Medical Students' Knowledge, Familiarity, and Attitudes towards Hematopoietic Stem Cell Donation: Stem Cell Donation Behaviors

Comparison of Knowledge About Induced Pluripotent Stem Cells in Relation to Gender Among Healthcare Professionals and in the General Population

INTRODUCTION

Induced pluripotent stem cells (iPSCs) are derived by reprogramming adult somatic cells using a forced expression of four specific transcription factors in a highly controlled artificial environment. The aim of this paper is to examine the knowledge about these cells of the general population and the population of health workers in relation to gender.

METHODS

The research was designed as a cohort study conducted with a validated questionnaire to assess knowledge about iPSCs. Respondents were people over 18 years of age on the territory of the cities of Belgrade and Kragujevac in Serbia.

RESULTS

The study surveyed a total of 1,047 respondents, 560 (53.5%) women and 487 (46.5%) men. Statistically significant differences were observed for both genders. Women from both populations were better informed, more often agreed to treatment with iPSCs, more often supported further research, and were willing to take further education about iPSCs.

CONCLUSION

Comparing men and women from both populations, we found that men and women health workers showed greater knowledge compared to the general population. Level of knowledge and attitudes of the public can have multiple effects on further research emphasizing the importance of the support of public opinion about this type of treatment.

Perceptions and Attitudes Regarding Hematopoietic Stem Cell Donation Among Blood Donors in Riyadh, Saudi Arabia

Introduction In recent years, there has been a growing trend toward using stem cell transplantation for therapeutic purposes, making a positive impact in the medical field. Access to a compatible and willing donor is essential for those therapeutic purposes, yet the current number of registered donors remains inadequate. The present study aimed to investigate the attitude and perception of stem cell donation among blood donors in Saudi Arabia while also exploring their knowledge of hematopoietic stem cells, willingness towards donation, and fear of complications after stem cell donation. Methods A cross-sectional study was implemented to investigate the perception and attitude toward stem cell donation among blood donors in Riyadh, Saudi Arabia, through a validated self-administered questionnaire. The questionnaire comprised 35 questions divided into five sections, namely, demographics, knowledge, attitude, willingness, and fear of stem cell donation. Results The survey was distributed to 400 subjects. Out of the 400 respondents, 98.8% (n=395) were male, and 90.8% (n=363) were Saudi nationals. The majority had a high school level of education (n=259, 64.75%). Only 10.8% (n=43) of the participants were knowledgeable about stem cells. Knowledge of stem cells was highest among females aged 40-49 years, participants knowledgeable of platelet donation, and participants who donated blood more than 10 times (p-value <0.05). Participants with a bachelor's or master's degree had significantly more fear of stem cell donation complications, with a p-value of 0.003. The attitude toward stem cell donation was highly positive. Most participants strongly agreed to donate stem cells to a family member or anyone in need, 94.5% (n=378) and 62% (n=248), respectively. Conclusion Knowledge about stem cell donation among blood donors was scarce, while their willingness to donate after conversing was high. We highly recommend the initiation and establishment of educational programs to increase the knowledge of the public and, specifically, blood donors.

A Multicenter Study to Determine Knowledge and Perceptions on Stem Cell Donation, Transplantation Among Saudi Medical Students

BACKGROUND

Despite significant contributions to stem cell research in Saudi Arabia, knowledge and awareness of stem cell research is the subject of ongoing studies with controversial findings, specifically among medical students. This was a cross-sectional study with 685 medical students aimed to explore their knowledge and attitudes in relation to stem cell research and transplantation.

METHODS

A validated survey exploring knowledge and attitudes in relation to stem cell research and transplantation was administered. The total knowledge, attitude, and age scores were presented through mean and SD RESULTS: The results of the present study showed that university students in the Eastern Province had an average 35.88 knowledge of stem cell research. In contrast, the attitudes were positive among the entire study sample, with a mean of 3.79 out of 5. Both men and women had significant knowledge about the definition of stem cells and adult stem cells, bone marrow, whether stem cells can be used for drug testing, and recommended stem cell treatment if available.

CONCLUSIONS

The medical curriculum needs to be refined and enriched with additional data on organ and stem cell donation. This can be further enriched with experimental evidence through additional training initiatives that will allow those with negative attitudes to re-evaluate their perceptions and provide accurate information to patients as future health care providers.

Effective and Elaborative Induction Program for Mitigating Myths and Misconceptions Linked to Hematopoietic Stem Cell Transplantation in a Resource Limited Setting

Since the first transplant in 1957 and hematopoietic stem cell transplantation (HSCT) is the curative modality for numerous hematological disorders. Nevertheless, it is not available for all patients. Besides unavailability of matched donors a lot of factors could hinder HSCT in a resource limited setting, as financial and administrative factors. In our daily practice we noticed other factors that hinder HSCT in our center, the common myths and misconceptions about HSCT and donation. This quasi-experimental study assessed, for the first time, common myths and misconceptions about HSCT among 218 medical and nursing students before and after an interventional educational program. The study tool was an investigators' developed self-administered questionnaire. Participants' male to female ratio was 1:2.5, and FAS was middle in 52.7%. Pretest high myths scores were reported in 53.4% and 90% of medical and nursing students that was reduced to 0% and 4% post-test, respectively. Pretest, 26.3% and 7% of medical and nursing students welling to donate HSC, that increased to 66% and 39% post-test, respectively. Rural residency, low and middle FAS associated with higher myths scores. Myths score is an independent effector of willingness to donate HSC among participants. In conclusion medical/nursing students had significant myths and misconceptions about HSCT that was corrected with the educational program. Thus, wide based educational programs about HSCT are mandatory to correct myths and augment HSC donation. www.clinicaltrrial.gov: clinical trial ID NCT05151406.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12288-023-01634-5.

Factors Influencing Individuals' Decision-Making Regarding Hematopoietic Stem Cell Donation: A Cross-Sectional Study in Saudi Arabia

INTRODUCTION

Hematopoietic stem cell transplantation (HSCT) is a vital medical intervention for treating various conditions. The preferred methods, i.e., bone marrow transplantation and peripheral blood stem cell transplantation, have saved lives and attracted attention. Saudi Arabia, with a high sickle cell disease and leukemia incidence, faces the challenge of matching donors for HSCT. Factors like knowledge, attitudes, cultural beliefs, and access to information impact donation decisions.

METHODS

In May 2023, a cross-sectional online survey was conducted in Saudi Arabia, targeting the general population. Data were collected through an online questionnaire, analyzing demographics, knowledge, attitudes, and factors influencing donation intention.

RESULTS

Demographic analysis showed that females, younger individuals (18-25 years), those with higher education, and healthcare workers had better knowledge. Attitudes toward donation varied: 42.4% were willing to donate, while 57.6% were not. Psychological barriers, health concerns, pain, and inadequate knowledge influenced donation reluctance. Of the participants, 3.5% were registered stem cell donors, with 58.8% expressing willingness but not registered. Donors' intent was influenced by family members' need for transplants and knowledge. A majority (56.6%) supported employer support for health programs, while 65.7% believed government funding should assist donors.

CONCLUSION

HSCT is vital in treating diseases like sickle cell and leukemia in Saudi Arabia. While many recognize its importance, knowledge gaps about its specifics and donation deter potential donors. Enhanced awareness campaigns and support from employers and the government could increase donor registrations.

'Be the Match'. Predictors of Decisions Concerning Registration as a Potential Bone Marrow Donor-A Psycho-Socio-Demographic Study

(1) Background: The study was aimed at a better understanding of the factors determining making a decision to become a potential bone marrow donor, in a Polish research sample; (2) Methods: The data was collected using a self-report questionnaire among persons who voluntarily participated in the study concerning donation, conducted on a sample of the Polish population via Internet. The study included 533 respondents (345 females and 188 males), aged 18-49. Relationships between the decision about registration as potential bone marrow donor and psycho-socio-demographic factors were estimated using the machine learning methods (binary logistic regression and classification & regression tree); (3) Results. The applied methods coherently emphasized the crucial role of personal experiences in making the decision about willingness for potential donation, f.e. familiarity with the potential donor. They also indicated religious issues and negative health state assessment as main decision-making destimulators; (4) Conclusions. The results of the study may contribute to an increase in the effectiveness of recruitment actions by more precise personalization of popularizing-recruitment actions addressed to the potential donors. It was found that selected machine learning methods are interesting set of analyses, increasing the prognostic accuracy and quality of the proposed model.

A review of whole-blood donors' willingness, motives, barriers and interventions related to donating another substance of human origin

Diversification of blood collection agencies' (BCAs) core business requires donors to donate substances of human origin (SoHO) beyond whole-blood. Whole-blood donors are assumed to be willing to convert to donate other SoHO as well as whole-blood. However, no reviews consider the evidence on conversion (i.e., willingness/intention, behaviour, retention, attrition). This rapid review provides a narrative synthesis of whole-blood donors' conversion to another SoHO, characteristics contributing to conversion, motives and deterrents, and interventions encouraging conversion. Sixty-five studies were reviewed. Most were cross-sectional and examined whole-blood donor conversion to organ (willingness/pledge for deceased donation), plasma or stem cell donation. Most examined conversion rather than characteristics contributing to conversion, motives, deterrents or interventions. Whole-blood donors appear willing to donate another SoHO, yet conversion rates are unclear. Besides self-efficacy, there is little consistency in reported characteristics of donors converting, and few theories applied to understand characteristics encouraging conversion. Intrinsic (altruism, self-esteem, curiosity) and extrinsic (perceived need, service experience, direct requests) motives and barriers (lifestyle, fearing reduced health) appear important and require further research. Interventions encouraging conversion need replication and may include in-person, in-centre approaches, raising awareness of the functional benefits of other SoHO (high need, usefulness), and developing promotional materials that pique donors' curiosity, invite questions, and encourage donor-initiated conversations about conversion. Centralising BCAs as a single business or partnering with other organisations appears mutually beneficial to encourage conversion and sustainable panels/resources. Research is needed to understand the impact of encouraging conversion on donors and organisations, and identify optimal management strategies for multi-SoHO donors.

Awareness and Acceptance of Hematopoietic Stem Cell Transplantation for Sickle Cell Disease in Jazan Province, Saudi Arabia

BACKGROUND

Sickle cell diseases (SCD) are a group of inherited disorders that lead to abnormal beta subunits of hemoglobin (Hb) and are characterized by several complications which can be life-threatening. The prevalence of this disease is high in Jazan province, Saudi Arabia. The current protocol for the treatment of SCD is mainly based on alleviating signs and symptoms to avoid severe complications. Hematopoietic stem cell transplant (HSCT) is considered a definitive therapy for SCD. However, there is a long patient waiting list for HSCT in Saudi Arabia. A lack of community awareness and incorrect information about the importance of HSCT in SCD treatment is believed to be contributing to the shortage in HSCT. Thus, this study aims to assess community awareness and attitudes toward HSCT as a cure for SCD in Jazan province, Saudi Arabia.

METHODS

An observational cross-sectional retrospective study was conducted in Jazan province. General and demographic data were collected and pretested survey including questions about public knowledge and attitude toward HSCT for SCD were answered. Both t-test and chi-square tests were used for analysis.

RESULTS

1167 participants were included in this study with a mean age of 26 (SD: 8). About 50% of the study participants believed that SCD can be treated and 78% of the study participants already have heard about HSCT. About 57% of the participants defined HSCT correctly and 42% were willing to donate. Better knowledge and positive attitude toward HSCT were significantly reported among patients with SCD or their relatives as well as among people with higher education and healthcare workers (HCW).

CONCLUSION

About 57% of the study participants were able to define HSCT and most related questions were answered correctly. A positive correlation was found between the knowledge about HSCT and people with higher education or those who were diagnosed with SCD or their relatives and friends. Further, only 42% of our study participants were willing to donate, a percent that is positively associated with better knowledge about HSCT. National education programs are needed to enhance the overall awareness of Jazan communities toward HSCT which could contribute to reducing the number of patients waiting for HSCT.

A Multiethnic Asian Perspective of Presumed Consent for Organ Donation: A Population-Based Perception Study

Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remains a paucity of literature on public attitude and barriers regarding the opt-out system, with existing studies limited to Western nations. Therefore, this study aimed to understand public sentiment and different barriers toward organ donation from the perspective of Singapore, a highly diverse and multiethnic Asian society.

Methods: A cross-sectional community semi-structured interview was conducted in a public housing estate in Singapore. Pilot test was undertaken before participants were interviewed face-to-face by trained personnel. All statistical evaluations were conducted using Stata. The χ²-test compared subgroups based on patient characteristics while multivariable logistic regression identified predictors of willingness to donate/ assent. Effect estimates were quantified using odds ratio (OR).

Findings: Out of 799 individuals, 85% were agreeable to organ donation after death and 81% were willing to assent to donations of family members' organs, which declined by 16% (p < 0.001) after a clinical scenario was presented. Demographic factors including ethnicity, education, marital, and employment status affected willingness to donate and assent. Knowledge correlated significantly with willingness to donate and assent. In particular, knowledge regarding brain death irreversibility had the strongest correlation (AOR 2.15; 95% CI 1.60–2.89).

Conclusions: Organ donation rates remain low albeit presumed consent legislation, due to patient-level barriers, including but not limited to knowledge gaps, cultural values, religious backgrounds, and emotional impact at relatives' death. To effectively boost donor rates, it is crucial for policy makers to invest in public education and improve transplant provisions and family protocols.

Knowledge, Opinions, and Attitudes of Students of Warsaw Universities Toward Hematopoietic Stem Cell Transplantation

BACKGROUND

Hematopoietic stem cell transplantation is a method of treatment in many diseases, including oncology. For a large group of patients, such a therapy is a procedure that saves their health and life. Most of the transplants come from unrelated donors, which are still insufficient in comparison to the recipients in need. The purpose of the study to assess the knowledge, opinions, and attitudes of students of Warsaw universities toward hematopoietic stem cell transplantation.

METHODS

The survey was conducted among 351 students of Warsaw universities. The research method was a diagnostic survey, and the tool was the author's questionnaire. The statistical analysis was performed using the StatSoft Statistica 13.1 PL statistical package and Microsoft Office package.

RESULTS

The respondents answered correctly on an average 59% of the analyzed issues. Medical students older than 25 and women had a higher level of knowledge; 41.6% of respondents were registered in the donor database, and this more often referred to medical students (P < .0001). The motivation for registering (97.3%) was the willingness to help another person. The unregistered reported that their lack of a decision on registration, among others, was because their general health condition made it impossible to become a donor (34.6%) or they had insufficient knowledge (31.7%)-this more often referred to nonmedical students (P < .0001). In addition, 55% of students would be interested in attending a meeting/lecture at their university about being a potential donor (including 63.1% of medical and 44.9% of nonmedical students).

CONCLUSIONS

The knowledge of the surveyed students was at an average level, and the opinions and attitudes were mostly favorable. It seems that the organization of meetings on bone marrow donation at universities could enable a larger number of undecided students to decide to enter into the donor register.

Factors Associated with Intention to Donate Hematopoietic Stem Cells among Blood Donors

Introduction

Past studies pay little attention to the intention to donate hematopoietic stem cells (HSC) among blood donors. This study investigated the level of and the influence of socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC among blood donors.

Methods

This cross-sectional study recruited blood donors at selected public hospitals in the Malaysian State of Sarawak in 2019. A structured questionnaire was developed based on the review of relevant literature. It gathered information on socio-demographic characteristics, knowledge, attitude, subjective norm and self-efficacy on the intention to donate HSC. Variables with a p value <0.200 in bivariate analysis were included in the variable selection for regression modeling to examine their associations with the intention to donate HSC.

Results

A total of 569 blood donors participated (94.5% response rate). Overall, 87.1% reported a positive intention to donate HSC. In the regression model, the factor with the greatest association with intention to donate HSC was subjective norms about HSC donation (β = 0.35, 95% CI 0.27-0.42), followed by attitude about regulations of HSC donation (β= 0.21, 95% CI 0.13-0.35), self-efficacy on HSC donation (β = 0.15, 95% CI 0.09-0.32), attitude about the potential side effects of HSC donation (β = 0.14, 95% CI 0.02-0.10) and highest education level (β = 0.10, 95% CI 0.03-0.44).

Conclusions

The findings can be used to formulate a better strategy in promoting HSC donation among blood donors in the region.

Physical and Psychological Discomfort Experienced by Hematopoietic Stem-Cell Donors

This study investigates the types and degrees of physical and psychological discomfort experienced by hematopoietic stem cell donors before, during, and after the donation process in order to provide helpful information for developing education programs that can help donors to cope with their discomforts. One hundred and thirty-one individuals who donated hematopoietic stem cells from 2017 to 2019 were asked to self-report the types and degrees of physical and psychological discomfort they felt in the process, and the results were analyzed using SPSS. All participants donated peripheral blood stem cells; the most commonly reported physical discomfort was myalgia (72.5%), followed by bone pain (62.6%), fatigue (60.3%), and headache (55.0%). Of the donors, 88.5% responded that they experienced psychological discomforts, including fear (44.3%), anxiety (44.3%), stress (39.7%), depression (31.3%), loneliness (31.3%), regret (29.8%), and ambivalence (23.7%). In particular, female donors experienced more discomfort than males in rash (Z = -2.123, p = 0.034), fear (Z = -2.851, p = 0.004), and anxiety (Z = -1.861, p = 0.044). Therefore, it is necessary for healthcare providers and experts to make efforts to educate and help donors to prepare and mitigate their discomfort throughout the donation process, and to strategically manage donors' well-being by monitoring and evaluating their discomfort levels and providing interventions if necessary.

Does Being A Cancer Patient or Family Caregiver of A Cancer Patient Affect Stem Cell Donation Awareness?

Objective:

One of the most difficult challenges regarding hematopoietic stem cell transplantation in Turkey is finding donors for allogeneic transplantation candidates who do not have related donors. This study aims to determine whether there is any difference in the awareness of stem cell donation and transplantation between cancer and noncancer patients and their family caregivers. In addition, this study aims to determine the awareness of stem cell donation and transplantation in the entire study population.

Methods:

This descriptive study was conducted in Turkey using a data collection form comprising questions about demographics, stem cell transplantations, donations, and medical history. On analyzing the research data, variables were expressed as mean ± standard deviation and as numbers (n) and percentages (%). The Chi-square and Fisher's exact tests were performed to evaluate differences among cancer and noncancer diagnosed patients and their family members.

Results:

A total of 192 patients and 169 family caregivers participated in the study. In comparison with noncancer patients, cancer patients showed more awareness on what stem cell transplantation is, how lifesaving it is, and how to donate stem cells. Similarly, the family caregivers of cancer patients were more aware of what stem cell transplantation is and how to donate stem cells.

Conclusions:

The results of this study showed that cancer patients and their families were more aware of stem cell donation and transplantation; however, most of the patients and families did not know enough about the national registry program and how to donate stem cells.

Knowledge and attitude towards hematopoietic stem cell transplantation among medical students at Jazan University, Saudi Arabia

Objectives:

To identify the knowledge and attitudes of medical students at Jazan University towards hematopoietic stem cell transplantation (HSCT).

Methods:

This cross-sectional study involved all medical students at the Faculty of Medicine, Jazan University, Jazan, Saudi Arabia, between October 2018 and February 2019. Data were collected using a questionnaire that has been used in a previous study conducted at Mayo Medical School, Minnesota, USA.

Results:

Out of 800 students, 744 completed the questionnaire (the response rate was 93%). Sixty-seven students (9%) were already registered in the Saudi stem cell donor registry (SSCDR). The participants’ knowledge on donor eligibility was 37.4% and the donation process was 23.6%. Registered students were more likely to join the registry if there was a drive in their area (n=65 [97%], p=0.000), and more likely to donate stem cells to any matched patient (n=58 [86.6%], p=0.000). The main concern of the participants was the long-term side effects (48%).

Conclusion:

Most students lack the knowledge on HSCT. However, the students who registered in SSCDR had better knowledge and attitudes towards HSCT than the unregistered. Long-term side effects of HSCT were the most common concern of the participants. However, time commitment was the major concern of the registered students.

Effect of Educational Program on Knowledge, Attitude, and Willingness of Nursing Students for Hematopoietic Stem-Cell Donation

This study explored how an educational program on hematopoietic stem-cell donation (HSCD) affects the knowledge, attitude, and willingness for HSCD among nursing students. The subjects were the nursing students at a university in Korea: 43 in the experimental group and 42 in the control group. All subjects took a pre-test, and only the experimental group attended an educational program. Both the groups completed two post-tests. Variables of interest were knowledge, attitude, willingness, and registration ratio for HSCD. The educational program increased knowledge (F = 8.093, p < 0.001) and attitude (F = −6.422, p < 0.001) of the experiment group. After the program, the experimental group showed higher willingness for HSCD (χ² = 7.609, p = 0.006) and higher registration ratio for HSCD (χ²= 4.258, p = 0.039) compared to the control group. The educational programs for knowledge and attitude about HSCD will affect the students’ future nursing, and influence clients and their families toward positive perception on HSCD and organ donations.

Prior blood donations do not affect efficacy of G-CSF mobilization nor outcomes of haematopoietic stem cell collection in healthy donors

BACKGROUND AND OBJECTIVES

Many consider volunteer blood donors as ideal candidates for unrelated haematopoietic progenitor cell (HPC) donation. However, frequent blood donations could influence the results of HPC mobilization. To our best knowledge, there are no data on the possible impact of repeated blood donation on efficiency of subsequent HPC mobilization by granulocyte colony-stimulating factor (G-CSF).

MATERIALS AND METHODS

We compared outcomes of HPC mobilization in unrelated donors with and without a history of blood donation. We conducted a prospective study on 287 consecutive donors admitted to the Department of Hematology since January 2016. The final analysis included 153 donors who agreed to take part in the study and had undergone stem cell mobilization with G-CSF.

RESULTS

History of blood donations prior to haematopoietic stem cell mobilization with G-CSF does not have a significant impact on the number of collected CD34+ cells in the first leucocytapheresis (516.2 x 10⁶ (170-1148) in blood donors vs 490.5 x 10⁶ (101-1154) in non-donors) (P = 0.32). In all donors, in this study mobilization of HPC was successful: 87.5% of blood donors and 85.6% of non-donors collected the required cell number in a single apheresis. In blood donors, a higher number of blood donations within 2 and 5 years prior to HPC mobilization correlated significantly with successful donation within one leucocytapheresis (P = 0.014 and P = 0.024, respectively).

CONCLUSION

Multiple blood donations do not significantly influence the outcome of HPC collection in unrelated donors. Blood donors and non-donors have similar results of HPC collection, so there is no reason to favour either group.

Hematopoietic Stem Cell Transplantation: A Bioethical Lens

Hematopoietic stem cell transplantation (HSCT) is one of a range of therapeutic options available to patients suffering from various diseases. HSCT procedure involves important ethical and legal aspects that can occur at every phase of the procedure: the clinical choice of whether to perform the procedure, pretransplantation preparation regimens, donor selection, stem cell harvest procedure, transplantation phase, and short-term and long-term follow-up care. In this discussion paper, we outline the ethical issue-facing physicians involved in HSCT. Currently, HSCT is a widely accepted treatment for many life-threatening diseases. It thus represents a real therapeutic hope for many patients. It does, however, carry a burden of possible morbidity and mortality. Consequently, there are substantial information and communication issues involved in the consent process for HSCT. In the final decision, the judgements of different parties, such as patients, family members, and healthcare professionals, intersect and overlap and this is particularly true when the patient is a minor. Finally, HSCT is a very expensive procedure. The social and economic concerns of HSCT are discussed within the actual contextual framework of the dramatic increase in healthcare costs and inequalities in healthcare in relation to socioeconomic status, educational status, and ethnicity.