Article(id=1322630862370358054, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.18.021, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1764000000000, receivedDateStr=2025-11-25, revisedDate=1786291200000, revisedDateStr=2026-08-10, acceptedDate=null, acceptedDateStr=null, onlineDate=1793269370882, onlineDateStr=2026-10-29, pubDate=1790265600000, pubDateStr=2026-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793269370882, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793269370882, creator=13701087609, updateTime=1793269370882, updator=13701087609, issue=Issue{id=1322630794611380728, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='18', pageStart='3153', pageEnd='3344', issueExtLink='null', onlineDate='null', pubDate='1790265600000', pubDateStr='2026-09-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1793269354727, creator='13701087609', updateTime=1793343080645, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940023645011984, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940023645011985, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322630794611380728, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3286, endPage=3291, ext={EN=ArticleExt(id=1322630862550713127, articleId=1322630862370358054, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Qualitative study on motivations for hematopoietic stem cell donation behavior among unrelated donors based on the Fogg behavior model, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the influencing factors of hematopoietic stem cell donation behavior among unrelated donors(URDs) based on the Fogg behavior model,and to provide reference for enhancing donation willingness.

Methods

Purposive sampling was adopted.A total of 14 URDs who donated hematopoietic stem cells in a tertiary grade A hospital in Nanchang from December 2024 to July 2025 were selected as research subjects.Semi-structured interviews were conducted with them.The data were analyzed using a descriptive qualitative research method and directed content analysis.

Results

A total of 3 themes and 10 sub-themes were extracted,including initial donation drivers(growth environment,life supremacy,manageable costs,and perceived benefits),donation capability(physical autonomy,reconstruction of medical risks,and scientifically informed information discernment),and social contextual prompts(promotion of blood donation behavior,situation-triggered compassion,and expectations of patients with low-probability matching).

Conclusions

The hematopoietic stem cell donation behavior of URDs is collaboratively driven by initial motivation,self-capability,and contextual prompts.Healthcare professionals and Red Cross staff may improve the donation support system and promote URD donation behavior through life education,risk assessment support,and the construction of social prompt networks.

, authors=Qi HU1, 2, Luru LIU2, Qiling LU3, Haizhen HU1, Dan XIAO1, Defeng ZOU4, Liang FANG1, authorsList=Qi HU, Luru LIU, Qiling LU, Haizhen HU, Dan XIAO, Defeng ZOU, Liang FANG, authorCompany=null, correspAuthors=Liang FANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322630863075001130, articleId=1322630862370358054, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=基于福格行为模型的非亲属捐赠者造血干细胞捐献行为动因质性研究, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

基于福格行为模型探究非亲属捐赠者(URDs)的造血干细胞捐献行为影响因素,为提升捐献意愿提供参考。

方法

采用目的抽样法,选取2024年12月—2025年7月在南昌市某三级甲等医院捐献造血干细胞的14名URDs为研究对象,对其进行半结构式访谈,并采用描述性质性研究方法和定向内容分析法进行资料分析。

结果

共提取3个主题及10个亚主题,包括捐献初始动因(成长环境、生命至上、代价可控、益处感知)、捐献行为能力(身体支配权、医疗风险重构、科学辨别信息)、社会情境提示(献血行为的推动、情景触发恻隐心、低概率匹配的病人期待)。

结论

URDs的造血干细胞捐献行为由初始动机、自主能力、场域提示要素协同驱动。医护人员与红十字会工作人员可通过生命教育、风险评估支持、社会提示网络构建完善捐献支持系统,促进URDs的捐献行为。

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胡期,硕士研究生在读

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方亮,E-mail:
FANG Liang, E-mail:
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Affiliated Hospital of Nanchang University), AuthorCompanyExt(id=1322630865067295542, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630862370358054, companyId=1322630865046324020, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4南昌大学第四 附属医院)])], figs=[ArticleFig(id=1322630867441271655, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630862370358054, language=EN, label=Figure 1, caption=Fogg Behavior Model, figureFileSmall=DSdAwG+puIBOyE93XExuYQ==, figureFileBig=MSQDYvT8Rt+uMHr01srYLw==, tableContent=null), ArticleFig(id=1322630867516769128, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630862370358054, language=CN, label=图1, caption=福格行为模型

(资源来源:FOGG B J.福格行为模型[M].徐毅,译.天津:天津科学技术出版社,2021.)

, figureFileSmall=DSdAwG+puIBOyE93XExuYQ==, figureFileBig=MSQDYvT8Rt+uMHr01srYLw==, tableContent=null), ArticleFig(id=1322630867692929897, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630862370358054, language=EN, label=Table 1, caption=

General information on the research subjects(n=14)

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编号年龄(岁)性别学历常住地家人态度入库方式婚姻状况
A25男本科农村反对献血站登记未婚
B35男本科城镇强烈支持献血站登记已婚
C24男硕士研究生农村支持献血站登记未婚
D42男初中农村支持献血站登记离异
E33男本科城镇中立“三献活动”未婚
F27女本科城镇反对献血站登记已婚
G42女高中城镇支持献血站登记已婚
H30女专科农村中立献血站登记已婚
I23女本科城镇反对献血站登记已婚
J25女本科农村反对献血站登记未婚
K21男本科城镇中立献血站登记未婚
L45男初中农村反对献血站登记已婚
M37男高中城镇反对献血站登记离异
N28女专科城镇中立献血站登记未婚
), ArticleFig(id=1322630869353874282, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322630862370358054, language=CN, label=表1, caption=

研究对象一般资料(n=14)

, figureFileSmall=null, figureFileBig=null, tableContent=
编号年龄(岁)性别学历常住地家人态度入库方式婚姻状况
A25男本科农村反对献血站登记未婚
B35男本科城镇强烈支持献血站登记已婚
C24男硕士研究生农村支持献血站登记未婚
D42男初中农村支持献血站登记离异
E33男本科城镇中立“三献活动”未婚
F27女本科城镇反对献血站登记已婚
G42女高中城镇支持献血站登记已婚
H30女专科农村中立献血站登记已婚
I23女本科城镇反对献血站登记已婚
J25女本科农村反对献血站登记未婚
K21男本科城镇中立献血站登记未婚
L45男初中农村反对献血站登记已婚
M37男高中城镇反对献血站登记离异
N28女专科城镇中立献血站登记未婚
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胡期 1, 2 , 刘渌如 2 , 卢其玲 3 , 胡海珍 1 , 肖丹 1 , 邹德凤 4 , 方亮 1, *, *
护理研究 | 综合研究 2026,40(18): 3286-3291
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护理研究 |综合研究 2026 , 40 (18) : 3286 -3291
基于福格行为模型的非亲属捐赠者造血干细胞捐献行为动因质性研究
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胡期1, 2, 刘渌如2, 卢其玲3, 胡海珍1, 肖丹1, 邹德凤4, 方亮1, *, *
作者信息
  • 1南昌大学第二附属医院,江西 330006
  • 2南昌大学江西医学院护理学院
  • 3江西省人民医院
  • 4南昌大学第四 附属医院
通讯作者:
方亮,E-mail:
FANG Liang, E-mail:
作者简介:

胡期,硕士研究生在读

Qualitative study on motivations for hematopoietic stem cell donation behavior among unrelated donors based on the Fogg behavior model
Qi HU1, 2, Luru LIU2, Qiling LU3, Haizhen HU1, Dan XIAO1, Defeng ZOU4, Liang FANG1
Affiliations
  • 1The Second Affiliated Hospital of Nanchang University, Jiangxi 330006 China
  • 2School of Nursing,Jiangxi Medical College, Nanchang University
  • 3Jiangxi Provincial People's Hospital
  • 4The Fourth Affiliated Hospital of Nanchang University
出版时间: 2026-09-25 doi: 10.12102/j.issn.1009-6493.2026.18.021
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目的

基于福格行为模型探究非亲属捐赠者(URDs)的造血干细胞捐献行为影响因素,为提升捐献意愿提供参考。

方法

采用目的抽样法,选取2024年12月—2025年7月在南昌市某三级甲等医院捐献造血干细胞的14名URDs为研究对象,对其进行半结构式访谈,并采用描述性质性研究方法和定向内容分析法进行资料分析。

结果

共提取3个主题及10个亚主题,包括捐献初始动因(成长环境、生命至上、代价可控、益处感知)、捐献行为能力(身体支配权、医疗风险重构、科学辨别信息)、社会情境提示(献血行为的推动、情景触发恻隐心、低概率匹配的病人期待)。

结论

URDs的造血干细胞捐献行为由初始动机、自主能力、场域提示要素协同驱动。医护人员与红十字会工作人员可通过生命教育、风险评估支持、社会提示网络构建完善捐献支持系统,促进URDs的捐献行为。

福格行为模型(FBM)  /  异基因造血干细胞移植  /  非亲属捐赠者(URDs)  /  利他主义  /  质性研究  /  护理
Objective

To explore the influencing factors of hematopoietic stem cell donation behavior among unrelated donors(URDs) based on the Fogg behavior model,and to provide reference for enhancing donation willingness.

Methods

Purposive sampling was adopted.A total of 14 URDs who donated hematopoietic stem cells in a tertiary grade A hospital in Nanchang from December 2024 to July 2025 were selected as research subjects.Semi-structured interviews were conducted with them.The data were analyzed using a descriptive qualitative research method and directed content analysis.

Results

A total of 3 themes and 10 sub-themes were extracted,including initial donation drivers(growth environment,life supremacy,manageable costs,and perceived benefits),donation capability(physical autonomy,reconstruction of medical risks,and scientifically informed information discernment),and social contextual prompts(promotion of blood donation behavior,situation-triggered compassion,and expectations of patients with low-probability matching).

Conclusions

The hematopoietic stem cell donation behavior of URDs is collaboratively driven by initial motivation,self-capability,and contextual prompts.Healthcare professionals and Red Cross staff may improve the donation support system and promote URD donation behavior through life education,risk assessment support,and the construction of social prompt networks.

Fogg behavior model, FBM  /  allogeneic hematopoietic stem cell transplantation  /  unrelated donors, URDs  /  altruism  /  qualitative research  /  nursing
胡期, 刘渌如, 卢其玲, 胡海珍, 肖丹, 邹德凤, 方亮. 基于福格行为模型的非亲属捐赠者造血干细胞捐献行为动因质性研究. 护理研究, 2026 , 40 (18) : 3286 -3291 . DOI: 10.12102/j.issn.1009-6493.2026.18.021
Qi HU, Luru LIU, Qiling LU, Haizhen HU, Dan XIAO, Defeng ZOU, Liang FANG. Qualitative study on motivations for hematopoietic stem cell donation behavior among unrelated donors based on the Fogg behavior model[J]. Chinese Nursing Research, 2026 , 40 (18) : 3286 -3291 . DOI: 10.12102/j.issn.1009-6493.2026.18.021
2022年全球癌症统计数据显示,血液恶性肿瘤占全球癌症病例总数的6.6%,占癌症相关死亡总数的7.2%[1]。造血干细胞移植(hematopoietic stem cell transplantation,HSCT)是治疗血液疾病的有效手段之一[2],但目前仅有较少(25%~30%)病人能找到人体白细胞抗原相合的亲属供者(related donors,RDS),绝大多数移植依赖于非亲属捐赠者(unrelated donors,URDs),而URDs实际捐赠仅占50%[3-4],悔捐行为时有发生,其原因涉及生理恐惧、家庭反对、信息支持缺失及医疗突发状况等因素[5]。既往研究多从生命拯救、家庭期许、身份认同、宗教信仰、风险淡化、社会压力等方面分析捐赠初始动机[6-7],缺乏对捐献全程的行为探究。福格行为模型(Fogg behavior model,FBM)主张通过动机、能力和提示3个维度分析行为[8],被广泛运用于疫苗接种[9]、慢性病管理[10]等健康行为研究。造血干细胞捐献过程复杂、周期长,涉及捐献者相关的认知、情感、社会支持等因素,传统的动机视角无法完整揭示行为发生机制,更难以保障捐献事宜的顺利完成[11]。因此,本研究基于福格行为模型,通过质性访谈探讨URDs捐献行为的影响因素,为构建多层次的捐献促进策略提供参考。
福格行为模型揭示了驱动人类所有行为的3个关键要素,即动机、能力、提示,动机为驱使个体采取行动的内在动力或外部诱因;能力为个体在特定情境下执行某项行为的可行性和容易程度;提示为提醒个体做出特定行为的信号或刺激。以坐标横轴代表实施行为所需要的能力,纵轴代表动机程度,象限内曲线右上方代表提示,绘制福格行为模型[8],见图1。为确保行为的产生,所有条件均被视为必要要素。动机不足时,应该设置某种机制刺激行为意向;能力不足时,可以加以引导提高行为能力;在动机和能力都满足的情况下,只需要设置某种提示即可触发行为[12]。鉴于造血干细胞捐献行为的复杂性,本研究基于福格行为模型突破传统捐献动机的聚焦视角,从捐献者的初始动机、行为能力和社会感知多方面深入剖析其捐献行为的发生。
采用目的抽样法,选取2024年12月—2025年7月在南昌市某三级甲等医院血液科捐献造血干细胞的URDs为研究对象。纳入标准:1)既往1年成功捐献造血干细胞;2)与受者非亲属关系;3)年龄≥18岁,初中及以上文化程度;4)意识清楚,能流畅表达自己的观点。排除标准:1)存在认知障碍或精神、心理疾病;2)患有恶性肿瘤或严重器质性疾病;3)个人或家庭近期发生重大灾害事件;4)拒绝对访谈内容进行记录。剔除标准:1)因身体及其他客观因素中断访谈或无法继续接受访谈;2)录音效果欠佳致资料缺失。基于差异最大化原则,抽样过程中覆盖不同性别、年龄、文化程度等一般人口学特征,以求最大限度获得相关信息,最终纳入14名URDs(样本量以访谈资料饱和、不再出现新主题为准,编号A~N),其一般资料见表1。本研究已通过江西省人民医院伦理委员会审批[审批号:科快2025(45)号],所有URDs均签署知情同意书,自愿参与本研究。
组建研究团队,团队成员具备医务工作者、红十字会志愿者双重身份,曾多次参与质性研究专题工作坊,阅读相关书籍,具有扎实的理论基础,并长期从事“三献”志愿事业,熟悉造血干细胞捐献全流程,兼具理论与实践经验。访谈中,研究者以红十字会志愿者身份参与,利于拉近与URDs距离、建立信任以提升访谈质量。为避免因文献回顾与过往研究形成的固有认知影响中立性,团队成员始终保持自我反思,客观真实“深描”对URDs的所见所感。
以福格行为模型为理论指导,通过回顾国内外文献和课题组讨论,初步拟定访谈提纲。预访谈2名URDs,结合访谈情况和专家意见修改,形成正式访谈提纲。1)过程回顾:请您讲讲从登记成为志愿者,到完成捐献及之后恢复的整个过程?2)决策核心:是什么让您最终决定加入中华骨髓库并进行捐献?3)能力判断:您通过哪些渠道了解捐献相关信息以判断自己是否具备完成捐献的条件。4)自我感知:整个过程中,您认为哪些环节对自身的生理或心理能力构成了挑战?您是如何应对这些挑战的?5)社会契机:请您简单讲述是否有具体的事件、信息或场景推动您顺利完成捐献?6)深刻瞬间:整个过程中哪刻或哪件事让您印象最深?为什么?
采用描述性质性研究方法,由2名接受过访谈训练的研究团队核心成员提前与URDs约定时间、地点,于捐献完成后进行面对面半结构式访谈(避免影响URDs捐献前的心理状态)。1名研究者于访谈前说明研究目的、签署知情同意书、取得录音权限,访谈过程中视情况调整访谈问题,鼓励、尊重其表达,以总结、询问方式澄清问题;另1名研究者全程录音,细致观察URDs面部表情、肢体动作等关键非言语信息,过程中积极倾听,做到不诱导、不评价。访谈约60 min,文本存疑处24 h内回访,同时撰写访谈备忘录与反思日记。当资料收集无法产生新核心类属时,再招募2名URDs验证,确认无新类属或关系后,判定类属饱和并结束资料收集。
访谈结束后24 h内由2名研究者转录录音并标注相关备忘录,以福格行为模型为指导,采用定向内容分析法,借助MAXQDA2024独立进行资料存储、编码与分析(访谈与分析间隔不超24 h,避免信息还原产生偏差),具体步骤如下:1)反复阅读原始文本,体会URDs的“隐含情感”;2)开放式编码,标注捐献行为相关的话语及备忘录,以最小分析单位命名;3)以福格行为模型的动机、能力、提示要素为指导,归类概括相似编码,并构建初步框架;4)识别核心范畴,归入预设主题,迭代调整亚主题;5)回归原始文本验证主题,确保有合理案例支撑;6)编码最终成型后反馈给URDs,以核实其是否贴合URDs本意且具备足够解释力。资料分析结果有意见分歧时由课题组集体讨论确定最终结果,确保编码一致性。
研究团队成员始终保持自我反思性实践,主动揭示和修正研究者自身主观性:1)长期扎根志愿服务(实验田野),深入接触URDs,已建立良好联系;2)充分利用备忘录和反思日记记录研究假设、解释、互动,确保基于参与者叙述[13];3)研究过程持续复盘,坦承研究者与URDs身份差异带来的影响,团队讨论、同行评审贯穿始终;4)结合访谈文本、非语言信息的观察记录和文献等多数据源三角验证,再由研究团队另外2名成员进行审核。
共提炼出3个主题及10个亚主题。
捐献者表示捐献行为的发生并非偶然,与过往遇到的人或事相关。捐献者C:“我们的中学物理老师经常献血,除了献血还捐献了造血干细胞,他还鼓励我们长大后去适当献血”。捐献者D:“家旁边着火,爸妈立马去救火,以后我也要像他们这样救人于危难之中”。捐献者E:“在乡下,邻居都是互帮互助的,这种氛围对我有潜移默化的影响”。
对生命价值的深刻认知是捐献者动机体系的重要源头,也是驱动捐献行为的核心力量。捐献者B:“我经历过至亲离世,非常能够感受到家人健康的可贵,不希望病人家庭遭受沉重打击”。捐献者C:“一点造血干细胞和1条人命比起来孰轻孰重呢!”捐献者G:“不想看到病人这样离开人世间,想着我的造血干细胞能够给他种下希望的种子”。
捐献者在明确造血干细胞捐献无损健康后,基于理性评估,在确认自身安全及能力可及的前提下,捐献动机得到进一步强化。捐献者A:“在不伤害自己的情况下,我就会去帮助他们”。捐献者B:“它不会对我造成很大的影响,我觉得这是很有意义的事情”。捐献者F:“当然我捐献造血干细胞的重要前提是不会对自己的身体产生太大影响,不可能用我的命换病人的命”。捐献者G:“首先你得保全自己,在不损害自身的情况下能帮就帮一点吧”。
多数捐献者在询问捐献意愿阶段未进行复杂的利弊权衡,直觉感知捐献事件整体趋好,适当思考后当即表示愿意参与救治。捐献者I:“如果说捐献总的来说是有利的,值得去做那就可以不用犹豫”。捐献者J:“就是说你正好碰到了这个事,然后你又能做的那你就去做吧,我觉得也没有想那么多,没有好或者不好,毕竟它也是件救人的好事”。捐献者M:“红十字会询问我的救人意愿,虽然我还不知晓具体流程,但是救命这种事情我肯定是愿意的”。
捐献者在决策过程中主动屏蔽外界消极评价,弱化对代际权威的依赖,并将捐献后果完全内化为个人责任,从而实现对身体的主导。捐献者C:“爸妈给我的施压小,对捐献行为的影响不大”。捐献者F:“我告诉爱人你可以提建议,但不允许干涉我的决定”。捐献者L:“如果捐献期间我的这个决定产生了一些影响,我自己可以承担,也能对捐献行为负责”。捐献者M:“工作影响、朋友和亲人的评价、社会不好的眼光都不在我的考虑范围内,我不在意别人的看法”。
捐献者通过参考真实案例、自查数据、对医疗操作的了解和自我评估等进行多维度风险重构,形成对于捐献风险的多元认知和理性判断。捐献者G:“身边有熟人捐献过造血干细胞且没事,能踏实不少”。捐献者H:“我看有好多人都捐过造血干细胞,这些捐献者说的话可信度还是很高的,听了他们说的,就知道这事安全”。捐献者N:“实际风险都在我的接受范围内,都是可控的”。
捐献者在处理信息时有意过滤负面信息,主动获取正面依据并主张信息自查代替机构输出,通过构建踏实的认知框架以强化捐献行为。捐献者A:“印象深的大部分是积极内容”。捐献者D:“病人给捐献者的感谢信都特别暖人心”。捐献者I:“相对于红十字会告诉我的知识,我肯定相信自己查到的,但也会稍微辨别一下”。捐献者J:“红十字会、医院只会和我讲一下大致流程和有没有害处,至于过程中的生理不适、后续的不良反应他们肯定都会淡化啊,所以我还是自己查踏实一些”。
日常献血作为制度化捐献行为的启动框架,为捐献行为启动提供了直接指引,从而有利于实现公益行为的阶梯升级。捐献者B:“单位动员去街上献血屋献血,医护人员说可以多抽8 mL的血入个库”。捐献者F:“我在初次入库捐献时被血站的那些过往捐献者实景海报触动了,心想我是不是也可以和他们一样加入”。捐献者K:“我有献血的习惯,偶然得知还可以捐献造血干细胞救人”。捐献者N:“每年我去献血,血站的工作人员都会询问我是否需要进行造血干细胞登记入库”。
造血干细胞捐献常以病患场景、同性病人作为触动行为的重要信号。捐献者E:“去病房的时候看到基本上都是一些可怜的血液疾病病人,就更加坚定了我的捐献意愿”。捐献者H:“救的是个小男孩,想着他以后和我一样,会是家里的希望和顶梁柱,不救不行啊”。捐献者N:“对方是个小女孩,尤其可能在不发达地区,生了重病还没被爸妈放弃,那我能救她,就觉得特别有意义”。
医护人员强调造血干细胞配型成功概率极低,匹配成功后病人救治期待间接投射到捐献者身上,捐献者的唯我性激活其责任感知,成为行为推进的隐性助力。捐献者A:“没想到之后居然变成了成功匹配的捐献者”。捐献者D:“特别激动,我居然有机会去拯救1条生命”。捐献者N:“已经匹配上了,我可能就是他现在唯一的希望啊,如果说我匹配成功再撤下来,那自己的良心就过不去”。捐献者J:“因为实际情况就像非你不可的感觉了,你如果在匹配成功的情况下悔捐就是破灭了病人重生的希望”。
本研究发现,捐献的初始动机由环境习得、价值觉醒与理性计算、认知偏向共同形成。一方面,捐献者在成长过程中受到教育熏陶、个人经历等外部刺激,为捐献行为奠定基础。外部环境对于生命认知影响至关重要,生命教育需在家庭、学校、社会的联动协同下进行,形成珍惜生命的社会新风尚[14]。因此,医护人员可联动家庭与学校,为各年龄段的青少年构建系统、完整、科学的板块化生命教育课程[15];同时开展社区科普活动,邀请捐献者分享经历,增强宣传可信度。另一方面,捐献者在评估捐献可行性基础上,理性利他倾向与结果积极导向也会使其持续强化捐献行为。Freiman[16]研究显示,志愿精神的核心是有效的利他主义,以对自身有益或无害的方式配置慈善资源。医护人员宣传时应提供涵盖登记入库到预后反馈等步骤的透明化、全流程时间轴示意图,告知采集医院的资质和技术规范、捐献后所提供的定期体检和健康追踪等全方位保障服务,帮助捐献者理性判断自身承受能力,进而形成两类认知与情感导向[17],即基于低成本利他的认知方法(仅需少量造血干细胞即可救人)、基于高收益感知的情感方法(能挽救生命,意义重大)。
本研究结果显示,捐献者凭借决策行为的独立意识,有效突破“身体发肤受之父母”等传统规训,实现对身体主权的根本性掌控。已有研究证实,捐献者会通过自主意识缓解由捐献事件或环境引起的决策压力[18]。因此,医护人员在告知捐献者需与家人商议的同时,也应告知其年满18岁在捐献行为上拥有自主独立性,保障造血干细胞捐献者的自主决策权利。此外,本研究还发现捐献者通过了解既往数据、真人真事等会主动屏蔽争议信息,构建“实证说明→正面筛选→负面屏蔽→稳定认知”的信息闭环。然而,在信息过载和社交媒体复杂化的环境下,个体信息辨别能力易被削弱[19-20],对此,可组织构建中国造血干细胞捐献者健康数据库,制定以三级甲等医院为主体的统一回访机制[21],同时按季度上传捐献者数据,涵盖捐献者ID、康复指数、生活质量评分等信息,据此生成既往捐献者的动态风险地图、健康状况更新报告,为捐献者科学评估潜在风险提供实证依据。
献血站是大众了解造血干细胞捐献的首要场地。献血与造血干细胞捐献是同属性的替代关系,有献血经历的人会有更强的动机加入造血干细胞捐献[22]。因此,献血站医护人员可通过科学的健康教育,降低献血者担忧情绪,提升造血干细胞捐献者入库概率。本研究中,捐献者通过视觉冲击产生苦难感代入,对同性年轻生命易产生性别共情,触发情感共鸣,与既往研究结果[23-24]相似。提示医护人员可主动安排捐献者参观血液科病房,向其科普临床病人分布情况;在供者与受者性别一致的情况下,基于病人隐私保护原则,通过病例匿名化透露病人年龄与性别信息,激活同性关怀本能。此外,捐献者得知捐献匹配成功极低等信息后会提升响应紧迫感和参与者使命感。救治唯一性的责任感强化,能为捐献者提供明确目标和内在驱动力[25]。但应注意,医护人员向潜在捐献者告知匹配概率较低时,也需说明已建立多级保障机制,并非完全依赖单一捐献个体。此举不仅可以避免感情和道德绑架问题[26],还能确保病人救治工作的顺利推进。
本研究基于福格行为模式对URDs进行深度访谈,突破传统的单一动机聚焦,揭示了URDs的造血干细胞捐献行为受初始动机、行为能力、社会提示等因素影响,为完善捐献行为发生机制提供参考。医护人员应通过生命教育刺激行为意向,通过完善风险评估体系提升URDs的造血干细胞捐献行为能力,通过构建社会提示网络触发URDs的造血干细胞捐献行为。但本研究纳入的研究对象来源较为局限,后续可通过多中心研究和多样化样本,了解不同地区URDs造血干细胞捐献行为的发生路径;通过量性研究进一步探讨异基因造血干细胞捐献者的捐献影响因素,为构建更具针对性的捐献促进策略提供参考。

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2026年第40卷第18期
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doi: 10.12102/j.issn.1009-6493.2026.18.021
  • 接收时间:2025-11-25
  • 首发时间:2026-10-29
  • 出版时间:2026-09-25
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  • 收稿日期:2025-11-25
  • 修回日期:2026-08-10
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    1南昌大学第二附属医院,江西 330006
    2南昌大学江西医学院护理学院
    3江西省人民医院
    4南昌大学第四 附属医院

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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