Who signs an organ transplant donor card? A study of personality and individual differences in a sample of Israeli university students

The general public's attitude towards accepting payment for kidney donation

Introduction

Kidney transplantation has become the most cost-effective treatment for patients with end-stage kidney disease (ESKD) and offers them the highest quality of life. Yet, kidney donation is often inaccessible due to cultural and traditional beliefs about organ donation. The goal of our study is to assess the value of kidney donation using the Willingness to Accept (WTA) technique. We also aim to understand the factors influencing an individual's willingness to donate an organ.

Methods

A self-administered survey was completed by 985 participants from the general public. The quantitative method and survey design that were chosen used descriptive, correlational, nonparametric, and multivariate statistical tests.

Results

Most of the respondents, 895 (90.9%) are not willing to donate a kidney while alive. Four hundred and five (41.1%) of the respondents are not willing to donate a kidney after their death, while the rest are willing to donate their kidney after their death without financial compensation. The same attitude applies to the donation of a kidney from their relatives. Significant predictors from the results of the logistic regression model in predicting the lowest (minimal) amount that will encourage donation of one kidney after death were: Marital status; Nationality; Adi card holder; Knowing people who need a kidney donation; confidence in the medical staff; and consideration of the family's opinions regarding organ donation.

Discussion

Using cost benefit analysis (CBA), with the aim of evaluating the willingness of individuals to accept payment for innovative medical procedures, such as kidney donation, allows an assessment of the perceived value of the medical procedure and enables policymakers to decide whether to allocate funds or offer subsidies for kidney donation, given the limited healthcare resources available. During our research, we found that most participants did not support the commercialization of organs. Our recommendation for policymakers and health professionals is to continue providing adequate funding for kidney donations and to implement educational programs aimed at improving attitudes towards organ donation.

Moderating Role of Religiosity and the Determinants to Attitude, Willingness to Donate and Willingness to Communicate Posthumous Organ Donation Decisions among University Students in Pakistan

Organ transplantation is considered an alternative treatment to save lives or to improve the quality of life and is a successful method for the treatment of patients with end-stage organ diseases. The main objective of the current study was to explore the determinants of the attitudes and willingness to communicate the posthumous organ donation decisions to the families. Questionnaires were used to test the hypothesized relationships. The results confirmed altruism, knowledge, empathy, and self-identity as the antecedents to attitude. We also found perceived behavioral control, moral norms, and attitude as significant antecedents to the willingness to donate organs after death. The results of the study also indicated that those who were willing to sign the donor card were also willing to communicate their decision to their families. Religiosity moderated the relationship between willingness to donate and signing the donor card, and it strengthened the relationship. The findings of this study would provide insight into the factors which can influence posthumous organ donation among university students in Pakistan.

Body Donation Registration in Taiwan: Reasons and Associated Psychological Factors

Dissection is an essential element of medical training and depends on the availability of cadavers. However, traditional Chinese culture widely regards the body as a gift from one’s parents that should remain intact after death, resulting in a shortage of cadavers for medical training and research. This situation changed in Taiwan when Master Cheng Yen, the founder of the Buddhist Tzu Chi Medical Foundation, supported the donation of bodies to medical science. This study aimed to investigate the current situation of body donation in Taiwan, including donors’ motivation and psychological characteristics. A questionnaire was conducted with 681 adult participants, including 336 people who pledged to donate their bodies to medical science after death and a control group comparable in age, gender, and level of education. All participants answered questions regarding anxiety over death, purpose in life, gratitude, altruism, and life satisfaction. In addition, the registered donor group answered questions regarding the motivation for donating their bodies to science. The main influencing factors were to help advance medical science, make a positive contribution to society, and release attachment from the body. Further, many male participants indicated the desire to reduce trouble and expenses that their families would incur in making funeral and burial or cremation arrangements. The main predictors of donating one’s body to medical science were low anxiety concerning death, a high level of altruism, and gratitude.

How Perceived Similarity Moderates Sympathy and Pride Appeal in Organ Donation Messages

BACKGROUND

Organ transplantation is the only medical procedure that can save a person who is suffering from organ failure. However, the shortage of transplantable organs remains a universal problem. Although more than 90% of the America population supports the concept of organ donation, less than half are registered as donors.

METHODS

An online experiment (N = 224) was conducted to examine how perceived similarity moderates pride and sympathy appeal messages for organ donation. Participants were recruited from Amazon Mechanical Turk. Emotional appeal messages were respectively manipulated through emphasizing patient's suffering (sympathy) and organ donor's achievements (pride). A pretest was also performed on Amazon Mechanical Turk to ensure the effectiveness of emotional appeal message. Perceived similarity was achieved by presenting a picture of either a male or female individual with a neutral emotion to participants.

RESULTS

The study showed that perceived similarity was a positive predictor of intentions to become an organ donor. Furthermore, perceived similarity can moderate the effects of both sympathy and pride appeal messages on attitudes and intentions of organ donation.

CONCLUSIONS

This study found that perceived similarity could change people's behavioral intentions to become organ donors. Therefore, this study can inform potential strategies to persuade people to become organ donors through emphasizing perceived similarity and using emotional appeals.

Attitudes, knowledge, and preferences of the Israeli public regarding the allocation of donor organs for transplantation

Background

There is a stark disparity between the number of patients awaiting deceased-donor organ transplants and the rate at which organs become available. Though organs for transplantation are assumed to be a community resource, and the organ supply depends on public willingness to donate, current allocation schemes do not explicitly incorporate public priorities and preferences. This paper seeks to provide insights regarding the Israeli public’s preferences regarding criteria for organ (specifically, kidney) allocation, and to determine whether these preferences are in line with current allocation policies.

Methods

A market research company administered a telephone survey to 604 adult participants representing the Jewish-Israeli public (age range: 18–95; 50% male). The questionnaire comprised 39 questions addressing participants’ knowledge, attitudes, and preferences regarding organ donation and criteria for organ allocation, including willingness to donate.

Results

The criteria that respondents marked as most important in prioritizing waitlist candidates were maximum medical benefit (51.3% of respondents) and waiting time (21%). Donor status (i.e., whether the candidate is registered as an organ donor) was ranked by 43% as the least significant criterion. Most participants expressed willingness to donate the organs of a deceased relative; notably, they indicated that they would be significantly more willing to donate if organ allocation policies took their preferences regarding allocation criteria into account. Unlike individuals in other countries (e.g., the UK, the US, and Australia) who responded to similar surveys, Israeli survey respondents did not assign high importance to the candidate’s age (24% ranked it as the least important factor). Interestingly, in some cases, participants’ declared preferences regarding the importance of various allocation criteria diverged from their actual choices in hypothetical organ allocation scenarios.

Conclusions

The findings of this survey indicate that Israel’s citizens are willing to take part in decisions about organ allocation. Respondents did not seem to have a strict definition or concept of what they deem to be just; yet, in general, their preferences are compatible with current policy. Importantly, participants noted that they would be more willing to donate organs if their preferences were integrated into the allocation policy. Accordingly, we propose that allocation systems must strive to respect community values and perceptions while maintaining continued clinical effectiveness.

Governing evolution: A socioecological comparison of resistance management for insecticidal transgenic Bt crops among four countries

Cooperative management of pest susceptibility to transgenic Bacillus thuringiensis (Bt) crops is pursued worldwide in a variety of forms and to varying degrees of success depending on context. We examine this context using a comparative socioecological analysis of resistance management in Australia, Brazil, India, and the United States. We find that a shared understanding of resistance risks among government regulators, growers, and other actors is critical for effective governance. Furthermore, monitoring of grower compliance with resistance management requirements, surveillance of resistance, and mechanisms to support rapid implementation of remedial actions are essential to achieve desirable outcomes. Mandated resistance management measures, strong coordination between actors, and direct linkages between the group that appraises resistance risks and growers also appear to enhance prospects for effective governance. Our analysis highlights factors that could improve current governance systems and inform other initiatives to conserve susceptibility as a contribution to the cause of public good.

Death anxiety and psychological distress post-donation in non-directed living kidney donors

The current study sought to assess death anxiety and psychological distress among kidney donors, in comparison to a control population. Seventy-eight non-directed living kidney donors were recruited through the Israeli voluntary kidney donation association. This sample was compared to 396 participants from a control population. The results revealed that non-directed living kidney donors had higher levels of death anxiety in comparison to the control population while their psychological distress was lower in comparison to the control population. The results of this study highlight the importance of relating to non-directed living kidney donors' death anxiety.

Is Signature Size Associated With Organ Donor Designation on Driver's Licenses?

INTRODUCTION

Previous studies suggest that large signature size is associated with narcissistic characteristics. By contrast, organ donation is an indicator of altruism. Because altruism and narcissism may be viewed as opposites, we sought to determine if smaller signature size is associated with willingness to be an organ donor.

METHODS

Using a cross-sectional study design, we reviewed the health records of 571 randomly selected primary care patients at a large urban safety-net medical system to obtain their demographic and medical characteristics. We also examined driver's licenses that were scanned into electronic health records as part of the patient registration process. We measured signature sizes and obtained the organ donor designation from these driver's licenses.

RESULTS

Overall, 256 (45%) patients were designated as donors on their driver's licenses. Signature size averaged 113.3 mm(2) but varied greatly across patients (10th percentile 49.1 mm(2), 90th percentile 226.1 mm(2)). On multivariate analysis, donor designation was positively associated with age 18-34 years, non-black race, having private insurance, and not having any comorbid conditions. However, signature size was not associated with organ donor designation.

CONCLUSIONS

Signature size is not associated with verified organ donor designation. Further work is needed to understand the relationship between personality types and willingness to be an organ donor.

Pro-donation behaviours of nursing students from the four countries of the UK

BACKGROUND

The effectiveness of the organ donation system depends on the health professionals involved in procurement and in dealing with donors and their families. Concerns about lack of knowledge and experience of organ donation have been expressed among such professionals but there is a paucity of literature to indicate the basis of such concerns and where knowledge may be lacking. Given that regional variations in organ donation rates exist in the UK, this study investigates knowledge about and attitudes towards organ donation among student nurses in different countries of the UK and examines regional variations.

METHODS

A questionnaire was distributed to 667 student nurses (female:male = 582∶85) aged 18 to 50 years (mean [SD] 25.4 [7.1] years) recruited from a total of five Universities (Scotland, Wales, Northern Ireland, England) during the period of January to September 2011.

RESULTS

Registration behaviour among participants was shown to vary depending upon many different factors that include birthplace, residency, fear of death and concerns of medical distrust.

CONCLUSIONS

Regional variations in organ donation behaviour in the UK were found in the cohorts of student nurses who participated in this study. These variations include willingness to register and to donate specific body parts and not others. The relationship between attitude and behaviour and how this may influence the decision making process of organ donation, as well as the underlying factors that result in regional variations, require further investigation.

The Draw-A-Person Test and Body Image

The Draw-A-Person (DAP) test has been the center of a long-lasting debate regarding its validity. This study investigated the DAP indices of height, width (size), and inclusion/omission of details and their relation to body image as measured by a self-report scale (Gray’s body image scale) and manifested by the diet behaviors and body mass index of 55 healthy female students. Although the drawings of the diet group were smaller, there was no significant relationship between figure size and diet behaviors. However, body image as measured by a self-report scale did result in significant differences between groups. Moreover, there was a significant correlation between the size of the figure drawn and body image as measured by a self-report scale (larger figures correlated with better body image). No significant results were found for the omission/inclusion indices of the DAP. These results are discussed in light of previous findings regarding the DAP.

Tissue banking: relationship with blood donor and organ donor card status

Understanding the relationships among altruistic health acts may serve to aid therapeutic research advances. In this paper, we report on the links between two such behaviours—donating blood and carrying an organ donor card—and willingness to donate urological tissue to a tissue bank. Reasons for the differential willingness to do so are examined in this paper. A systematic sample of 259 new and returning attendees at a tertiary urology referral clinic in Ireland completed a self-report questionnaire in an outpatient setting. In addition to demographic details, details of known diagnosis of malignancy and family history of cancer; attitudes to tissue donation for research purposes were gauged using a 5-point Likert scale. Both blood donors and organ donor card carriers were more likely to be willing to donate tissue for research purposes. Blood donors were more likely want to know their overall results in comparison to nonblood donors and want their samples to be used for nonprofit research. Our hypothesis that being a blood donor would be a better predictor to donate urological tissue than being an organ donor card carrier borne out by the trends reported above.

Donating organs: a theory-driven inventory of motives

Two studies examined the motives that lay behind patients' acceptance or reluctance at donating organs after death. They also examined the way these motives were related to demographic characteristics, personality, and signing a donor card. Six separable motives for donation were found: Financial Incentive, Humanistic or Religious Duty, Positive Consideration from Others, Living on Through a Receiver, Gift of Life, and Close Others. Five motives for not donating were found: Preserving the Absolute Integrity of the Corpus, Strict Individualism, Lack of Control over the Use of the Organs, Anonymity of the Procedure, and Respecting Family Wishes. These motives were linked to personality factors in a meaningful way. Willingness to sign was higher among female participants and among participants with lower scores on Integrity of the Corpus and higher scores on Duty and Gift of Life. When Integrity of the Corpus scored highly, however, the effect of the other factors was practically eliminated. In other words, Integrity of the Corpus acted as a protected value: Trying to change people's belief that the integrity of the corpus at death is a sacrosanct issue would come with its own ethical issues.

Knowledge and attitude of donor cardholders toward organ and tissue donation and transplantation in an Iranian tissue bank: a case-control study

BACKGROUND

Cadaveric organ shortage is the most important obstacle to more widespread provision of transplants. Many factors influence the donation rate: social factors, religion, familial relations, and especially knowledge and attitudes toward organ and tissue donation and transplantation. Increasing public awareness can reform the incorrect beliefs and myths about donation and transplantation. This study investigated knowledge and attitudes of donor cardholders toward organ and tissue donation as well as transplantation.

METHODS

This case-control study was performed in 2006 among 178 donor cardholders and the same number of a control group who completed a questionnaire including 23 questions and demographic information.

FINDINGS

Knowledge and attitude among the cardholder was significantly greater than the control group (P < .05). We observed a inverse correlation between age and a positive attitude toward donation and transplantation among cardholders.

CONCLUSION

This study suggested that the main reasons for refusal to donate organ and tissue were insufficient knowledge and negative attitudes due to misinformation regarding donation and transplantation. We believe that educating and motivating the public via the mass media can increase the rate of consent for organ and tissue donation and transplantation.

The Self-Protective Altruist: Terror Management and the Ambivalent Nature of Prosocial Behavior

Three studies examined the hypothesis that mortality salience (MS) will increase prosocial behaviors when the prosocial cause promotes terror management processes. However, when the prosocial cause interferes with these processes, MS will reduce prosocial behavior. In Study 1, following a MS procedure, participants indicated their willingness to donate money to charity or to donate to an organ donation organization. In Study 2, a research assistant randomly distributed fliers with reminders of death or back pain, and another research assistant solicited participants' assistance from either a charitable fund booth or an organ donation booth. Study 3 examined the impact of MS on helping a wheelchair-bound confederate or a walking confederate. The results indicated that MS increased charitable donations and increased help to a walking confederate. However, MS significantly decreased organ donation card signings and decreased help to a wheelchair-bound confederate. The discussion examines the tension between personal fear and worldview validation.