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

Healthcare Professionals’ Understandings of the Definition and Determination of Death: A Scoping Review

Background.

During the 1950s, advances in critical care, and organ transplantation altered the relationship between organ failure and death. There has since been a shift away from traditional cardiocirculatory based to brain-based criteria of death, with resulting academic controversy, despite the practice being largely accepted worldwide. Our objective is to develop a comprehensive description of the current understandings of healthcare professionals regarding the meaning, definition, and determination of death.

Methods.

Online databases were used to identify papers published from 2003 to 2020. Additional sources were searched for conference proceedings and theses. Two reviewers screened papers using predefined inclusion and exclusion criteria. Complementary searches and review of reference lists complemented the final study selection. A data extraction instrument was developed to iteratively chart the results of the review. A qualitative approach was conducted to thematically analyze the data.

Results.

Seven thousand four hundred twenty-eight references were identified. In total, 75 papers met the inclusion criteria. Fourteen additional papers were added from complementary searches. Most were narratives (35%), quantitative investigations (21%), and reviews (18%). Identified themes included: (1) the historical evolution of brain death (BD), (2) persistent controversies about BD and death determination, (3) wide variability in healthcare professionals’ knowledge and attitudes, (4) critical need for BD determination revision.

Conclusions.

We concluded that although BD is widely accepted, there exists variation in healthcare providers’ understanding of its conceptual basis. Death determination remains a divisive issue among scholars. This review identified a need for increased opportunities for formal training on BD among healthcare providers.

Health Care Professionals as Relatives in Organ Donation Interviews: Analysis of the Important Role of Health Care Professionals as Family Members

INTRODUCTION

The organ and tissue donation interview is a vital step in obtaining the donation. Therefore, it is important to obtain as much information as possible regarding the relatives of the potential donor prior to this interview and know if there is a health care professional among the relatives who may act as an interlocutor.

OBJECTIVE

The objective of this study is to assess the influence that relatives who are health care professionals may have if present at the interview for the organ and tissue donation request.

METHODS

This is a descriptive study of all the organ donations from 1996 to 2019. Variables of the interview record form were completed by the Regional Transplant Coordination Office. Quantitative variables are expressed as mean (standard deviation) or median (interquartile range), and qualitative variables are expressed in percentage. The χ² test was used for inferential statistics.

RESULTS

Health care professionals were present as interlocutors in 8.4% of the total interviews conducted (9279). Organ donation was accepted in 86% of these interviews, while the relative who was a health care professional gave a 93.8% (729) positive response to the donation. Having a health care professional as an interlocutor favors the acceptance of the donation (odds ratio 9.325, 95% confidence interval: 5.054-17.205; P < .001).

CONCLUSION

Health care professionals have a very positive attitude toward donation. This attitude positively impacts other relatives' acceptance of the donation.

Information About Donation and Organ Transplantation Among Spanish Medical Students

INTRODUCTION

Health professionals are asked to promote health, especially organ transplantation; however, they do not always have specific training.

OBJECTIVE

To analyze information about donation and organ transplantation among Spanish medical students.

METHOD

The population under study is medical students in Spanish universities using the database of the International Donor Collaborative Project, stratified by geographic area and academic year (n = 9275). The instrument used is the attitude questionnaire for organ donation for "PCID-DTO-Ríos" transplantation, validated with an explained variance of 63.203% and α = 0.834. The Student t test was applied together with the χ² test, complemented by an analysis of the remainders, and Fisher's exact test was applied.

RESULTS

Of the students, 74% indicate that they have received information from university professors about organ transplant. Concerning specific issues with the donation, it is notable that only 66.7% (n = 6190) know and accept the concept of brain death as the death of a person. However, only 22% consider themselves as having good information, and 35.3% indicate that their information is scarce or void. Students indicate having received information about transplant from other extra-university sources, such as television and Internet (80.9%), books and magazines (73.2%), and the press (66.9%). From the information obtained in the sociofamilial field, 60.7% have obtained information from the family and 58.1% from friends. Of this information, 9% has been negative from friends, 7.5% from family, 6% from the Internet and television, and 4% from university professors.

CONCLUSION

Spanish medical students believe they have little information about organ transplantation and have received negative information.

A Multicentre and stratified study of the attitude of medical students towards organ donation in Spain

INTRODUCTION

Medical students represent a new generation of medical thought, and if they have a favourable attitude towards organ donation this will greatly encourage its promotion.

OBJECTIVE

To analyse the attitude of medical students in Spanish universities towards the donation of their own organs and to determine the factors affecting this attitude.

MATERIAL AND METHODS

Type of study: A sociological, interdisciplinary, multicentre, and observational study in Spain.

STUDY POPULATION

Students studying a degree in medicine enrolled in Spain (n = 34,000).

SAMPLE SIZE

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

RESULTS

The questionnaire completion rate was 95.7% (n = 9.275). 80% were in favour of donation, 2% against and 18% were undecided. The following main variables were related to a favourable attitude: being of the female sex (Odds Ratio = 1.739); being in the sixth year of the degree (OR = 2.506); knowing a donor (OR = 1.346); having spoken about the subject with one's family (OR = 2.132) and friends (OR = 1.333); having a family circle that is in favour, more specifically, having a father (OR = 1.841), mother (OR = 2.538) or partner in favour (OR = 2.192); being a blood donor (OR = 2.824); acceptance of the mutilation of the body if it were necessary (OR = 2.958); and being an atheist or an agnostic (OR = 1.766).

CONCLUSIONS

Spanish medical students generally have a favourable attitude towards organ donation, although 20% are not in favour.

Emotional experiences of health professionals in organ procurement and transplantation. A systematic review

INTRODUCTION

The objective was to explore, discuss and synthesize the emotional experiences of health professionals during the process of organ procurement and transplantation.

METHODS

A systematic review was made in Medline, Science Direct and the Virtual Library of the Andalusian Public Health System, selecting 16 original articles for inclusion in the review, with qualitative evaluation and narrative synthesis.

RESULTS

The results revealed the main use of qualitative methodology, and 4emergent themes were identified: working in organ procurement and transplantation; the transition of professional roles; emotional experiences; and, coping strategies and emotional management. This systematic review revealed the complex and diverse character of professionals' emotional experiences as well as the importance of the interpersonal relationship.

CONCLUSIONS

Intense emotional experiences related to the sense of responsibility, the work challenge and coping strategies based on reward searching explained important contradictions and tensions about professional roles and functions, especially during the donation interview.

Psychological profile and disease-coping strategies of patients on the waiting list for liver transplantation

AIM

To determine the psychological characteristics of patients on the liver transplant waiting list; to analye the implications of the patient's psychological profile on coping with the disease.

MATERIAL AND METHODS

Study population: patients on the liver transplant waiting list. Psychological-profile: Socio-personal history; Mini Mental State Examination; Brief-Symptom Inventory of psychopathological problems; International Neuropsychiatric Interview; Family APGAR questionnaire; Social Support Questionnaire. Coping with the disease: A questionnaire about mental adaptation to the disease. Patients were recruited for the study at the time when they were included on the waiting list.

RESULTS

The patients (n=112) had the following characteristics: 68% of the patients had symptoms of emotional psychopathology, with 48% being of a depressive, anxious and obsessive-compulsive type, respectively. In terms of social and family support, 27% had the perception of being in a dysfunctional family (slight-23%; serious-4%). What is more, according to the Global Support Index, 21% had non-functional social and family support. Coping with the disease: 8% were well-adapted to the disease, the remaining 92% were poorly adapted; of which, 79% had a weaker fighting spirit, 51% expressed anxiety and concern about coping with the disease, 34% found they resorted to fatalism, 29% were in denial and 27% felt helpless.

CONCLUSIONS

Once liver patients are included on the transplant waiting list, they poorly adapt to the disease, with important emotional implications that result in psychological alterations.

Sensitization Toward Organ Donation Among Medical Students in Spanish Regions With More Than 50 Donors Per Million Population

The awareness of organ donation among health professionals is important at the time of transplant promotion. In this sense, the training and awareness of the professionals in training is fundamental.

OBJECTIVE

To analyze the differences in the attitude toward organ donation and the factors that condition it among medical students of regions with donation rates >50 donors per million population (pmp) with respect to those with rates <40 donor pmp.

METHOD

Population under study: medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: Group 1 (n = 1136): students in universities of regions with >50 donors pmp. Group 2 (n = 2018): university students in regions with <40 donors pmp. Assessment instrument: attitude questionnaire for organ donation for transplant PCID-DTO-Ríos.

RESULTS

The attitude toward organ donation for transplantation is similar among students from the autonomous communities with >50 donors pmp and with <40 donors pmp. In group 1, 79% (n = 897) of students are in favor compared with 81% (n = 1625) of group 2 (P=.29). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): sex, having discussed transplantation with family and as a couple, considering the possibility of needing a transplant, involvement in prosocial activities, attitude toward the manipulation of corpses, knowledge of the brain death concept, and religion.

CONCLUSIONS

The awareness of organ donation in Spanish medical students is quite homogeneous and is not related to the local donation rates of each region.

There Is Great Ignorance About the Brain Death Concept Among the Population in Santiago de Cuba (Cuba)

INTRODUCTION

The knowledge of the brain death (BD) concept is important when determining the attitude toward organ donation.

OBJECTIVE

To analyze the level of knowledge of the BD concept among the population in Santiago de Cuba and determine the factors that condition it.

METHODS

From the Collaborative International Donor Project, we obtained a sample of Cubans living in the area of Santiago de Cuba (n = 455). The attitude was assessed using a validated questionnaire (PCID-DTO-RIOS). The survey was self-administered and completed anonymously. Student t test, χ², Fisher, and logistic regression analysis were used.

RESULTS

Forty percent (n = 180) of the respondents know the BD concept and consider it as the death of an individual. Of the rest, 43% (n = 199) do not know about it, and the remaining 17% (n = 76) consider that it does not mean the death of a patient. The variables significantly related to the correct knowledge of BD in the multivariate analysis and considered as independent are: level of studies; the opinion of the couple toward organ donation; the religion of the respondent; having offspring; and a favorable attitude toward organ donation.

CONCLUSION

There is ignorance about the brain death concept among the population of Santiago de Cuba. This lack of knowledge has a direct relationship with various psychosocial factors.

Are High Rates of Deceased Donation Conditioning the Attitude Toward Liver Donation Among Medical Students?

The involvement of health professionals from their training period is important for the promotion of living liver donation. There are data that indicate that the awareness of living donation is lower in areas with high rates of deceased donation.

OBJECTIVE

To analyze the attitude toward living liver donation among Spanish medical students, according to donation rates of their regions.

METHOD

Population under study: Medical students in Spanish universities. Database of the Collaborative International Donor Project, stratified by geographic area and academic course. The completion was anonymous and self-administered. Groups under study: group 1 (n = 1136): students in universities of regions with >50 donors per million population (pmp); group 2 (n = 2018): students in region universities with <40 donors pmp. Assessment instrument: the attitude questionnaire for living liver donation Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Hepático-Ríos (PCID-DVH Ríos).

RESULTS

The attitude toward related liver donation is more favorable among the students of regions with <40 donors pmp than among those of >50 donors pmp. Thus, in group 1, a total of 88% (n = 1002) of students are in favor compared with 91% (n = 1831) of group 2 (P=.02). The psychosocial profile of each study group about their attitude toward living related liver donation is analyzed. There is a similar profile between the 2 groups, although there are differences in some variables such as age, a belief that one might need a transplant, family discussion about donation and transplantation, discussion with friends about donation and transplantation, and knowing about a donor.

CONCLUSIONS

The awareness of living related donation among Spanish medical students is greater among the regions with lower organ donation rates.

Gypsy Population With University Studies Is a Key Ethnic Subgroup for the Promotion of Organ Donation Among the Gypsy Population

INTRODUCTION

The refusal to consider death and the donation and transplantation of organs make Gypsies one of the subpopulation groups with the lowest donation rates in Europe. The approach of this social group implies the support of the most favorable social groups within their own ethnic group. In this sense, the young population with a high level of education is usually the most favorable toward organ donation.

OBJECTIVE

To analyze the attitude toward the donation of one's own organs for transplantation among the Gypsy population under 45 years and with secondary or university studies.

METHOD

Population under study: The Gypsy population under 45 years old with secondary or university studies who currently reside in Spain. Assessment instrument: The attitude questionnaire for organ donation for transplantation PCID-DTO Ríos. Fieldwork: A random selection based on stratification. Anonymity and self-administered fulfillment.

STATISTICS

Student t test and χ².

RESULTS

A total of 44 Gypsy people under 45 years of age were surveyed (mean age 31 ± 8.9 years); 66% were women, and the rest were men. Of these, 20 had university studies, and 24 had secondary or vocational studies. The attitude is favorable toward organ donation in 64% of the respondents, with 80% among university students and 50% among those with secondary or vocational education (P < .005).

CONCLUSIONS

The young Gypsy population with university studies has a very favorable attitude toward organ donation. This population subgroup must be key in the promotion of organ donation in the Gypsy population, so the transplant coordinators must request their collaboration in the promotion campaigns of organ donation and transplantation.

Attitude Toward Organ Donation in the Population of Cienfuegos, Cuba

INTRODUCTION

The sensitization of the population toward organ donation is fundamental; for that reason, it is important to determine the factors that condition the opinion toward donation on the population scope in order to carry out cost-effective campaigns.

OBJECTIVE

To analyze the attitude toward the donation of the proper organs for transplantation among the population residing in Cienfuegos, Cuba.

METHOD

Population under study: Population who reside in Cienfuegos, Cuba.

INCLUSION CRITERIA

Population over 15 years old as stratified by age and sex. Assessment instrument: The attitude questionnaire for organ donation for transplant-PCID-DTO Ríos. Fieldwork: A random selection based on stratification. The available data from the census were used. The completion was anonymous and self-administered. Verbal consent was requested to collaborate in the study.

STATISTICS

Student t test, χ², Fisher, and a logistic regression analysis.

RESULTS

A sample of 636 respondents was included in the study, of which 71% (n = 453) are in favor of donating their organs after death, 16% (n = 103) are against, and 13% (n = 80) are undecided. This attitude is associated with different psychosocial variables (P < .001): age, marital status, having offspring, level of studies, carrying out prosocial activities, discussing with the family the subject of donation and transplantation, knowledge of the concept of brain death, the attitude toward the manipulation of the corpse, the religion of the respondent, and the attitude of the couple toward organ transplantation. The main independent factors obtained in the multivariate analysis (odds ratio >2.5): knowledge of the brain death concept, attitude toward the manipulation of the corpse, religion, and attitude of the couple toward transplantation.

CONCLUSIONS

The attitude toward organ donation among the population of Cienfuegos, Cuba, is favorable and is conditioned by several psychosocial factors.

Gypsy Population Presents a Favorable Attitude Toward Related Living Donation

INTRODUCTION

Negative organ donation rates among the Gypsies is much higher than that of any other social group in Spain. However, living donation rates have not been raised much in this social group, despite the existence of several Gypsy patients on the waiting list for transplantation.

OBJECTIVE

To analyze the attitude toward related living donation among the Gypsy population who reside in Spain.

METHODS

This type of study is an observational sociological study. The study consisted of the adult Gypsy population residing in Spain, and a random sampling of 230 adult gypsies was conducted. Attitude questionnaires for live donation, both hepatic PCID-DVH-Ríos and renal PCID-DVR-Ríos, were used, and random selection was based on stratification. Questionnaires were self-administered and completed anonymously. Student t test, χ2, Fisher, and a logistic regression analysis were used.

RESULTS

A sample of 206 Gypsies (52% women) with a mean age of 34 years is obtained. Seventy-two percent (n = 150) would donate an organ to a relative in life, 8% (n = 16) would not donate it, and 20% (n = 41) have doubts. Respondents with a favorable attitude toward living donation presented a more favorable attitude toward cadaveric organ donation (55% vs 0%, P < .001). The attitude toward living kidney donation was more favorable (81% in favor) than toward living liver donation (P < .001).

CONCLUSIONS

The Gypsy ethnic group is sensitized to live donor transplantation. The family and cultural roots of Gypsy people could condition this favorable attitude, a fact to be taken into account to sensitize this social group and promote donation campaigns with the aim of increasing donation rates.

Attitudes of Latin American Immigrants Resident in Florida (United States) Toward Related Living Kidney Donation

INTRODUCTION

Latin American immigrants comprise an important population group in the United States. The purpose of this study was to analyze the attitude toward living kidney donation found among Latin American citizens who are residents in Florida and to identify the psychosocial variables affecting their attitude.

MATERIAL AND METHODS

A sample of Latin American residents in the state of Florida was randomly obtained and stratified by nationality, age, and sex (n = 1524). Attitude was assessed through a validated questionnaire that was self-administered and completed anonymously. Descriptive, Student t test and the χ² test were used to analyze findings.

RESULTS

The questionnaire completion rate was 94% (N = 1433), with 59% (n = 845) in favor of related living donation, 40% (n = 571) were opposed to donation, with the remaining 1% (n = 17) undecided. The following variables were related to attitude toward living donation: country of origin (P < .001), marital status (P < .001), having descendants (P = .004), educational background (P < 0.001), having had previous experience of donation and transplantation (P < .001), attitude toward deceased donation (P < .001), considering the possibility of needing a transplant (P < .001), the respondent's partner's opinion (P < .001), having considered the subject with one's family (P < .001), having carried out prosocial type activities (P < .001), the respondent's religion (P < .001), knowing that one's religion is in favor of this therapy (P < .001), concern about mutilation after donation (P < .001), and considerations of the risks of living donation (P < .001).

CONCLUSIONS

The attitude toward related living kidney donation of Latin American residents in Florida is not very favorable (only 59%).

Multivariate Analysis of Factors Affecting Attitude Toward Living Kidney Donation Among the Puerto Rican Population Resident in Florida

Puerto Rican and Cuban populations are 2 of the most important migration groups in Florida. Awareness about organ donation among them is fundamental. It is important to determine the factors that influence attitudes toward organ donation.

OBJECTIVE

To analyze the attitude toward living kidney donation (LKD) among Florida's Puerto Rican residents.

METHODS

Study population: Population born in Puerto Rico resident in Florida (United States).

INCLUSION CRITERIA

A sample of population older than 15 years was obtained randomly and stratified by age and sex. Instrument valuation: LKD attitude questionnaire Proyecto Colaborativo Internacional Donantesobre Donación de Vivo Renal, Rios.

SETTING

for the study: Random selection based on stratification. Immigration support associations in Florida were needed to locate potential respondents. Anonymized and self-administered with verbal consent completion.

RESULTS

Of the 259 respondents, 55% (n = 143) are in favor of related LKD (family or friends). The following factors were associated with this attitude: marital status (P = .008); educational level (P < .001); personal experience with organ donation and transplantation (P < .001); attitude toward deceased organ donation (P < .001); realization of prosocial activities (P = .02); family comments about organ donation (P < .001) and comments within couples (P < .001); not being concerned about possible mutilation of the body after donation (P < .001); believing that one's own religion was in favor of donation and transplantation (P < .001); economic incentives of donation (P < .001), and evaluation of the risk from living kidney donation (P < .001). In the multivariate analysis, only marital status is featured as an independent variable (odds ratio, 32.258; P < .001).

CONCLUSIONS

The attitude toward related LKD among the Puerto Rican population who resides in Florida is not very favorable; only 55% would do it.

What Is the Attitude Toward Cadaveric Organ Donation of the Ghanian Residents in Spain?

INTRODUCTION

The Ghanaian population is migrating toward the European economic community, especially toward the southern countries.

OBJECTIVE

To analyze the attitude toward organ donation among the population born in Ghana but currently residing in Spain.

METHOD

The study included the population born in Ghana who are ≥ 15 years of age and residents of Spain, stratified by age and sex. The assessment instrument used is the donation and transplant attitude questionnaire of Proyecto Colaborativo Internacional Donante (PCID-DTO Ríos), which was self-administered and anonymously completed with verbal consent. The statistics used were descriptive, χ², Student t test, and a logistic regression analysis.

RESULTS

The questionnaire was completed by 237 Ghanaians. Forty-three percent (n = 102) are in favor of cadaveric organ donation, 35% (n = 83) are against donating their own organs, and 20% (n = 48) are undecided. In the multivariate analysis, the association was maintained at the level of the primary studies (P < .001, OR = 25), not being afraid of possible mutilation after donating (P < .001, OR = 76.923), religion (P < .001; OR = 27.777), performing prosocial activities (P = .016, OR = 12.048), and having previously commented on the issue of organ donation and transplantation in the family setting (P = .012, OR = 4.878).

CONCLUSIONS

The Ghanaian immigrant population in Spain has an unfavorable attitude toward the donation of their own organs at death, which is conditioned by multiple psychosocial factors.

Are Dominicans in Favor of Xenotransplantation? A Study of the Attitude of Dominican Immigrants Residing in Spain and the United States

Xenotransplantation carries many social and cultural implications. The immigrant population in countries with xenotransplantation programs, such as Spain and the United States, will play an important role in accepting such therapy. The objective of the study is to analyze the attitude toward xenotransplantation among the Dominican population residing in the United States and Spain.

METHODS

The study population was born in the Dominican Republic and resides in the southeastern United States and Spain. A sample population older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on psychosocial aspects toward xenotransplantation (PCID-XENOTx-Ríos). A random selection of people to be surveyed was carried out. Assistance from immigration support associations was needed to advise on the location of potential respondents.

RESULTS

A total of 123 respondents were included in the study: A sample was taken of residents of the population from the Dominican Republic residing in Florida, United States (n = 66), and in Spain (n = 57). If it was assumed that xenotransplanted organs functioned as well as human ones, 30% would be in favor. If the results were worse, only 7% would be in favor. This favorable attitude was related to the following variables (P < .05): level of education, an attitude in favor of deceased and living organ donation, and having spoken about donation and transplantation within the family.

CONCLUSIONS

The attitude toward xenotransplantation among the population from the Dominican Republic who are residing in the southeastern United States and Spain is unfavorable.

Nigerian Residents in Spain Have Poor Awareness of Organ Donation and Transplantation

INTRODUCTION

The number of people of Nigerian origin in Europe is growing. However, there are no studies that have analyzed their awareness of organ donation and transplantation.

OBJECTIVE

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

METHODS

The sample population was a selection of people born in Nigeria who are now living in Spain. A sample of this cohort older than 15 years was obtained randomly and stratified by age and sex. Attitude was assessed using a validated questionnaire on the psychosocial attitudes toward organ donation (PCID-DTO-Ríos). A random selection of people from this cohort was surveyed.

RESULTS

A sample of 183 respondents was included in the study. Of their attitudes toward cadaveric donation, 33% were in favor of it, 34% were against it, and 33% were undecided. The variables associated with having a more favorable attitude (P < .001) were: 1. Knowledge related to donation and transplantation; 2. attitude toward the body; 3. religion; and 4. social interaction. In the multivariate analysis, the main independent factor associated with the attitude toward organ donation was the knowledge of the concept of encephalic death. Respondents who are familiar with the concept of brain death are 10 times more likely to be in favor of donation than those who are not.

CONCLUSIONS

The attitude toward organ donation among the Nigerian-born population living in Spain is not very favorable and is associated with psychosocial factors. A campaign to raise awareness among Nigerian residents in Spain has become a priority.

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.

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.

Factors That Condition the Attitude Toward Living Related Kidney Donation Among Santiago of Cuba's Population

INTRODUCTION

Living kidney donation is currently the most important kidney donor source in Latin America, and it is necessary to further increase its rates.

OBJECTIVE

To analyze the attitude toward living kidney donation among the Santiago de Cuba's population and to determine the sociopersonal factors with which it is associated.

METHOD

The population over 15 years old residing in Santiago de Cuba, stratified by sex and age, was screened. The "PCID-LKD Ríos" attitude questionnaire toward living kidney donation was administered to a random selection of the people surveyed according to the stratification and the census data. The completion was anonymized and self-administered. Verbal consent was obtained.

RESULTS

The study was completed by 445 people, of whom the 86% (n = 389) were in favor of living related kidney donation. This attitude is associated with the level of education (P < .001); previous experience with organ donation (P = .006); attitude toward cadaveric organ donation (P < .001); carrying out of prosocial activities (P = .010); discussion of the issue with the family (P < .001) and the significant other (P < .001); concern about mutilation after donation (P = .001); religious beliefs (P = .001); and assessment of the risk of living kidney donation (P < .001). In the multivariate study, the following variables persisted: (1) level of education; (2) attitude of cadaveric donation; (3) carrying out of prosocial activities; and (4) risk assessment of living donation.

CONCLUSIONS

Living related donation is very well accepted among the Santiago de Cuba's population.

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.

Knowledge and Attitudes Toward Organ Donation in Health Care Undergraduate Students in Italy

INTRODUCTION

The number of organ donors in Italy is increasing, but with still disappointing living donation activity and relatively frequent objection by potential deceased donors' relatives to organ recovery. Few studies have assessed health care students' knowledge and attitude on donation.

METHODS

We administered a questionnaire to medical (MS) and nursing students (NS) at University of Modena and Reggio Emilia, Italy, and 749 students (406 MS and 343 NS) completed the questionnaire.

RESULTS

Although 95% of students were in favor of donation, only 21.9% of NS and 24.9% of MS were registered as donors. One quarter of students reported family disagreement. MS appeared more confident with personnel involved in donation. Overall, 60% of students knew the term donation after brain death but only 40% were aware of the criteria used to define it. Barely 27.1% of NS and 15.3% of MS believed they had received sufficient information in lessons. Backward logistic regression demonstrated that students whose families agree with them and who knew the definition of donation after brain death were more likely to express the disposition of registering, and those who showed distrust in the declaration of brain death were half as likely to register as donors.

DISCUSSION

Students expressed a lack of knowledge, controversial attitudes on donation, and strong need for education; increased awareness may help increase donation rates. The majority of educational institutions in Italy do not directly address training on organ donation and transplantation for health care students; an integrated curriculum favoring interpersonal discussion including practical aspects is urgently required.

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.

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.

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.

Do Spanish Medical Students Understand the Concept of Brain Death?

Objective:

To analyze the level of understanding of the brain death concept among medical students in universities in Spain.

Methods:

This cross-sectional sociological, interdisciplinary, and multicenter study was performed on 9598 medical students in Spain. The sample was stratified by geographical area and academic year. A previously validated self-reported measure of brain death knowledge (questionnaire Proyecto Colaborativo Internacional Donante sobre la Donación y Transplante de Organos) was completed anonymously by students.

Results:

Respondents completed 9275 surveys for a completion rate of 95.7%. Of those, 67% (n = 6190) of the respondents understood the brain death concept. Of the rest, 28% (n = 2652) did not know what it meant, and the remaining 5% (n = 433) believed that it did not mean that the patient was dead. The variables related to a correct understanding of the concept were: (1) being older ( P < .001), (2) studying at a public university ( P < .001), (3) year of medical school ( P < .001), (4) studying at one of the universities in the south of Spain ( P = .003), (5) having discussed donation and transplantation with the family ( P < .001), (6) having spoken to friends about the matter ( P < .001), (7) a partner’s favorable attitude toward donation and transplantation ( P < .001), and (8) religious beliefs ( P < .001).

Conclusions:

Sixty-seven percent of medical students know the concept of brain death, and knowledge improved as they advanced in their degree.

Organ Donation: What Are the Opinions of Nursing Students at the University of Bialystok in Poland?

BACKGROUND

Nursing students, as future professionals, have an enormous impact on the opinion of the rest of the population on topics of organ donation and transplantation (ODT). The objective of this study was to analyze the attitudes of nursing students at the University of Bialystok toward ODT, and to determine the factors that affect ithemt.

METHODS

Academic year 2011-2012.

STUDY POPULATION

nursing students at the University of Bialystok. Type of sampling: sampling points during 5 compulsory-attendance nursing courses with >80% fulfillment. Measuring instrument: validated questionnaire (PCID-ODT Rios) filled out anonymously and self-administered.

RESULTS

Completion rate of 90% (331/367): 58% (n = 191) in favor, 35% (n = 118) undecided, and 7% (n = 22) against. The most important variables were: being in the 1st year (odds ratio [OR], 4.444; 95% confidence interval [CI], 11.627-1.700; P = .002); not knowing any donor (OR, 12.048; 95% CI, 55.555-2.57; P = .018); being in favor of organ donation by a relative (OR, 6.25; 95% CI, 14.705-2.666; P < .001); discussing the topic with friends (OR, 2,785; 95% CI, 5.347-1.447; P = .002); not worried about the possible mutilation of the body after donation (OR, 3.039; 95% CI, 5.882-1.569; P = .001); favorable attitude toward ODT of mother (OR, 3.676 (0.881-1.814; P < .001); accepting other treatment options, such as inhumation (OR, 3.436; 95% CI, 7.092-1.655; P = .001); accepting autopsy after death (OR, 2.141; 95% CI, 4.065-1.126; P = .020); and professing the Catholic religion (OR, 3.436; 95% CI, 8.333-1.410; P = .007).

CONCLUSIONS

More than 42% of the nursing students were not in favor of organ donation, their attitudes influenced by various psychosocial factors.

Donate a Piece of Liver: Is This an Option Accepted by Future Nurses of Pomeranian Medical University in Poland?

BACKGROUND

Liver transplantation from living donors (LLD) has become a viable and important source of liver grafts. The objective of this study was to analyze the attitude of nursing students at the Pomeranian Medical University in Poland on donation of live liver, and to determine the factors that affect it.

METHODS

Academic year 2011-2012, nursing students at a university in Poland, sampling points in 5 compulsory-attendance nursing courses with a completion rate of 80%, validated questionnaire (PCID-DVH Rios) filled out anonymously and self-administered.

RESULTS

The completion rate was 89% (227/254). Of the 227 students surveyed, 92% (n = 209) were in favor, 6% (n = 14) undecided, and 2% (n = 4) against. When the LLD is not related, 44% (n = 100) of respondents would be in favor. With a positive attitude toward this type of donation, we associated the following variables: 1) age, with the youngest showing a more favorable attitude (P = .006); 2) attitude in favor of living kidney donation (98% vs 85%; odds ratio, 4.950; 95% confidence interval, 9.259-2.652; P = .002); 3) attitude in favor of accepting a family LLD (96% vs 81%; P = .003); 4) discussing donation and transplantation with family (95% vs 87%; P = .043).

CONCLUSIONS

Ninety-two percent of nursing students at the Pomeranian Medical University in Poland were in favor of live organ donation, an attitude conditioned by various psychosocial factors.