Attitudes Toward Organ Donation in Rural Areas of Southeastern Spain

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.

The Impact of Religion and Provision of Information on Increasing Knowledge and Changing Attitudes to Organ Donation: An Intervention Study

One of the most significant developments in recent history has probably been organ donation and organ transplantation. They are frequently the only treatment available in certain cases. However, there is an ever-increasing discrepancy between the number of people needing transplantation and the organs available, because the decision to donate an organ is up to each individual. The study aims to assess the impact of the intervention on knowledge, attitudes and practices on organ donation among religious immigrants in Sweden. Data were collected through three group interviews using open-ended questions and qualitative content analysis. Thirty-six participants, 18 males and 18 females from six countries, participated in the focus group interviews. The analysis of the collected data resulted in two main categories: "Religion in theory and practice" and "More information-more knowledge about organ donation" including seven subcategories. Understanding of religion and religiosity, happiness by taking the class, the practice of religion in everyday life, the overcoming the prejudices in religion, having more information about organ donation and the donations process, as well as that the increased information changes people's minds, were some of things the informants emphasised as predictors of the decision of organ donation. A class dealing with religion, the religious aspects of organ donation and the way the Swedish healthcare system is organised increased people's knowledge and changed their attitudes so they became potential organ donors. More intervention studies are needed in every field of medicine to build confidence and give time to educate and discuss issues with potential organ donors in Sweden.

Can financial rewards complement altruism to raise deceased organ donation rates?

BACKGROUND

Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.

METHODS

Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.

ETHICAL CONSIDERATIONS

The study was approved by the University of Malaya ethics committee.

RESULTS

The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.

CONCLUSION

Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

A Bibliometric Analysis of the Articles Focusing on the Subject of Brain Death Published in Scientific Citation Index-Expanded Indexed Journals: Analysis of 3487 Articles Published Between 1995-2019

BACKGROUND

Although the topic of brain death (BD) has been increasing in popularity considerably in recent years by the snowballing number of patients suffering from end-organ failure and waiting for organ transplantation, the literature indicates insufficient information regarding the comparison of scientific articles focusing on BD, authors' and nations', even governments' tendency about this issue.

OBJECTIVES

In the present study, we aimed to make a bibliometric analysis of the articles focusing on the subject of BD, which is one of the most trendy topics in organ transplantation.

MATERIAL AND METHODS

The terms "brain death," were searched in Thomson Reuters, Web of Science search engine for the years between 1995 and 2019. All the articles found were subjected to bibliometric analysis.

RESULTS

Web of Science database included 3487 articles. The United States was found to be the most productive country in all methods, and Transplantation Proceedings was the journal that contributed most to the literature on the subject of BD. A positive correlation between publication productivity and gross domestic product/gross domestic product per capita and human development index was found (r = 0.470, P < .05; r = 0.359, P < .05; r = 0.603, P < .001, respectively). Also, there was a negative correlation between the number of published articles and the population of the country (r = -0.083, P < .001).

CONCLUSION

Although the top country focusing on the subject of BD was the United States in terms of bibliometrics, we found that there is a correlation between the indices measuring the welfare and development level of the country and publication productivity about BD, which means developed countries show more tendency about BD, which is the main component of the definitive treatment of end-organ failure.

Global Scientific Outputs of Brain Death Publications and Evaluation According to the Religions of Countries

In 1950s, the concept of brain death, which began to be discussed primarily in terms of medicine and then in terms of religion, law, and ethics, became a central topic in all world countries as it was an early diagnosis of death. Despite the fact that brain death (BD) diagnosis is of importance for benefitting from organ and tissue transplantation of patients in the world, the literature still involves no bibliometric studies that made a holistic evaluation of the publications about this issue. The present study aims to investigate the top-cited articles about BD published between 1980 and 2018, identify the citation collaboration of the journals, demonstrate the collaboration between the countries, define the relationship between organ transplantation and BD, and reveal the latest developments and trend topics about this issue. In addition, this study aims to investigate the relationship between religions of countries and brain death publication productivity. Documents for bibliometric analysis were downloaded from Web of Science. The literature search was performed using the keywords "brain death/dead" during 1980-2018. The correlations between gross domestic product (GDP), Human Development Index (HDI) and publication productivity of the countries on BD were investigated with Spearman's correlation coefficient. There was a high-level, statistically significant correlation between the number of publications and GDP, and HDI and the number of publications about BD (r = 0.761, p < 0.001; r = 0.703, p < 0.001). The USA was the top country in terms of publication productivity, which was followed by developed countries such as Germany, Japan, France, and Spain. However, the contribution of the undeveloped or developing countries such as China, Brazil, Turkey, Iran, and South Africa was found to be considerably important. While many people in the world die with undamaged organs, many other people die needing those organs. Therefore, it is considered that the collaborations and thus multidisciplinary studies about BD should be increased in the world countries, and the countries should be involved in bigger collaborations instead of little clusters. Especially, Muslim countries should be encouraged to do research and publish studies about the issues of brain death and organ transplantation.

The Influence of Age, Gender and Religion on Willingness to be an Organ Donor: Experience of Religious Muslims Living in Sweden

The transplantation of organs is one of the most successful medical advances in recent decades, and transplantation is the treatment of choice for severe organ failure worldwide. Despite this situation and the general acknowledgment of organ donation (OD) as a global priority, the demand for organs outstrips the supply in virtually every country in the world. The study aims to elucidate whether age, gender and religion influence decision-making about organ donation in religious Muslims living in Sweden Data were collected through three group interviews using open-ended questions and qualitative content analysis. Twenty-seven participants, 15 males and 12 females from four countries, participated in the focus group interviews. The analysis of the collected data resulted in three main categories: "Information and knowledge about organ donation," "The priorities when deciding about organ donation" and "The religious aspects of organ donation," including a number of subcategories. Good information about and knowledge of OD, priorities in OD, importance of the fact that religion must be studied and taught daily and religious education were only a few of the factors informants emphasized as predictors of the total and successful donation of organs. Age, gender or religion did not have an impact on organ donation. High levels of education through religious education and good information via various media, as well as a good knowledge of the Swedish language, are predictors of improved OD. In order to overcome religious ideology as a source of misinformation relating to OD and to promote increased OD in the future, specific intervention studies and the improved involvement of religious communities and education in schools and the healthcare system are vital and must be a starting point for improved OD.

Fresh osteochondral allografts-procurement and tissue donation in Europe

Fresh osteochondral allografts are a well-established treatment for large, full-thickness cartilage defects. The clinical outcome for carefully selected patients is very favorable, especially for the young and active and graft survival up to 25 years has been described in the literature. Furthermore, a high patient satisfaction rate has been reported, but the biggest obstacle to overcome is the availability of tissue for transplantation. Large fresh bone allografts for cartilage damage repair only can be harvested from organ donors following organ removal or cadaveric donors, preferably in the setting of an operation room to minimize possible contamination of the tissue. Apart from the logistic challenges this entails, an experienced recovery team is needed. Furthermore, the public as well as medical staff is much less aware of the possibility and requirements of tissue donation than organ donation and families of deceased are rarely approached for bone and cartilage donation. This review aims to highlight the current situation of organ and tissue donation in Europe with special focus on the processing of bones and possible safety and quality concerns. We analyze what may prevent consent and what might be done to improve the situation of tissue donation.

Knowledge of, beliefs about, and perceived barriers to organ and tissue donation in Serbian, Macedonian, and Greek Orthodox communities in Australia

CONTEXT

Despite the lifesaving benefits of organ and tissue donation, a worldwide shortage of suitable and registered donors exists. Although the reasons for this shortage are multifactorial, it has been recognized that distinct barriers to registration, family discussion, and consent that require targeted intervention and action are present among minority cultural, religious, and immigrant communities.

OBJECTIVE

To explore the knowledge, attitudes, and beliefs of 3 orthodox religious communities in Australia (Macedonian, Greek, and Serbian Orthodox) and determine the implications for engaging with these communities to improve knowledge, attitudes, family discussion, and the ability to make an informed decision about donation.

DESIGN

Qualitative approach using focus groups moderated by researchers and bicultural health workers with the assistance of accredited interpreters.

PARTICIPANTS

98 adult members of the Greek, Macedonian, and Serbian Orthodox communities in the Illawarra region of New South Wales, Australia.

RESULTS

Clear barriers to discussing and making an informed decision about organ and tissue donation were identified. Knowledge of processes and procedures was low and discussion about death (and organ and tissue donation) with family members and loved ones was considered taboo. Despite these barriers, all 3 communities expressed a desire for more information and engagement. Of particular interest were the perspectives of 3 types of "experts": medical, religious, and other community members (who had experience with the organ and tissue donation system). Future programs designed for orthodox religious communities should consider the need for active strategies that facilitate information sharing and engagement between community members and these 3 types of experts.

Relationships between Islamic religiosity and attitude toward deceased organ donation among American Muslims: a pilot study

BACKGROUND

Religion-rooted beliefs and values are often cited as barriers to organ donation among Muslims. Yet how Islamic religiosity relates to organ donation attitude among Muslims is less studied.

METHODS

Using a community based participatory research approach, we recruited adults from mosque communities to self-administer a questionnaire assessing levels of Islamic religiosity, attitude toward deceased organ donation, and sociodemographic descriptors.

RESULTS

Of the 97 respondents, there were nearly equal numbers of men and women. Over a third were Arab American (n=36), and nearly a quarter were either South Asian (n=23) or African American (n=25). Respondents viewing difficulties in life as punishment from God had a decreased odds of believing deceased organ donation to be justified (OR 0.85, P<0.05). Other measures of Islamic religiosity, such as intrinsic religiosity, positive religious coping and one related to following Islamic ethical guidelines, were not associated with organ donation attitude. Arab Muslims were more likely to believe deceased organ donation to be justified than South Asian or African Americans (OR 7.06, P<0.05). Sociodemographic descriptors including age, sex, and country of origin, as well as self-reported health and trust of the American health-care system, were not significantly associated with attitude toward deceased organ donation.

CONCLUSION

Higher levels of intrinsic religiosity or adherence to Islamic ethics do not appear to associate with negative attitudes toward deceased organ donation. Negative religious coping appears, however, to be related to lower rates of believing deceased organ donation to be justified. Future studies with larger samples that incorporate additional measures of religiosity can further clarify relationships between religiosity and organ donation attitude among Muslim communities.

Religious and ethnic influences on willingness to donate organs and donor behavior: an Australian perspective

CONTEXT

Globally, the demand for donated organs outstrips supply, meaning that there are both practical and theoretical reasons for examining factors that are predictive of individuals' willingness to donate their organs upon their death.

OBJECTIVES

To determine whether individuals of different religious denominations living in Australia have different views on organ donation, whether donation attitudes differ significantly across ethnic groups, and whether factors identified in international research are predictors of willingness to donate and actual donor behavior in this population.

PARTICIPANTS

Data for this study were collected from students at an Australian university from a range of religious and ethnic backgrounds, and their friends and relatives (N = 509). Intervention-Participants were administered the Organ Donation Attitude Scale, as well as additional attitudes and knowledge measures.

MAIN OUTCOME MEASURES

Self-reported "willingness to donate" and "donor behavior".

RESULTS

Our findings complemented those reported in comparable countries, with females, younger Australians, and those with high knowledge levels being more willing to donate than males, older persons, and those with low knowledge. Persons who described themselves as having stronger religious beliefs (particularly Buddhist and Islamic) held less favorable attitudes toward donation, had lower knowledge levels, and were more likely to oppose donation.

CONCLUSIONS

Although this study established that attitudes toward, knowledge about, and predictors of organ donation in Australia are similar to those reported elsewhere, donation rates remain low. Further in-depth research examining the impact of religion and culture on attitudes, beliefs, and behavior is essential when exploring strategies to improve organ donation rates in highly multicultural societies such as Australia.

Religious and Ethnic Influences on Willingness to Donate Organs and Donor Behavior: An Australian Perspective

Context

Globally, the demand for donated organs outstrips supply, meaning that there are both practical and theoretical reasons for examining factors that are predictive of individuals' willingness to donate their organs upon their death.

Objectives

To determine whether individuals of different religious denominations living in Australia have different views on organ donation, whether donation attitudes differ significantly across ethnic groups, and whether factors identified in international research are predictors of willingness to donate and actual donor behavior in this population.

Participants

Data for this study were collected from students at an Australian university from a range of religious and ethnic backgrounds, and their friends and relatives (N = 509).

Intervention

Participants were administered the Organ Donation Attitude Scale, as well as additional attitudes and knowledge measures.

Main Outcome Measures

Self-reported “willingness to donate” and “donor behavior.”

Results

Our findings complemented those reported in comparable countries, with females, younger Australians, and those with high knowledge levels being more willing to donate than males, older persons, and those with low knowledge. Persons who described themselves as having stronger religious beliefs (particularly Buddhist and Islamic) held less favorable attitudes toward donation, had lower knowledge levels, and were more likely to oppose donation.

Conclusions

Although this study established that attitudes toward, knowledge about, and predictors of organ donation in Australia are similar to those reported elsewhere, donation rates remain low. Further in-depth research examining the impact of religion and culture on attitudes, beliefs, and behavior is essential when exploring strategies to improve organ donation rates in highly multicultural societies such as Australia.

Attitudes toward organ donation and donor behavior: a review of the international literature

OBJECTIVE

To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior.

DATA SOURCES

MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009.

STUDY SELECTION

Eligible studies included members of the general public (i.e., not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors. Data Extraction-The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis.

DATA SYNTHESIS

Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs.

CONCLUSIONS

The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs. (Progress in Transplantation.

Attitudes toward Organ Donation and Donor Behavior: A Review of the International Literature

Objective

To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior.

Data Sources

MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009.

Study Selection

Eligible studies included members of the general public (ie, not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors.

Data Extraction

The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis.

Data Synthesis

Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs.

Conclusions

The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs.

A household study to determine attitudes and beliefs related to organ transplantation and donation: a pilot study in Yapracik Village, Ankara, Turkey

Rural areas display adverse attitudes toward organ donation. Through a population-based cross-sectional study of people 18 years of age or older in the rural area of Ankara, Yapracik Village, Turkey, we identified the attitudes and beliefs of people related to organ transplantation and organ donation. The research universe included 87 people in 75 households. The research instrument was a questionnaire. None of the respondents had been involved in organ donation. The percentage of willingness to donate an organ was 47% which was significantly associated with younger age, including 34.4% who expressed willingness while alive. Twenty-five percent believed that their religion is adverse to transplantation, 28% thought it would create pain in death, 20% were afraid, and 83% believed in life afterwards, 15% said that their custom and usage were adverse to organ donation, 50% stated that they can accept organ donation from other races, and 65% stated that they can request organs from their friends. Eighty percent thought that organ donation is a gift given to a human; 34% of them stated that they can be a donor while they are alive. Fifty-four percent of respondents stated that they wanted to get information about organ donation and transplantation. Therefore basic educational campaigns targeting the increase of knowledge about organ donation are warranted in the rural population. There is a need to increase awareness about organ donation and transplantation. Findings like those in this study will help campaigns conducted for organ donation.

Knowledge and willingness toward living organ donation: a survey of three universities in Changsha, Hunan Province, China

BACKGROUND

This study was conducted to clarify the knowledge and attitudes of Chinese university students regarding living organ donation and analyze the determinants impacting their decisions.

METHODS

A questionnaire was delivered to college students chosen by random assignment. The data was analyzed by Statistics Package for Social Science (SPSS) software.

RESULTS

Of 434 participants, 49.8% indicated they would be willing to be living organ donors, 58.4% believed living organ donation could ease the organ shortage, 48.2% thought that the recovery rate of recipients of living organ donors transplants was equal to or even better than deceased donation, 62.4% designated relatives as their most probable recipients, 48.0% argued that partial compensation was an effective method to increase live organ donation, and 53.7% wished to donate through transplantation centers. According to univariate analysis, attitudes regarding the value of life, relationship between body integrity and health as well as body integrity and conventional culture were factors that impacted on an individual's decision. Students' knowledge of the value of living organ transplantation and their economic background were considered to be determinants of individual willingness. Furthermore, the operation's impact on quality of life and postoperative complications were additional concerns. Multivariate analysis indicated that other factors influencing students' willingness to donate included attitudes toward the relationship between body integrity and health, beliefs regarding body integrity and conventional culture, value of living donor organ transplantation, economic background of students, and anxiety about the impact on postoperative complications.

CONCLUSIONS

Numerous students were willing to participate in living organ donation. At the same time, social education and advertisements for living organ donation were far from adequate, having little or no influence on the decision-making process.