The role of religiosity, religious norms, subjective norms, and bodily integrity in signing an organ donor card

Can Happiness and Sadness Overcome Organ Donation Barriers Following Exposure to Radio Ads?

Concerns related to bodily integrity, medical mistrust, superstition, and disgust with respect to organ transplantation remain commonly cited barriers among African American, Caucasian, and Hispanic non-donors. The current study examined two narrative strategies for mitigating these barriers by eliciting feelings of happiness or sadness. African American, Caucasian, and Hispanic non-donors (N = 576) were randomly assigned to a radio ad that communicated either a recipient narrative or a waiting list narrative. As expected, the recipient narrative elicited greater feelings of happiness whereas the waiting list narrative aroused greater feelings of sadness. Moderated mediation analyses revealed models in which happiness, not sadness, was the mediator, such that the narrative frame was associated with ad persuasiveness. Additionally, only medical mistrust interacted with happiness to predict ad persuasiveness The results are discussed with an emphasis on message design strategies to employ among reluctant adult African American, Caucasian, and Hispanic potential donors.

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.

A Test of Autonomy Restoration Postscripts to Mitigate Psychological Reactance to an Opt-Out Organ Donor Registry in the United States

The organ shortage continues to present problems around the world including the United States. In response, some countries have switched from an opt-in organ donor registry to an opt-out registry. The United States currently utilizes an opt-in registry where an individual is not considered an organ donor until they register their intentions. In the current study, U.S. adults were randomly assigned to a 2 (message valence: promotional, refutational) x 2 (autonomy restoration postscript: present, not present) x 2 (social proof: high likes, low likes) posttest only control group design evaluating social media message regarding an opt-out organ donor registry for implementation in the U.S. Results revealed an interaction between message valence and autonomy on freedom threat perceptions toward the message. Consistent with psychological reactance theory, freedom threat perceptions were positively associated with reactance, which in turn was positively associated with an intention to sign a petition and call a representative to voice disapproval of the opt-out organ donor registry. The discussion is focused on pragmatic recommendations for organ donor practitioners and advocates as well as the theoretical contributions to reactance theory.

Excavating the social representations and perceived barriers of organ donation in China over the past decade: A hybrid text analysis approach

Background

Organ donation has been claimed as a prosocial behavior to prolong the recipient's life and deliver great love. However, the supply-demand ratio of organs in China is highly unbalanced. Being entangled with multiple factors derived from individual and supra-individual levels, organ donation in China is important but sensitive. Previous scholars usually depended on obtrusive approaches to explore the facilitators and hindrances of organ donation, which is hard to discover genuine perceptions toward organ donation. Besides, relatively limited scholarly attention has been paid to what hampers organ donation in China.

Objective

We intended to excavate the diversified social representations and perceived barriers to organ donation in China over the past decade.

Method

Two kinds of text analysis methods-semantic network analysis and conventional content analysis, were applied to 120,172 posts from ordinary users on the Sina Weibo platform to address the research questions.

Results

Regarding social representations, the "hope, understanding, and acceptance" of organ donation was the most pronounced one (34% of the whole semantic network), followed by "family story" (26%), "the procedure of organ donation in NGOs" (15%), "the practical value of organ donation" (14%), and "organ donation in the medical context" (11%). Regarding perceived barriers, a four-layer framework was constructed, including (1) the individual level, mainly about the fear of death and postmortem autopsy; (2) the familial level, which refers to the opposition from family members; (3) the societal level, which alludes to distrust toward medical institutions and the general society; (4) the cultural level, which covers religious-cultural concerns about fatalism.

Conclusion

In concordance with prior works on social representations regarding organ donation, the current study also uncovered the coexistence of antithetical representations about organ donation-the longing for survival and the fear of death. This representation pair serves as the foundation of Chinese people's ambivalence. Besides, family-related narratives were dispersed over various representations, demonstrating the critical position of family support in organ donation. Moreover, the four-layer framework concerning donation barriers affords a reference for future empirical studies. The practical implications of this work are further discussed.

Willingness to Donate Organs After Death

Abstract. Background: Despite the growing number of organ transplants, there is still a significant difference between the number of donated organs and the number of people waiting for them. Knowing the reason people decide to donate is the first step to increasing organ donation rates. Aims: The main aim of the present study was to develop and validate a new scale for organ donation. Method: In three studies, 3,585 participants ranging in age between 14 and 89 years were selected through systematic random sampling. In the first study, we created a scale following the organ donation model theoretical framework and submitted the scale to exploratory factor analysis. In the second study, we performed a confirmatory factor analysis to cross-validate the hypothesized factor structure. In the third study, the scale was related to some important variables involved in organ donation. Results: Exploratory factor analysis and confirmatory factor analysis with a good fit index and acceptable levels of validity and reliability guarantee the quality of the scale and stable factor solution. Limitations: The main limitations are connected to social desirability, the presence of systematic bias of the population that refused to take part in the study, and the use of the Caucasian population. Conclusion: The resulting scale consists of 21 items in a seven-factor model (bodily integrity, fear of death, familial beliefs, altruism, medical mistrust, trust in the health institution, and emotional support). We also observed the relationship between scale factors, religiosity, and knowledge of organ donation with the willingness to donate organs.

Fundraising Appeals for the COVID-19 Epidemic Fight: A Cross-Country Study of Donor Responses

This research explores the intrinsic and extrinsic motivations driving donors to engage in fundraising appeals launched through social networking sites (SNSs) to mitigate COVID-19’s impact on vulnerable communities from a cross-national perspective. The research adopted a quantitative approach through a web-based survey; a total of 801 donors were obtained from Kuwait and Bahrain and were useable for the analysis. Smart PLS structural equation modelling was used to validate the research model and derive significant insights. In the Kuwaiti sample, we found that humanitarian projects, internet technology, SNSs and religiosity significantly drive donor attitudes towards online donation. All these relationships are indirectly related to the intention to give via SNS through the mediating role of attitudes. As for the Bahraini sample, humanitarian projects, non-profit organizations (NPOs), SNSs, and religiosity significantly influence donors’ attitudes. Attitudes, on the other hand, have a visible mediating role in the relationships between these predictors and behavioral intentions. The findings could be useful for the development of appropriate policies that boost online monetary donations to support emergency aid for communities crushed by the pandemic. This research differs from the existing literature in that its multi-national study scrutinizes the incorporation of both internal and external predictors of fundraising activities into a distinctive related context such as SNSs, particularly in a time of epidemiological crises such as COVID-19.

Impact of Religion on Opinions About Organ Donation and Transplantation in University Students From a Single University in Turkey

OBJECTIVES

The objective of the present report was to analyze the opinions, attitudes, and practices of Baskent University students with regard to the impact of religion on organ donation and transplantation.

MATERIALS AND METHODS

We sent a web-based, 5-point Likert scale questionnaire (1: strongly disagree; 5: strongly agree) to capture the opinions and attitudes toward organ donation and transplantation after participants attended or did not a panel discussion on these topics.

RESULTS

We sent 361 E-mails and received 69 responses, of which 46 students attended the panel discussion. Most of the participants who attended were part of the faculty of medicine. Participants who did not attend were composed of students from other faculties at Baskent University. Religion played less of a role with regard to opinions on organ donation in those who did not attend. Of the attendees, 54.3% strongly agreed to become organ donors, 50% believed in the important role of religion in organ donation, and 54.3% believed that media sources play important roles in shaping public opinion on organ donation. The majority felt comfortable discussing organ donation with family and friends.

CONCLUSIONS

Although religion has an undeniable effect on the decision-making process, our survey showed that more than half of the participants were willing to become organ donors. Education, through the joint efforts of medical and religious scholars, as well as the media, should contribute to raising awareness on organ donation, thus contributing to increased access to transplantation worldwide.

American Muslim Physician Attitudes Toward Organ Donation

Religious beliefs and values impact Muslim patients' attitudes toward a variety of healthcare decisions, including organ donation. Muslim physician attitudes toward organ donation, however, are less well studied. Utilizing a national survey of physician members of the Islamic Medical Association of North America, relationships between religiosity, patterns of bioethics resource utilization, and sociodemographic characteristics with attitudes toward organ donation were assessed. Of 255 respondents, 251 answered the target question, "in your understanding, does Islamic bioethics and law permit organ donation?." 177 respondents (70%) answered positively, 30 (12%) negatively, and 46 (18%) did not know. Despite the overwhelming majority of respondents believing organ donation to be permitted by Islamic bioethics and law, fewer than one-third (n = 72, 30%) are registered donors. Several sociodemographic features had a positive association with believing organ donation to be permitted: ethnic descent other than that of South Asian, having immigrated to the USA as an adult, and male sex. When using a logistic regression model controlling for these three variables as potential confounders, the best predictor of Muslim physicians believing organ donation to be permissible was utilization of an Imam as a bioethical resource (odds ratio 5.9, p = 0.02). Religiosity variables were not found to be associated with views on the Islamic permissibility of organ donation. While Muslim American physicians appear to believe there is religious support for organ donation, only a minority sign up to be donors. Greater study is needed to understand how physicians' attitudes regarding donation impact discussions between patients and physicians regarding the possibility of donating and of receiving a transplant.

Communication Apprehension About Death, Religious Group Affiliation, and Religiosity: Predictors of Organ and Body Donation Decisions

Communication willingness has previously been identified as an important communication factor in influencing individuals' decisions to become an organ donor. Missing from this conversation is the role of communication apprehension about death and its impact on donation decisions. The purpose of this study was to examine the relationships between communication apprehension about death, religiosity, religious affiliation, and donation decisions. Three hundred and thirty-three individuals participated in an online survey. Findings suggest that communication apprehension about death, especially communication avoidance about death, negatively impact donation decisions. In addition, religiosity and affiliation with a specific religion also negatively impact donation decisions. These variables were also predictors of organ and body donation. The findings show a need for more research on what prevents conversations about donation. In addition, the stark difference between organ donation likelihood and body donation likelihood underscores the need for communication scholars to examine communication about body donation.

The Mediating Role of Temporal Considerations on the Effects of Self-Affirmation on Responses to Organ Donation Messages

Previous self-affirmation research has shown that individuals who are allowed to reflect on their values and self-worth are less likely to exhibit message derogation and are more likely to accept risk information and change their behaviors compared to those who are not. However, the underlying mechanisms for the effect are unclear. Based on a randomized experiment (N = 331), we examined the mediating role of temporal considerations in participants' health-related cognitions and emotional responses. We found that self-affirmed participants (vs. not affirmed) were more likely to consider future consequences, which in turn was positively associated with message evaluation, attitudes toward organ donation, anticipated guilt for not registering as donors, and donor registration efficacy. Both theoretical and practical implications were discussed.

Ethnic/Racial, Religious, and Demographic Predictors of Organ Donor Registration Status Among Young Adults in the Southwestern United States

Context and Setting:

New Mexico (NM) is a minority–majority state. Despite its unique cultural characteristics and documented ethnic/racial disparities in deceased organ donation (DOD), past studies did not explore predictors of organ donor registration status (ODRS) in this state.

Objectives:

This study aimed at identifying demographic, cultural, and religious predictors of ODRS among a diverse sample of young adults in NM.

Design:

This study focused on recruitment of American Indian, Hispanic, and Asian American participants through online social network sites and university listservs. Participants (N = 602) answered an online survey. The largest racial/ethnic group included American Indians (n = 200). Main outcome measures included ODRS, demographics, religious affiliation, and open-ended question on reasons for objections to DOD.

Results:

Race/ethnicity, religion, and educational attainment were significant predictors of ODRS. Non-Hispanic whites (NHWs) were most likely to be registered as donors, with no significant difference between NHWs and Asians or Pacific Islanders. Non-Catholic Christians were most likely to be registered donors, followed by Catholics, practitioners of American Indian/Native American traditional religions, and Hindus, with Buddhists the least likely to register. This pattern was consistent with the propensity of individuals from these religious groups to cite religious objections to DOD. Finally, respondents who had graduated from high schools in NM were 2.3 times less likely to be registered as organ donors compared to those who had graduated in other states.

Conclusion:

This study provides evidence for the need for culturally tailored interventions targeting diverse communities in NM.

Does Donor Status, Race, and Biological Sex Predict Organ Donor Registration Barriers?

PURPOSE

The purpose of the current study was to examine differences among bodily integrity, disgust, medical mistrust, and superstition among African Americans, Caucasians, and Latinos; females and males; and registered organ donors and non-registered potential donors.

METHODS

A random digit dialing phone survey was utilized to garner information pertaining to organ donation beliefs among African American (n = 200), Caucasian (n = 200), and Latino (n = 200) Chicago residents. More specifically, participants responded to measures of bodily integrity, disgust, medical mistrust, and superstition, organ donor registration status, among others.

RESULTS

The results indicated that African American and Latino participants were less likely to be registered organ donors than Caucasians (p < .001). In general, females maintained fewer barriers than males with respect to bodily integrity (p < .05), disgust (p = .01), and superstition (p = .01). With respect to organ donation barriers, bodily integrity (p < .0001) emerged as a central concern among those surveyed.

CONCLUSION

This study highlights the significance of audience segmentation when promoting posthumous organ and tissue donation. Specifically, the results stress the importance of constructing distinct messages to non-registered potential donors compared to messages delivered to registered donors. Moreover, different barriers surfaced among females and males as well as among African American, Caucasian, and Latino residents. It is clear that a one size fits all approach will likely not work when promoting organ and tissue donation.

Jewish ethics and xenotransplantation

BACKGROUND

Although exclusively secular approaches to xenotransplantation are methodologically necessary to establish a fundamental verdict on its theoretical ethical acceptability, it is nevertheless pragmatically appropriate to take into account specifically religious positions, as religion is a factor relevant to societal acceptability. Apart from the aspect of societal acceptability, Jewish bioethics, like other religiously embedded ethics, may enrich the broader ethical discourse on xenotransplantation, as some of its principles-pikuach nefesh being the most prominent one-are plausible even in the framework of secular ethics.

METHODS

This paper first explores concepts of normativity in Jewish ethics before identifying specific ethical issues in Jewish bioethics and possible resolutions offered within the framework of Jewish ethics, and then finally examine the implications for the broader debate on xenotransplantation.

RESULTS

Religions in general and Judaism in specific cannot and should not be systematically excluded from ethical debates, not only because they may provide helpful input, but also because religion, religiousness and the affiliation to a religion can be crucial factors regarding the societal acceptability of specific medical technologies and procedures as they may be important aspects of an individual's identity. The principles of Jewish bioethics may be compelling to those who do not necessarily share the specifically religious prerequisites on which Jewish ethics is established. Among these rather cogent concepts is the status of natural law and naturalness, which is far more open to medical technologies and procedures deemed as unnatural and thus morally wrong by other religious parties in public discourse.

CONCLUSIONS

Jewish ethics has strong tendencies toward supporting xenotransplantation given a certain criteria is met. No categorical bans on xenotransplantation can be established on the grounds of Halacha.

Body image in transplant recipients and living organ donors

PURPOSE OF REVIEW

The purpose of this article is to describe the current evidence regarding the prevalence and significance of concerns about body image in transplant recipients and organ donors.

RECENT FINDINGS

Body image and organ integration concerns have been reported as main themes in the psychological adaptation to transplantation. Their prevalence, severity, description and impact vary wildly. There is a lack of validated instruments to measure body image or organ integration in transplant patients. For organ recipients, satisfaction with body image depends on the organ, genre, pretransplant medical illness, time since transplantation and post-transplant medication regimen. Complete or partial denial of the graft is frequently reported. For organ donors, body image is influenced by the type of surgical incision. There is little evidence that body image or organ integration impact medical or psychological outcomes after transplantation or organ donation.

SUMMARY

Body image is becoming a significant component of measuring the quality of life in transplant patients. Body image may become a factor in decisions about if and when to pursue transplant for nonlife-threatening conditions (e.g. face transplantation), about the type of incision or about the immunosuppressant regimen. For mental health professionals, understanding the complexities of body image and organ integration will help enhance the assistance provided before and after transplant or donation.

Breakdown in the organ donation process and its effect on organ availability

Background. This study examines the effect of breakdown in the organ donation process on the availability of transplantable organs. A process breakdown is defined as a deviation from the organ donation protocol that may jeopardize organ recovery. Methods. A retrospective analysis of donation-eligible decedents was conducted using data from an independent organ procurement organization. Adjusted effect of process breakdown on organs transplanted from an eligible decedent was examined using multivariable zero-inflated Poisson regression. Results. An eligible decedent is four times more likely to become an organ donor when there is no process breakdown (adjusted OR: 4.01; 95% CI: 1.6838, 9.6414; P < 0.01) even after controlling for the decedent's age, gender, race, and whether or not a decedent had joined the state donor registry. However once the eligible decedent becomes a donor, whether or not there was a process breakdown does not affect the number of transplantable organs yielded. Overall, for every process breakdown occurring in the care of an eligible decedent, one less organ is available for transplant. Decedent's age is a strong predictor of likelihood of donation and the number of organs transplanted from a donor. Conclusion. Eliminating breakdowns in the donation process can potentially increase the number of organs available for transplant but some organs will still be lost.

Understanding African American's religious beliefs and organ donation intentions

African Americans are overrepresented on the organ transplant waiting list and underrepresented among organ and tissue donors. One of the most highly noted reasons for lack of donation is the perception that donation is contrary to religious beliefs. The purpose of this cross-sectional study is to explore the complexities of religion (beliefs, religiosity, and religious involvement) and its association with willingness to donate and the written expression of donation intentions. Findings from a sample of 505 African American participants suggest that religion is a multidimensional construct and results differ depending on how the construct is measured and operationalized.

‘You have to die first’: Exploring the thoughts and feelings on organ donation of British women who have not signed up to be donors

Four White British women who had not signed up to be organ donors were interviewed in depth to investigate their feelings on organ donation. Transcripts were analysed using Interpretative Phenomenological Analysis to reveal how the ability to detach from the body affects the acceptance of organ donation, how organ donation can trigger difficult thoughts and how the family can be used to explain not having signed up. The findings confirm previous empirical evidence but also offer original insight on the discrepancy between attitudes and behaviours, how fears can inhibit action and the importance of communicating organ donation wishes to family.

Attitudes and behaviors regarding organ donation: a study on officials of religion in Turkey

The aim of this study is to determine the attitudes and behaviors of religious scholars regarding organ donation and transplantation. In this study, 540 officials working in the Department of Religious Affairs in Kayseri, Turkey, were included. Overall, 86.6% response rate (n = 468) was achieved. Although a majority of the officials of religion in this study stated that they believed in the importance of organ donation (90.8%), the rate of considering donation (57.9%) and the donation rate (1.1%) were found to be substantially low. There is a difference between the employment status and willingness to donate organs. The rate of willingness to donate was significantly high in men than women. And also was high in imams and preachers. Regarding the sources of information, the majority of the respondents (70.0%) cited mass media. Overall, 15.3% cited school education and 42.0% religious publications. The most common question (83.1%) that was asked was "whether or not organ donation was suitable for Muslim religious". Our study revealed that although the research groups have positive ideas about organ donation and transplantation, their role was low in informing and motivating people about organ donation and transplantation.

A focused educational program after religious services to improve organ donation in Hispanic Americans

Religion is an important determinant in Hispanic Americans (HA) becoming organ donors as HA often believe religion forbids donation. We investigated the effect of an educational program targeting HA organ donation in places of worship. A prospective observational study was conducted at four Catholic churches with a high percentage of HA. A 45-min "culturally sensitive" educational program, conducted in Spanish, was implemented. Organ donation awareness, knowledge, perception, and beliefs, as well as the intent to become an organ donor, were measured before and after the intervention. Differences between before and after the intervention were analyzed. A total of 182 surveys were conducted before and 159 surveys were conducted after the educational program. A significant increase was observed in organ donation knowledge (54% vs. 70%, p<0.0001), perception (43% vs. 58%, p<0.0001), and beliefs (50% vs. 60%, p=0.0001). However, no significant difference was found in the willingness to discuss donation with family, intent-to-donate, or registering to donate after the intervention. This study demonstrates that a focused educational program in places of worship can significantly improve HA knowledge, perceptions, and beliefs regarding organ donation. Further work is needed to understand why intent-to-donate does not increase despite the increase in organ donation awareness.

Level of awareness of personnel in hospital services related to the donation process: A Spanish and Latin American multicenter study

BACKGROUND

Services related to the donation and transplantation process are fundamental for developing solid organ transplantation and procuring organs from deceased donors. This study was conducted to analyze the attitude toward deceased organ donation among hospital personnel working in donation- and transplantation-related services in hospitals in Spain and Latin America.

METHODS

Nine hospital centers within the "International Donor Collaborative Project" were selected (Spain, Mexico, Cuba, and Costa Rica). A random employee sample was taken and stratified according to the type of service and job category in transplant-related hospital services.

RESULTS

Of the 925 employees surveyed, 78% were in favor of donation. By job category, attitude was more favorable among physicians (89%; p < 0.001). By type of service, attitude was more positive among personnel in transplant patient follow-up units (87%; p = 0.018). By country, the Cubans were most in favor (91%), followed by the Mexicans (81%), the Costa Ricans (77%), and the Spanish (70%; p < 0.001). Other factors were age (p < 0.001), sex (p = 0.005), considering the possibility of needing a transplant (p = 0.002), understanding the concept of brain death (p < 0.001), being in favor of living donation (p < 0.001), having discussed the subject of donation and transplantation within the family and the partner (p < 0.001), carrying out pro-social activities (p = 0.002), and concern about mutilation after donation (p = 0.002).

CONCLUSIONS

Transplant-related personnel had a favorable attitude toward deceased donation, although it was not as positive as we would expect, especially among non-physicians. This attitude needs to be improved because of the negative effect that can result in organ donation. There were pronounced differences between countries, and the discordance between attitude and actual deceased donation rates in each country is notable.

Gifts of giving: the role of empathy and perceived benefits to others and self in young adults' decisions to become organ donors

Trait empathy and self-interest exert a strong influence on different prosocial behaviors, but their role in the promotion of organ donation registration is unclear. A survey examined how perceived benefits of organ donation for others and the self affect people's willingness to register as donors. Perceived other-benefits did not predict registration. Those with lower risk and greater self-benefit perceptions were more willing to donate. Empathic concern predicted donation willingness and moderated the effect of other-benefit perceptions, such that other-benefit perceptions predicted donation willingness among those with greater empathic concern. Applications of these findings to organ donation promotion are discussed.

The role of anticipated guilt in intentions to register as organ donors and to discuss organ donation with family

This project extends previous cognition-based organ donation research by addressing the role of anticipated guilt in individuals' intentions to register as donors and to discuss organ donation with family under the theoretical framework of the integrative model of behavioral prediction. Structural equation modeling analysis revealed that after controlling for the influence of attitudes, norms, and self-efficacy, anticipated guilt positively predicted intentions and was a stronger predictor of intentions in the donor registration model than in the family discussion model. Anticipated guilt was in turn predicted by empathic concern and norms in the donor registration model and by empathic concern, attitudes, and norms in the family discussion model. Both theoretical and practical implications are discussed.

Social influence of a religious hero: the late Cardinal Stephen Kim Sou-hwan's effect on cornea donation and volunteerism

This study examined the mediated influence of a celebrated religious hero in South Korea, Cardinal Stephen Kim, through two forms of involvement--parasocial interaction and identification--on intention toward cornea donation and volunteerism, and it investigated how the news media diffused of his death. A structural equation modeling analysis with a Web-based voluntary survey of more than 1,200 people in South Korea revealed a multistep social influence process, beginning with parasocial interaction with Cardinal Kim, leading to identification with him, which predicted intention toward cornea donation and volunteerism. Additional investigations found that news of Cardinal Kim's death diffused rapidly through media and interpersonal communication. Results of this study demonstrate that religious leaders who achieve a celebrity hero status can prompt public discussion of important issues rather quickly through extensive media coverage, enabling them to promote prosocial behavior and positively affect public health.