Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers

Acceptance of organ xenotransplantation among Latin American immigrants resident in the United States

BACKGROUND

Making xenotransplantation socially acceptable is the first step in working toward the promotion of this potential therapy option for providing transplant organs.

OBJECTIVE

To analyze the attitude toward xenotransplantation among the Latin American population resident in Florida (the USA), and to determine the variables affecting this attitude.

METHODS

A sample of Latin American residents in the state of Florida was randomized and stratified according to nationality, age, and sex (n = 1524). Attitude was assessed using a validated questionnaire (PCID-XenoTx Rios) which was self-completed anonymously.

STATISTICAL ANALYSIS

descriptive analysis, Student's t-test, the chi-square test, and a logistic regression analysis.

RESULTS

The questionnaire completion rate was 95% (n = 1450). If it was assumed that xenotransplanted organs functioned as well as human ones, 10% (n = 147) would be in favor, 73% (n = 1092) against, and 17% (n = 246) undecided. If the results were worse, only 2% (n = 35) would be in favor. This favorable attitude was related to country of origin (Honduras and Guatemala; P < 0.001); age (P < 0.001); sex (women; P < 0.001); marital status (married; P < 0.001); descendents (yes; P < 0.001); level of formal education (secondary education and university; P < 0.001); participation in voluntary prosocial activities (yes; P < 0.001); having spoken about donation and transplantation within the family (yes; P < 0.001); a partner's favorable attitude toward transplantation (P = 0.040); religion (catholic; P < 0.001); knowing the attitude of one's religion toward donation (yes; P < 0.001); previous experience of donation and/or transplantation (yes; P < 0.001); a belief that one might need a transplant in the future (yes; P < 0.001); and a favorable attitude toward human donation (yes; P < 0.001). The following were associated with attitude in the multivariate analysis: age (≥40 yrs; OR = 1.152); marital status (married; OR = 500); prosocial activities (yes, I participate in them; OR = 9.196. No, but I would like to; OR = 332.538); religion (catholic; OR = 2000); attitude toward deceased organ donation (in favor; OR = 2000); and previous experience of donation and/or transplantation (yes; OR = 500).

CONCLUSIONS

The attitude of Latin Americans resident in Florida toward xenotransplantation is very negative, and is determined by many psychosocial factors, mainly related to their prior attitude toward the different kinds of human organ donation.

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude.

METHODS: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student´s t test, χ² test and logistic regression analysis.

RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001).

CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

Brain Death: Is It a Misunderstood Concept Among Nursing Students in the South of Poland?

BACKGROUND

The objective of the present study was to analyze the knowledge and acceptance of the brain death (BD) concept among nursing students.

METHODS

The study was undertaken in the academic year of 2011 to 2012 in nursing students from the University of the South of Poland. The sample was carried out in compulsory sessions, in the 5 years of the nursing degree study, with a completion rate of 80%. The questionnaire was validated (PCID-DTO Ríos), self-administered, and completed anonymously.

RESULTS

The completion rate was 93% (492 of 530). Of the students surveyed, 75% (n = 369) knew the concept of BD and considered it to mean a person's death. Of the rest, 19% (n = 93) did not know it, and the remaining 6% (n = 30) believed that it did not mean that a person was dead. The following variables were significantly related with the correct knowledge of the BD concept: 1) age (22 ± 2 years; P ≤ .001); 2) academic year (P ≤ .001); 3) discussion with friends about organ donation and transplantation (ODT) (P = .035); 4) partner's favorable attitude toward donation and transplantation (P = .009); and 5) being Catholic (P = .031). In the multivariate analysis, the following variables persisted as independent variables related to the BD concept: a) age [OR = 1.468 (1.247-1.697); P ≤ .001] and b) partner's opinion of ODT [OR = 2.248 (1.255-4.025); P = .006]. No association was found with attitude toward ODT.

CONCLUSIONS

More than 25% of the students from the Jagiellonian University of Kraków did not know or accept the concept of brain death.

Dominicans Resident in Spain and the United States Faced With Deceased Organ Donation

BACKGROUND

Investigating the attitude of subgroups of populations living in different countries is useful for establishing whether there are differences in opinion in terms of place of residence. The objective of the study was to analyze attitudes toward deceased organ donation in the population from the Dominican Republic who are residing in the southeast of the United States and Spain.

METHODS

A sample was taken of residents of the population from the Dominican Republic residing in Florida (the United States) (n = 63) and in Spain (n = 80), which was stratified by age and sex. A validated questionnaire about psychosocial aspects (PCID-DTO Rios) was self-administered and completed anonymously: the χ(2) test, Student t test, and logistic regression analysis were used.

RESULTS

The completion rate was 86% (123 respondents of the 143 selected). Of those surveyed, 54% were in favor, 23% were against, and 23% were undecided. Of the residents in Spain (n = 57) 63% (n = 36) were in favor, 12% (n = 7) were against, and 25% (n = 14) were undecided. Of the residents in the United States (n = 66) 46% (n = 30) were in favor, 33% (n = 22) were against, and 21% (n = 14) were undecided (P < .001). The following factors were found to be associated with attitude: 1) level of education [OR = 12.195 (52.631-2.808); P = .001]; 2) concern about the possible mutilation of the body after donation [OR = 11.363 (47.619-2.695; P = .001]; and 3) rejection of cremation or burial of the body after death [OR = 6.134 (21.276-1.763); P = .004].

CONCLUSIONS

Attitude toward the donation of the respondent's own deceased organs after death was more favorable among Dominican residents in Spain compared with those living in the United States.

The level of acceptance of spanish medical students of the transplantation of solid organs from animals: a stratified and multicentre study

INTRODUCTION

Research into the transplantation of solid organs from animals (xenotransplantation) is generating interest and curiosity given that this could be a way of resolving the shortage in transplant organs. However, the fact is that currently xenotransplantation is far from becoming a clinical practice.

OBJECTIVE

To analyse the attitude of medical students from Spanish universities towards the donation of organs from animals and to determine the factors affecting their attitudes.

MATERIAL AND METHODS

TYPE OF STUDY

A sociological, interdisciplinary, observational and multicentre study in Spain.

STUDY POPULATION

Students enrolled on the medical degree in Spain (n = 34 000).

SAMPLE SIZE

A sample of 9598 students (a confidence level of 99% and precision of ± 1%) stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ xenotransplantation (PCID-XenoTx RIOS) which was self-administered and completed anonymously.

RESULTS

A completion rate of 95.7% (n = 9275) was obtained. If the results of xenotransplantation were as good as in human donation, 81% (n = 7491) would be in favour, 3% (n = 308) against and 16% (n = 1476) undecided. The following variables affected this attitude: sex (P < 0.001); academic year (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); the opinion of one's partner (P < 0.001); the respondent's attitude towards organ donation (P < 0.001); religion (P < 0.001); and participation in altruistic activities (P < 0.001). The following variables persisted in the multivariate analysis: (1) being a female (OR = 1.794; P < 0.001); (2) academic year (OR = 2.487; P < 0.001); (3) having spoken about the issue with one's family (OR = 1.200; P = 0.019); (4) the favourable opinion of one's partner (OR = 1.526; P = 0.028); (5) an attitude in favour of donation (OR = 2.087; P < 0.001); (6) being an atheist/agnostic, (OR = 2.5; P < 0.001); and (7) a belief that one's religion is in favour of transplantation (OR = 1.317; P = 0.005).

CONCLUSIONS

Spanish medical students have a favourable attitude towards xenotransplantation. This willingness and interest could be a decisive platform for the development and strengthening of research, both for centres with a pre-clinical xenotransplantation programme and new healthcare centres.

[Hospital-based multicenter study in Spain, Mexico and Cuba on attitudes to living liver donation]

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. To do this, it is essential that health workers in hospitals are in favor of such donation, given that they are a key component in this treatment and that their attitudes influence public opinion.

OBJECTIVE

To analyze attitude toward LLD among hospital personnel from healthcare centers in Spain and Latin America.

MATERIAL AND METHOD

Ten hospitals were selected from the «International Donor Collaborative Project»: 3 from Spain, 5 from Mexico and 2 from Cuba. Random sampling stratified by type of service and job category was used. Attitudes to LLD were evaluated through a validated questionnaire on psychosocial aspects. The questionnaire was anonymous and self-administered. Statistical tests consisted of Student's T test, the chi-square test and logistic regression analysis.

RESULTS

Of the 2,618 employees surveyed, 85% (n=2,231) were in favor of related LLD; of these, 31% (n=804) were in favor of unrelated LLD. No association was found between the country of the interviewed, personal-social variables or work-related variables. The following factors were associated with a favorable attitude toward related LLD donation: having had personal experience of donation and transplantation (P<.001); being in favor of deceased donation (P<.001); believing that one might need a possible transplant (P<.001); being in favor of living kidney donation (P<.001); being willing to accept a liver from a living donor (P<.001); having discussed the matter of donation and transplantation within the family (P<.001) and with one's partner (P<.001); carrying out pro-social type activities (P<.001); being Catholic (P=.040); believing that one's religion is in favor of donation and transplantation (P<.001); and not being concerned about the possible mutilation of the body after donation (P<.001).

CONCLUSIONS

Hospital personnel from Spain and Latin America had a favorable attitude toward LLD, which was associated with factors directly and indirectly related to donation and transplantation, family and religious factors, and attitudes toward the body.