambivalence, uncertainty, guilt or regret, particularly when disagreement within the family or doubts regarding the diagnosis persisted. Beyond its practical implications, organ donation was frequently associated with symbolic meanings such as continuity of life, solidarity and the preservation of the deceased person's legacy. Families' experiences of organ donation are complex and emotionally nuanced. When relatives feel supported, informed and confident in the decision-making process, organ donation may help provide meaning and comfort during bereavement. These findings highlight the importance of sensitive, family-centred communication and relational care practices in deceased organ donation processes.