Validation of the Attitude Toward Living Liver Donation Questionnaire (PCID-DVH-Ríos) in Spanish-Speaking Populations: Characteristics and Psychometric Properties

INTRODUCTION

Given the lack of a sufficient number of livers available for transplantation, living liver donation (LLD) is being developed in the Spanish-speaking world. Knowing the population's attitude toward this donation will help in designing more effective campaigns to increase the number of such donations. However, there are few validated questionnaires.

OBJECTIVE

To analyze the psychometric characteristics of questionnaire PCID-DVH-Ríos [questionnaire of the International Collaborative Donor Project about Living Liver Donation ("Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Hepático" in Spanish) developed by Dr. Ríos, in order to validate the questionnaire for the Spanish-speaking population.

METHODS

The study population comprised native Spanish citizens. A sample of the population was obtained randomly and stratified by age and sex (N = 600) according to the following: 1. being older than 18 years; 2. being Spanish; and 3. living in Spain. Attitude was assessed using a validated questionnaire of attitude toward liver donation (PCID-DVH-Ríos). This questionnaire included items distributed into subscales or factors, an initial description of the data, an exploratory factor analysis, and an internal consistency analysis.

RESULTS

The questionnaire consists of a total of 11 items, distributed into 3 subscales: 1. factor 1 (6 items); 2. factor 2 (3 items); and 3. factor 3 (2 items), presenting a total explained variance of 63.995%. The factors have an explained variance of F1: 38.461%; F2: 14.228%; and F3: 11.306%, respectively. The analysis of items and internal consistency supported the 3 factors' composition. The internal consistency of each factor is as follows: α1 = 0.80; α2 = 0.70; and α3 = 0.55, respectively.

CONCLUSIONS

The dimensions analyzed in the PCID-DVH-Ríos questionnaire on attitudes toward living liver donation show a good fit in relation to their factorial validity and internal consistency values.

Are Senegalese Immigrants Residing in Spain in Favor of Organ Donation?

The Senegalese population is an emerging group in Europe. The number of foreign residents in Spain, France, and Italy has increased significantly. However, there are no studies that analyze their awareness of organ donation and transplantation.

OBJECTIVE

To analyze the attitude toward organ donation among the population born in Senegal residing in Spain.

METHODS

The study population was born in Senegal and resides in Spain. A sample of the population older than 15 years was obtained randomly and stratified by age and sex according to census data and immigrant support associations. Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation (PCID-DTO Rios). A random selection of people to be surveyed was carried out. Assistance from African immigration support associations in Spain was needed to advise on the location of potential respondents. The survey was self-administered and completed anonymously.

RESULTS

A sample of 295 respondents was included in the study. Attitude toward deceased donation was favorable in 37% (n = 109) of respondents; 35% (n = 104) were against and 28% (n = 82) were undecided. Several variables were associated with having a more favorable attitude (P < .05): sex, having discussed donation with the family, not being concerned about the possible mutilation of the body after donation, the respondent's religion, and knowledge of one's partner's attitude in favor of organ donation.

CONCLUSIONS

The attitude toward organ donation among the population born in Senegal and residing in Spain is unfavorable, and it is associated with psychosocial factors.

Multivariate Analysis of the Factors Affecting Attitude Toward Organ Donation Among the Ecuadorian Population Residing in Spain

INTRODUCTION

Immigrants from Ecuador represent the largest group of Latin Americans in Spain and are, therefore, a subgroup of interest to understand their attitudes and influences in respect to organ donation and transplantation.

OBJECTIVE

To analyze the attitude of nationals of Ecuador residing in Spain regarding deceased organ donation.

METHODS

The study population included the Ecuadorian population residing in Spain. A sample of population older than 15 years was obtained randomly and stratified by age and sex (n=461). Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation (PCID-DTO-Ríos). Assistance from immigration support associations in Spain was needed to advice on the location of potential respondents.

RESULTS

Attitude toward cadaveric donation was favorable in 59% (n=271) of respondents, 12% (n=57) were against cadaveric donation, and 29% (n=133) were undecided. Several variables were associated with having a more favorable attitude. In the multivariate analysis, the following variables were independently associated with a more positive attitude toward organ donation: 1. level of formal education (odds ratio [OR]=6.849 [25.641-1.818]; P = .004); 2. being in favor of donating a family member's organs (OR=8.849 [20.833-3.717]; P < .001); 3. having commented at a family level about transplant (OR=3.717 [6.578-2.109]; P < .001); 4. not being concerned about the possible mutilation of the body after donation (OR=4.608 [8.547-2.487]; P < .001) and 5. knowing the attitude of one's religion toward donation (OR=7.462 [34.482-1.623]; P = .010).

CONCLUSIONS

The attitude toward cadaveric organ donation among the Ecuadorian population residing in Spain is less favorable than that of the Spanish population and is determined by many different psychosocial variables.

Attitude Toward Organ Donation and Transplantation in Veterinary Students: A Multicenter and Stratified Study in Spain

BACKGROUND

Veterinarians often hold decision-making positions in the public health care system and can therefore influence public opinion about organ donation and transplantation (ODT). The aim of this work was to analyze the attitude of Spanish veterinary students toward ODT, because they may influence public opinion in the future, and to determine the factors that condition it.

METHODS

This was a sociologic, interdisciplinary, multicenter, observational study in Spain. The study population was students studying for a veterinary degree in Spain (n = 9000), and a sample of 2815 students (confidence of 99% and precision of ±1%) was stratified by geographic area and academic year. A validated questionnaire of attitude toward ODT (PCID-DTO-Ríos) was self-administered and anonymous.

RESULTS

Of the 2815 selected students (2790 plus the 0.9% per type of sample), 2650 completed the questionnaire (response rate, 94.14%): 83% (n = 2207) of the respondents were in favor of donation and 17% against. The following main variables were related to a favorable attitude: being female (odds ratio [OR], 0.752; P = .034); knowing a donor (OR, 1.834; P = .003); having discussed the matter with one's family (OR, 1.587; P = .002); having spoken about the subject in social circles with friends (OR, 1.633; P < .001), and being in favor of donating a deceased family member's organs (OR, 2.403; P < .001).

CONCLUSIONS

Seventeen percent of Spanish veterinary students were not in favor of ODT. It is important to know the factors that determine their attitude, because this will make it possible to optimize the resources invested in campaigns to promote ODT and to take more specific action.

Attitude Toward Organ Donation Related to Personal Preferences for the Final Disposition of the Dead Body in Nursing Students in Southeast Spain

INTRODUCTION

In organ donation and transplantation (ODT) and in nursing students, it is important to know the preferences about the final destination of the body once deceased. Whether these future professionals are afraid of this issue could influence their attitude toward ODT and future donation rates.

OBJECTIVE

To analyze the attitude of nursing students toward cremation, burial, and autopsy and to determine the factors affecting this attitude.

METHODS

A sociologic, interdisciplinary, multicenter, and observational study included nursing diploma students (n = 750) from 2010 to 2011 at 3 universities in the southeast of Spain. A validated questionnaire (PCID-DTO RIOS) was self-administered and completed anonymously.

RESULTS

Questionnaire completion rate was 92% (n = 687), with 71% (n = 486) of students accepting cremation as a body treatment after death. Those who were not worried about the possible mutilation of the body after donation (P < .05) and those who were in favor of deceased donation (P < .001) had a greater degree of acceptance. Of the students, 43% (n = 278) would accept burial of their body, which was related with being in the second year (P < .05) of study. Finally, 86% (n = 586) of students would accept an autopsy being carried out, if necessary, and this was related with the attitude toward ODT (P = .004).

CONCLUSIONS

A high percentage of nursing students would accept an autopsy being carried out. This degree of acceptance was related with a favorable attitude toward organ donation. The appropriate training of future nurses in ODT process will optimize their promotion.

Guinean Population Emigrant to Spain Has Very Little Awareness of the Donation and Transplantation of Organs

INTRODUCTION

The Guinean population is an emerging group in Europe, but the group's awareness of organ donation and transplantation has not been studied.

OBJECTIVE

To analyze the attitude toward organ donation among the population born in Guinea living in Spain.

METHODS

The population older than 15 years, born in Guinea, and resident in Spain was studied, stratified by age and sex, according to census data and immigrant assistance associations. The valuation tool used was the attitude questionnaire toward organ donation PCID-DTO RIOS (questionnaire on "Donor International Collaborative Project" on organ donation and transplantation developed by Dr Ríos). A random selection of people to survey was based on stratification. Support from African immigration support associations was needed to advise on the location of potential respondents. The completion was anonymous and self-administered. A descriptive statistic was performed, and Student t, χ², and Fisher tests and a logistic regression analysis were applied.

RESULTS

In all, 181 Guineans were surveyed, of whom 32% (n = 58) were in favor of the donation of their own organs after death, 32% (n = 57) were against, and 36% (n = 66) were undecided. The variables that are associated with attitude toward donation are separated mainly into 4 large groups (P < .001): (1) knowledge about the process of donation and organ transplantation; (2) attitude toward the manipulation of the body; (3) religious variables; and (4) sociofamily variables, especially in relation to the couple.

CONCLUSIONS

The Guinean population emigrant to Spain has an unfriendly attitude toward organ donation.

Emigration From Puerto Rico to Florida: Multivariate Analysis of Factors That Condition Attitudes of the Puerto Rican Population Toward Organ Donation for Transplant

BACKGROUND

The Puerto Rican population represents one of the largest immigration groups in Florida, and this has an impact on the organ transplant donation process. Our aim was to analyze attitudes toward organ donation among Puerto Ricans who currently reside in the state of Florida (USA).

METHODS

The population screened consisted of individuals >15 years old, who were born in Puerto Rico, living in Florida, and awaiting organs for transplant. All participants completed the "PCID-DTO Rios" questionnaire. Random selection was done according to stratification. Support from immigration associations in Spain was needed for advice on the locations of potential respondents. Study participation was anonymized and self-administered.

RESULTS

There were 259 respondents, 37% (n = 95) were in favor of donation, 36% (n = 93) were against donation, and 27% (n = 71) were undecided. The variables associated with these attitudes were: age (P = .017); civil status (P = .021); level of education (P < .001); previous experience with donation and transplant (P < .001); attitude toward organ donation of a relative (P < .001); carrying out pro-social activities (P < .001); discussing the issue of transplant with the family (P < .001) or couple (P < .001); attitude toward incineration (P < .001), burial (P < .001), and autopsy (P < .001); fear of mutilation after donation (P < .001); and religious beliefs (P < .001). In the multivariate study, it remained an independent variable to have discussed the issue at the family level (odds ratio = 11.627; P = .009).

CONCLUSION

The Puerto Rican study population residing in Florida has an unfavorable attitude toward organ donation.

Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List

BACKGROUND

It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients.

OBJECTIVES

To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy.

METHODS

Study population: patients on the LT waiting list who received group psychotherapy (n = 15).

CONTROL GROUP

patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered.

RESULTS

More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases.

CONCLUSIONS

Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.

Quality of Life and Group Psychological Intervention in Patients With Cirrhosis on Liver Transplant Waiting List

BACKGROUND

The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life can be improved.

OBJECTIVE

To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list.

METHOD

Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished.

RESULTS

Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire.

CONCLUSIONS

Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.

Psychosocial Factors Affecting Attitude Toward Organ Donation in Santiago, Cuba

INTRODUCTION

Awareness about organ donation among the general population is fundamental to organ donation programs. It is important to determine the factors that influence attitudes toward organ donation within the general population in order to carry out cost-effective campaigns.

OBJECTIVE

To analyze the attitude toward organ donation among Santiago, Cuba, citizens.

METHODS

The study population encompassed residents in Santiago, Cuba. A sample population of residents older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward organ donation and transplant (PCID-DTO Ríos). Available census data were used. The survey was self-administered and completed anonymously.

RESULTS

Of the 455 respondents, 70% of respondents are in favour of cadaveric donation, 16% are against, and 14% were undecided. Several variables were associated with having a more favorable attitude. And in the multivariate analysis, the following variables continue to feature as independent variables: 1. knowledge of the concept of brain death [OR = 2.386 (4.761-1.194); P = .014]; 2. being in favor of donating a family member's organs [OR = 3.067 (5.952-1.584); P = .001]; 3. a partner's favorable attitude [OR = 5.795 (1.477-22.731); P = .012]; 4. being an atheist/agnostic as the religious beliefs [OR = 1.845 (3.289-1.038); P = .037]; 5. not being concerned about the possible mutilation of the body after donation [OR = 7.437 (2.918-18.955); P < .001]; 6. not accepting other treatment options after death, such as inhumation [OR = 3.048 (5.714-1.626); P = .001].

CONCLUSIONS

The attitude toward cadaveric organ donation among the Santiago, Cuba population is favorable and it is associated with several psychosocial factors.

Importance for the Elderly of Discussion in the Family and Society About Attitude Toward Organ Donation

BACKGROUND

The aging of the population has changed some of the approaches to the organ donation and transplant (ODT) process, such as considering elderly people as potential donors. We aimed to assess social and family discussions among the elderly about ODT and its effect on their attitude toward organ donation.

METHODS

A study was carried out at 2 publicly-funded social centers for the elderly. Contact was made with individuals >65 years of age (n = 120) to seek their participation in the study. A questionnaire was distributed to them with questions about ODT. A descriptive assessment was performed with the Student t test and χ² test used for statistical analysis.

RESULTS

The completion rate was 87% (n = 104). Of the respondents with a partner and children, 48% had discussed the topic of ODT. It was found that talking about the subject with one's partner, children, or friends had a favorable influence on attitude compared with when this was not done (93%, 86%, and 83% vs 19%, 30%, and 31%, respectively; P < .001). In addition, the opinion of one's partner and children toward ODT also had an influence; if favorable, the respondent's attitude was more favorable, compared with when they did not know their opinion (92% to 88% vs 58% to 37%, respectively; P < .001). Other ODT-related variables did not affect their attitude (P > .05).

CONCLUSIONS

Almost half of the elderly people had discussed ODT socially or with their family. This discourse has a favorable influence on their attitude toward organ donation and, therefore, it is important to encourage social and family dialog among this group.

Factors That Affect the Attitudes of the Bolivian Population in Spain With Regard to Organ Donation for Transplant

BACKGROUND

The Bolivian population is an emerging Latin American immigrant group in Spain, several of whom have been transplanted or are awaiting transplant. We aimed to assess attitudes toward organ donation among Bolivians currently residing in Spain.

METHOD

The population screened was born in Bolivia but living in Spain, stratified by gender and age. The appraisal tool used was a questionnaire that assesses attitudes toward organ donation for transplant ("PCID-DTO Ríos"). Support from immigration associations in Spain was needed for advice on locations of potential respondents. Survey participation was anonymized and the questionnaire was self-administered. Verbal consent was obtained before participation.

RESULTS

There were 206 respondents: 49% (n = 101) in favor of donating their organs after death; 21% (n = 44) against donation; and 30% (n = 61) undecided. Their attitudes were found to be associated with level of education (P = .008), previous experience with donation and transplant (P = .011), concern regarding mutilation after donation (P = .002), knowing the attitude of their religion toward transplant (P = .001), the opinion of their partner (P < .001), and the possibility of needing a future transplant (P = .050). In the multivariate study, the main factor was having a partner in favor of organ donation (odds ratio = 16.129; P = .003).

CONCLUSION

Attitudes toward organ donation among Bolivians residing in Spain are far more negative compared with rest of the Spanish population, due to various factors.

Multivariate Analysis of Factors That Influence the Attitude of the Ecuadorian Population Resident in Spain Toward Living-Related Kidney Donation

BACKGROUND

The Ecuadorian population is the largest Latin-American immigrant group in Spain. Currently, several Ecuadorians have received transplants or are awaiting transplants in Spain. The aim of this work was to analyze the attitude toward living kidney donation among the Ecuadorian population residing in Spain.

METHODS

The population screened were born in Ecuador, residing in Spain, and >15 years old, stratified by gender and age, and appraised with the use of the questionnaire on attitude toward organ donation for transplantation "PCID-DVR-Ríos." Support from immigration associations in Spain was used to advise on the location of potential respondents. The completion was anonymous and self-administered. Verbal consent was obtained. Statistics included Student t test, χ², Fisher exact test, and logistic regression analysis.

RESULTS

A total of 461 respondents were included: 80% (n = 367) were in favor of living-related kidney donation (for a relative or close friend). This attitude was associated with psychosocial variables that persisted in the multivariate study: 1) female gender (odds ratio [OR], 3.086; P = .001); 2) considering oneself a potential kidney receptor in the future (OR, 16.949; P = .002); 3) economic incentive in the donation (OR, 100; P = .004); and 4) knowing the attitude of their religion toward transplantation (OR, 32.258; P < .001).

CONCLUSIONS

Living-related donation is accepted among the Ecuadorian population residing in Spain and is associated with sociopersonal and religious factors.

Veterinary Students' Attitude Toward Living Kidney Donation: A Multicenter Stratified Study From Spain

Living kidney related donations (LKRD) should be promoted because of the current deficit of organs for transplantation. The objective of the study was to analyze the attitude of Spanish veterinary students toward LKRD, because they may influence public opinion in the future, and to determine the factors that condition it.

METHODS

A sociological, interdisciplinary, multicenter, and observational study was carried out in the veterinary students enrolled in Spain (n = 9000) in the university academic year 2010-2011. A sample of 2815 students was stratified by geographical area and academic year. The students' attitude toward LKRD was assessed using a psychosocial validated questionnaire (PCID-DVR Rios), was self-administered, and was completed anonymously. Veterinary schools were randomly selected. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis was preformed using t test, χ² test, and logistic regression analysis.

RESULTS

The completion rate was 95% (n = 2683); 93% (n = 2504) were in favor of LKRD and 36% (n = 945) supported unrelated living kidney donation. The following variables were associated with having a more favorable attitude: (1) sex (P < .001), (2) being a student of southern universities (P = .03), (3) attitude toward deceased donation (P < .001), (4) having a father (P < .001) or a mother (P < .001) in favor of organ donation, and (5) having discussed the subject with friends (P = .03) or family (P = .02). However, only 60% would accept a kidney from a relative.

CONCLUSION

Spanish veterinary students have a favorable attitude toward LKRD. However, only 60% would accept a kidney from a relative.

Multicenter Stratified Study From Spain About Acceptance of Living Liver Donation Among Veterinarian Students

Veterinarians often hold decision-making positions in the public health care system, and therefore can influence public opinion about organ donation. The objective is to analyze the attitude of Spanish veterinarian students toward living liver donation (LLD) and to establish which factors have an influence on this attitude.

METHODS

A sociological, interdisciplinary, multicenter, and observational study was carried out in the veterinarian students enrolled in Spain (n = 9000) (university academic year 2010-2011). A sample of 2854 students was stratified by geographic area and academic year. A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. The questionnaire was applied to each academic year at compulsory sessions at randomly selected veterinary schools. Statistical analysis included t test, χ² test, and logistic regression analysis.

RESULTS

Completion rate was 94% (n = 2683); 89% (n = 2345) were in favor of related LLD, and 40% (n = 1053) supported unrelated LLD. The following variables were associated with a more favorable attitude: (1) age (P < .001), (2) sex (P < .001), (3) academic year (P < .001), (4) believing in the possibility of needing a transplant oneself in the future (P < .001), (5) attitude toward deceased donation (P < .001), (6) attitude toward living kidney donation (P < .001), (7) acceptance of a donated liver segment from a family member if one were needed (P < .001), (8) having discussed the subject with one's family (P = .009) and friends (P < .001), (9) a partner's opinion about the subject (P = .002), and (10) fear of the possible mutilation of the body after donation (P < .001).

CONCLUSION

Spanish veterinary students have a favorable attitude toward LLD.

Attitude Toward Organ and Tissue Xenotransplantation Questionnaire (PCID-XENOTx-Ríos): Characteristics and Psychometric Properties of the Validation in Spanish-Speaking Populations

INTRODUCTION

Making xenotransplantation socially acceptable is the first step in working toward the promotion of this potential therapy option for providing transplant organs. However, most of the questionnaires used for this task are not validated.

OBJECTIVE

To analyze the psychometric characteristics of the questionnaire of attitud toward xenotransplantation PCID-XENOTx-Ríos (Questionnaire of Proyecto Colaborativo Internacional Donante about Xenotransplantation developed by Dr. Ríos) to validate the questionnaire in the Spanish speaking population.

METHODS

The study population was the native Spanish population living in southeast Spain. A sample of the population was obtained randomly and stratified by age and sex (N = 600), using the following inclusion criteria: 1. being older than 18 years; 2. being Spanish; and 3. living in Spain. Instrument valuation. Attitude was assessed using the validated PCID-XENOTx-Ríos questionnaire to gauge attitudes toward organ and tissue xenotransplantation. The statistical analysis included an initial description of the data, an exploratory factor analysis, an items analysis, and an internal consistency analysis.

RESULTS

The questionnaire consists of a total of 30 items, distributed in 4 subscales: 1. Factor 1: consequences (11 items); 2. Factor 2: associated risks (7 items); 3. Factor 3: transmission of infections (6 items); and 4. Factor 4: origins of transplantation (6 items). This structure presents a total explained variance of 61.18%. The internal consistency of each factor was as follows: α1 = 0.91; α2 = 0.92; α3 = 0.89; and α4 = 0.72. The analysis of items and internal consistency supported the 4 factors' composition.

CONCLUSIONS

Dimensions analyzed in the PCID-XENOTx-Ríos questionnaire of attitudes toward organ and tissue xenotransplantation show a good fit in relation to their factorial validity and internal consistency values.

Attitude of the Citizens of Havana, Cuba, Toward Organ Donation: A Multivariate Analysis of the Psychosocial Factors Affecting Attitude

INTRODUCTION

Because personal decisions affect the availability of organs for transplants, awareness about organ donations among the general population is fundamental.

OBJECTIVE

To analyze attitudes toward organ donation among the citizens of Havana, Cuba.

METHODS

The sample population was the residents of the city of Havana, Cuba. The inclusion criterion was being older than 15 years; the sample was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects of organ donation and transplant (PCID-DTO-Ríos). A random selection of people to be surveyed was carried out.

RESULTS

A sample of 920 respondents was included in the study. Attitude toward cadaveric donation was favorable in 68% of respondents, while 14% were against and 18% were undecided. Several variables were associated with having a more favorable attitude. In the multivariate analysis, the following variables continue to feature as independent variables (P <  .05): 1. level of studies; 2. knowledge of the concept of brain death; 3. attitude toward organ donation of a relative; 4. having discussed the issue of organ donation and transplantation with one's family; 5. the attitude of the couple toward organ donation and transplantation; 6. the religion of the respondent; 7. knowing the opinion of one's religion toward organ transplantation; 8. fear of manipulation of the body after death; and 9. acceptance of burial as a treatment of the body after the death.

CONCLUSIONS

The attitude toward cadaveric organ donation among the residents of Havana is favorable and similar to that of the citizens of Spain. Improving the organ procurement system will increase donation rates given the population's awareness of the issue.