Attitude and Impact Factors Toward Organ Transplantation and Donation Among Transplantation Nurses in China

Factors Associated with Willingness toward Organ Donation in China: A Nationwide Cross-Sectional Analysis Using a Social–Ecological Framework

Improving public willingness toward organ donation is an important solution to the low organ donation rate. This study aimed to explore factors impacting public willingness for organ donation in China from a multi-agent perspective and further explore the impact of these factors on high or low willingness, using a social–ecological framework. Data from a total of 11,028 (effective rate, 94.18%) participants were analysed. Generalised linear model (GLM) and quantile regression were used to explore factors associated with willingness and high/low willingness toward organ donation, respectively. The mean willingness toward organ donation was 56.9 (range, 0–100) points. GLM regression revealed that age, family health, males, lower educational levels, and agricultural hukou were negatively associated with willingness. For personality, conscientiousness was negatively associated with willingness, whereas openness was positively associated with willingness. Health literacy perceived social support, and media utilisation were positively associated with willingness. Quantile regression further indicated that educational levels of college, bachelor, master’s, and PhD, openness, health literacy, perceived social support, and media utilisation were positively associated with organ donation willingness at all percentiles. It is necessary to adopt more targeted and diversified publicity, education, and guidance for different types of individuals. Meanwhile, social support needs to be strengthened. To enhance the willingness of the residents to donate organs, media publicity should be strengthened, particularly by using modern ways to improve their health literacy.

A Survey of 1000 Respondents on the Polish Population's Knowledge and Attitudes about Tissue/Organ Donation and Transplantation in Times of Allogeneic Tissue Shortage

Tissue-engineered human allogeneic skin grafts retrieved from a deceased donor play an important role in the therapy of extensive and deeply burned patients. However, there is a vital deficit of allogeneic skin donors, and the reserves of human allogeneic skin grafts are not sufficient. The goal of this work was to analyze the level of knowledge and attitudes of Polish society in the field of transplantation, with particular emphasis on allogeneic skin transplantation. The study used a self-made questionnaire comprised of 23 questions. 1000 respondents took part in this research. The respondents were a diverse group in terms of age, sex, education, and place of residence. The obtained results show a general positive attitude of the respondents towards the idea of transplantology. However, people with lower education presented a more negative attitude towards the donation of tissues and organs. Additionally younger people were not able to clearly declare readiness for organ procurement. What is more data analysis revealed certain gaps in more detailed knowledge and surprising attitudes. In that respect, the lack of awareness about the criteria for determining brain death could be mentioned. There was also a lack of acceptance for skin procurement in specific population groups. It can therefore be concluded that a key role in the success of the idea of transplantation in Poland is the broad and systematic education of the society.

Nurses' Perspectives and Experiences Regarding Organ Transplantation in Turkey: A Qualitative Study

As professionals, nurses are often required to provide care for patients from different cultural and religious backgrounds during an organ transplantation process. It is therefore important to understand the views and experiences of nurses regarding the organ transplantation process. The aim of this study was to explore nurses' perspectives and experiences in providing care to donors and transplant recipients. In this descriptive qualitative study, semistructured in-depth interviews were conducted with 17 nurses in Turkey. The qualitative interviews were analyzed using thematic analysis. At the end of the study, four themes were represented: nurses' characteristics, nurses' roles and responsibilities, nurses' views on organ transplantation, and nurses' experiences with providing care. The results of the study revealed that nurses have positive and negative attitudes about organ transplantation, and they need education on this topic. In addition, considering the cultural factors and religious beliefs that prevent organ donation, cooperation between health professionals and religious authorities is necessary. Furthermore, support systems should be developed to reduce the problems that nurses face. The relevant authorities should collaborate to increase the number of donors by informing the public that the religious view is favorable to organ donation.

Investigation and Strategic Analysis of Family Barriers to Organ Donation in China

BACKGROUND

Families play a prominent role in the eventual organ donation decision. Because the deceased cannot directly express their wishes, their families become the actual decision makers. In China, families are permitted to make decisions regarding organ donation that may not be in accordance with the wishes of the deceased family member, and objections by families are a main bottleneck in the donation process.

METHODS

Face-to-face questioning was conducted with organ procurement organization coordinators. At the same time, questionnaires were distributed in 11 cities in Zhejiang Province.

RESULTS

Of the respondents, 69.9% considered family consent necessary and 77.1% thought that the view of their family had a great, even decisive, influence on them to decide to become donors. If the deceased family member had registered as an organ donor, 65.2% of families decided that they would respect the wishes of the deceased person. Adult children (58.6%) were more likely to donate than parents (37.4%; χ² = 123.009, P < .001). Those born after 2000 and after 1990 (62.5% and 52.8%, respectively) were much more likely to donate than those born after 1960 (18.1%; χ² = 191.485, P < .001). The interviews indicated that there were high rates of donation refusals within potential donation families. Most donor families chose to make hidden donations, and the majority of donor families had a simple family structure.

CONCLUSIONS

To promote organ donation, China needs to reconsider the role of families in the decision-making process. It is essential to increase organ donation awareness within the younger generation and encourage them to discuss with their families their willingness to donate.

Attitudes towards multi-organ donation among intensive care unit nurses in transplant hospitals

AIM

To evaluate the attitudes towards deceased multi-organ donation and transplantation among nurses within the critical care units of the six public tertiary transplant hospitals in Madrid, Spain.

BACKGROUND

Spain has a rate of 49 donations per million population, whereas Madrid has a lower donation rate of 34.2 per million population. Nurses generate social opinion, and their attitude can be one of the barriers against organ donation.

METHOD

An observational descriptive study was conducted among critical care units' nurses. The measuring instrument was the Collaborative International Donor Project in Organ Donation and Transplantation. Data were collected from January to October 2019, and a statistical analysis was performed.

RESULTS

A total of n = 313 questionnaires achieved a response rate of 51%. Of the intensive care unit nurses surveyed, 85% had a favourable opinion towards the donation of their organs being affected by psychosocial variables related to social variables with respect to family, religion and attitude towards the body.

CONCLUSION

The intensive care unit nurses of the Madrid transplant hospitals maintain a favourable attitude towards organ donation and transplantation. It is necessary to implement specialized training and periodically evaluate training in this sector. To maintain and improve the attitude towards organ donation, family discussion among health personnel should be encouraged. Religion influences the attitude of nurses and donation rates.

IMPLICATION FOR NURSING AND HEALTH POLICY

Intensive care nurses' attitude towards organ donation is influenced by social variables. This study shows that the attitude is positive but improvable. These findings contribute to promote awareness of the lack of organs and the benefits of organ donation.

Knowledge, Attitude, and Performance of ICU, CCU, and Emergency Wards Nurses in Kermanshah, Iran, regarding Organ Donation

Background

Providing an organ for donation is a major problem worldwide and nurses play an important role in facilitating the process of organ donation. This study is aimed at investigating the knowledge, attitude, and performance of nurses working in the ICU, CCU, and emergency wards regarding organ donation.

Methods

In this descriptive-analytical study, 185 nurses working in ICU, CCU, and emergency wards were studied through systematic random sampling. The data collection was done by a self-administered questionnaire.

Results

The mean knowledge of nurses was 8.9 ± 1.4 out of 10. There was a significant relationship between knowledge of nurses regarding donation and religion and having organ donation card (P < 0.001). The mean attitude of nurses was 7.8 ± 2.2 out of 8. The variables, including “having a donation card and marriage,” were associated with attitude of nurses toward organ donation. The mean performance of nurses was 0.4 ± 0.7 out of 3. There was a significant relationship between performance of nurses and having a donation card (P < 0.001). Knowledge was the strongest predictor of nurses' performance (P < 0.01).

Conclusion

The studied nurses showed sufficient knowledge and favorable attitude toward organ donation; however, they had poor performance. It is suggested to hold training courses to improve performance of nurses. The revision of the nursing students' curriculum as future nurses should also be considered.

Cross-cultural adaptation and psychometric validation of the Flodén ATODAI instrument in the North American context

Background

Intensive and critical-care nurses are the key to successful donor management in the critical-care setting. No studies measuring attitudes toward organ donor advocacy existed before 2011, when the 51-item Swedish “Attitudes Toward Organ Donor Advocacy Scale” was developed. The aim of this study was to translate, adapt and establish the psychometric properties of the North American version of the Flodén ATODAI (Attitudes Toward Organ Donor Advocacy Instrument) in terms of validity and reliability.

Methods

A multi-step approach was used: Initial translation; Back-translation; Review and synthesis of these translations; Expert panel (N = 7) rated the prefinal version of the instrument for content validity index (CVI); International panel made adjustments guided by the expert panel. Reliability testing with test and retest of the adjusted 46-item version was conducted using intraclass correlation coefficient (ICC), weighted kappa (ҡ_Weight), sign test, and Cronbach’s alpha coefficient (α), (N = 50); and finally Delphi technique procedure with a preselected Delphi panel (N = 15).

Results

The CVI was determined to be greater than the 0.05 significance level. Item level (I-CVI) ranged 0.82–1.0, with a mean of 0.97. Scale level (S-CVI) on the entire instrument was 0.97. Test-retest procedure was performed to estimate stability. In total, 34 of the items had good-to-high ICC. Accepting an ICC of ≥ 0.70 resulted in a total of 24 items. Homogeneity reliability was estimated by α and was calculated for these items where α = 0.90. In total, 20 of the items had a substantial or almost perfect ҡ_Weight and 23 showed a moderate ҡ_Weight. None of the items showed systematical differences. The Delphi technique procedure was used on the 22 items with ICC < 0.70 resulted in adjustments establishing that consensus was achieved.

Conclusions

Undertaking this multi-step, cross-cultural adaptation procedure has effectively ensured that the 46-item Flodén ATODAI [North American version] produces valid and reliable measurements.

Beyond Altruism: Framing Organ Donation in a 19-year Review of Chinese News Coverage

Despite a significant legal transformation of the organ donation system in China, the public's willingness to become organ donors remains low. This study provides the first empirical examination of how Chinese newspaper coverage reflects the complex interplay among multifaceted factors associated with the stagnant donation rate. Using framing as the primary theoretical lens, we analyzed 923 organ donation newspaper articles from 2000 to 2018 in terms of topics, facilitators and barriers, valence, and policy development. The three most common topics emphasized were: a new official information release regarding organ donation promotion; the challenges of promoting organ donation in social, cultural, and legal contexts; and the positive emotional appeals of organ donors, coordinators, and transplant surgeons. Findings suggest that the values that facilitators of and barriers to organ donation represent can be culturally favored but in conflict with each other. Sharp increases in the presence of policy development framing are associated with the official announcements of new legislation. A better understanding of trending topics and interacting influence from facilitators and barriers is imperative for developing culturally tailored messages to raise awareness about organ donation promotion.

Cultural barriers to organ donation among Chinese and Korean individuals in the United States: a systematic review

Asian Americans have the lowest organ donation registration rates in the United States, and the reason for this is incompletely understood. Aiming to understand the reasons for low organ donation registration rate among Asian Americans, more specifically Chinese and Korean Americans, we conducted a systematic search of databases, websites, and gray literature. Altogether, 34 papers were retained after the assessment of relevance and quality. Commonly reported barriers to organ donation registration among Chinese and Koreans in the literature included lack of knowledge about organ donation, distrust of health-care and allocation system, cultural avoidance of discussion of death-related topics, and desire for intact body mainly stemming from the Confucian concept of filial piety. Strong family values coupled with a cultural reluctance to discuss death-related topics among family members appear to underscore the reluctance to organ donation among Chinese and Koreans. Notably, improved knowledge negatively impacted organ donation intent and religion seemed to play a more important role when making decision about organ donation among Koreans, and the distrust of the allocation system is more prominent among Chinese. This information should be used to inform the development of culturally competent organ donation educational materials.

End-of-life Care and Social Security Issues among Geriatric People Attending a Tertiary Care Hospital of Eastern India

Context

The care of sick members is the hallmark of a civilized society. End-of-life care and social security for elderly are emerging issues nowadays.

Aims

The aim of this study is to explore the desires of the elderly regarding the end-of-life care decisions along with to find out social security measures among the study population.

Settings and Design

The cross-sectional study conducted in the geriatric outpatient department of a tertiary care hospital.

Subjects and Methods

The study period was 4 months from August to November 2017. The geriatric patients attending geriatric outpatient department were interviewed using a predesigned and pretested questionnaire. Convenient sampling was used and a total of 138 participants were included in the study.

Statistical Analysis Used

Proportions were used in the study.

Results

A total of 63.77% participants expected to die at home surrounded by their family members during their time of death followed by hospital (31.88%). Majority (63.77%) stated their opinions to die a senile death. Organ donation after death was the willingness shown by as high as 70.3%, but registered organ donors were 6.5%. 94.2% participants expected to be cremated after their death while others buried in accord to their religious practices. Only 7.24% of participants had a legal will of their financial establishments. It was observed that even half of the population (47.8%) did not have any form of health or life insurance.

Conclusion

Home-based care of the elderly is needed so that they can live their last days of life peacefully. Awareness about health and life insurance should be increased by urgent intervention.