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Cowie S, Choy SH, Shah DM, Gomez MP, Yoong BK, Koong JK. Healthcare System Impact on Deceased Organ Donation and Transplantation: A Comparison Between the Top 10 Organ Donor Countries With 4 Countries in Southeast Asia. Transpl Int 2023; 36:11233. [PMID: 37711402 PMCID: PMC10498995 DOI: 10.3389/ti.2023.11233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/11/2023] [Indexed: 09/16/2023]
Abstract
The need for organ donation is constantly increasing. Some countries have made improvements, while others, such as countries in Southeast Asia (SEA), have some of the lowest rates of deceased donors (pmp). This review aims to compare 14 countries with regards to many variables related to healthcare systems. Countries leading in deceased organ donation spend more on health and education, which is associated with increased potential for deceased organ donation. Out-of-pocket expenditure, is also associated with a decrease in deceased organ donation. Countries in SEA are lacking in healthcare resources such as workforce and materials, which are both necessary for a successful transplant program. Most countries in SEA have an excellent foundation for successful organ donation systems, including proper legislation, government support, and brain death laws along with an overall acceptance of brain death diagnosis. Priorities should include improving coordination, donor identification, and healthcare worker education. Countries in SEA have a lot of potential to increase deceased organ donation, especially by investing in healthcare and education. There is no one size fits all for organ donation programs and countries in SEA should focus on their strengths and take cultural differences into consideration when planning interventions.
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Affiliation(s)
- Sandra Cowie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Seow-Huey Choy
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Boon-Koon Yoong
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jun-Kit Koong
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Fan X, Li M, Rolker H, Li Y, Du J, Wang D, Li E. Knowledge, attitudes and willingness to organ donation among the general public: a cross-sectional survey in China. BMC Public Health 2022; 22:918. [PMID: 35534843 PMCID: PMC9082919 DOI: 10.1186/s12889-022-13173-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to assess the level of knowledge, attitudes, and willingness to organ donation among the general public in China. METHODS The study population consisted of 4274 participants from Eastern, Central and Western China. The participants' knowledge, attitudes and willingness to organ donation were collected by a self-designed questionnaire consisting of 30 items. Knowledge is measured by 10 items and presented as a 10 point score, attitudes is measured by 20 items using a 5-step Likert scale and total score ranged between 0 and 80; while the willingness to donate is assessed as binary variable (0 = No; 1 = Yes). A logistic regression model was used to assess the association of knowledge and attitudes with willingness to organ donation, controlling for demographic and socioeconomic confounders. RESULTS The questionnaire response rate was 94.98%. The mean score (± SD) of the general public's knowledge to organ donation was 6.84 ± 1.76, and the mean score (± SD) of attitudes to organ donation was 47.01 ± 9.07. The general public's knowledge and attitudes were the highest in Eastern China, followed by West and Central China. The logistic regression model indicated a positive association between knowledge and the willingness to organ donation (OR = 1.12, 95%CI: 1.08, 1.17; P < 0.001); attitudes were also positively potential determinant of more willingness to organ donation (OR = 1.08, 95%CI: 1.07, 1.09; P < 0.001). CONCLUSIONS Knowledge and attitudes were found to be positively associated with the Chinese general public's willingness to organ donation. Knowledge about the concept of brain death and the transplant procedure may help raise the rate of willingness to organ donation.
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Affiliation(s)
- Xiaojing Fan
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Meng Li
- School of Marxism, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang, China
| | - Heike Rolker
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Yingying Li
- Centre of Health and Bioethics Research, Wenzhou Medical University, Wenzhou Chashan Higher Education Park, Wenzhou, 325035, Zhegjiang, China
| | - Jiaoyang Du
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 Yanta West Road,, Xi'an, Shaanxi, 710061, PR China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Enchang Li
- Centre of Health and Bioethics Research, Wenzhou Medical University, Wenzhou Chashan Higher Education Park, Wenzhou, 325035, Zhegjiang, China.
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Khan JF, Shah DM, Sivapakiam S, Mokhtar S, Subramaniam M, Raman K, Singh H, Pillai M, Sulaiman O. Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities. Transplantation 2021; 105:2507-2512. [PMID: 34818304 DOI: 10.1097/tp.0000000000003591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Johann F Khan
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Diana Mohd Shah
- National Transplant Resource Centre, Ministry of Health, Kuala Lumpur, Malaysia
| | - S Sivapakiam
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Suryati Mokhtar
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Manisekar Subramaniam
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Krishnan Raman
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Harjit Singh
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Mohanasundram Pillai
- Department of Hepatobiliary Surgery and Liver Transplantation, Hospital Selayang, Selangor, Malaysia
| | - Omar Sulaiman
- National Transplant Resource Centre, Ministry of Health, Kuala Lumpur, Malaysia
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Weng LC, Chiang YJ, Huang HL, Tsai YH, Chen KH, Wang WS, Lin MH. Factors associated with registration for organ donation among clinical nurses. PLoS One 2021; 16:e0247424. [PMID: 33606803 PMCID: PMC7895373 DOI: 10.1371/journal.pone.0247424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/05/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Healthcare professionals play an important role in the organ donation process. The aim of this study was to examine the organ donation registration rate and related factors among clinical nurses. MATERIAL AND METHODS In this cross-sectional, correlational study, we used mailed questionnaires to collect data from four geographical areas and three hospital levels in Taiwan from June 6 to August 31, 2018. Two thousand and thirty-three clinical nurses participated in this study. RESULTS Participants' mean age was 34.47 years, and 95.7% were women. Of them, 78.3% were willing to donate their organs and 20.6% had registered for organ donation after death. The results of logistic regression showed that in the personal domain, higher age (odds ratio (OR) = 1.03, p < 0.001), better knowledge of organ donation (OR = 1.09, p < 0.001), and a positive attitude toward organ donation (OR = 2.91, p < 0.001) were positively associated with organ donation registration, while cultural myths (OR = 0.69, p < 0.001) were negatively correlated. In the policy domain, the convenience of the registration procedure (OR = 1.45, p < 0.001) was positively associated with registration. A gap between willingness to donate and actual registration was observed. CONCLUSIONS Personal factors played an important role in organ donation registration. Therefore, efforts to improve knowledge and inculcate positive cultural beliefs about organ donation among clinical nurses are recommended. There is also a need to cooperate with government policies to provide appropriate in-service training and policy incentives and establish an efficient registration process.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Chang Gung Medical Foundation, Linkuo Medical Center, Taoyuan, Taiwan
- * E-mail:
| | - Yang-Jen Chiang
- Division of Transplant Urology, Department of Surgery, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Science, Taipei, Taiwan
| | - Yu-Hsia Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiovascular Medicine, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
| | - Kang-Hua Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
| | - Woan-Shyuan Wang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Hsiu Lin
- Division of Transplant Urology, Department of Surgery, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan
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Naghavi N, Mubarik MS, Rasiah R, Sharif Nia H. Prioritizing Factors Affecting Deceased Organ Donation in Malaysia: Is a New Organ Donation System Required? Int J Gen Med 2020; 13:641-651. [PMID: 32982381 PMCID: PMC7507418 DOI: 10.2147/ijgm.s253372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/26/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The gap between the demand and the supply of human organs for transplantation is on the rise in Malaysia, despite the efforts of governments to promote donor registration. Factors affecting willingness to donate are contextual and vary from country to country. This research mainly focuses on the selection of most suitable organ donation system through factors affecting willingness to donate in Malaysia. The objectives of this study are to prioritize those factors acting as the pillars of the organ donation system and further to select the most suitable organ donation system for Malaysia. Patients and Methods The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors. Results Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent. Conclusion This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.
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Affiliation(s)
- Navaz Naghavi
- Faculty of Business & Law, Taylor's Business School, Taylor's University, Lakeside Campus, Subang Jaya 47500, Selangor, Malaysia
| | - Muhammad Shujaat Mubarik
- Faculty of Business Administration & Social Sciences, Mohammad Ali Jinnah University, Karachi 7500, Pakistan
| | - Rajah Rasiah
- Asia-Europe Institute, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hamid Sharif Nia
- Department of Nursing, Mazandaran University of Medical Science, Sari, Iran
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Murakami M, Fukuma S, Ikezoe M, Izawa S, Watanabe H, Yamaguchi H, Kitazawa A, Takahashi K, Natsukawa S, Fukuhara S. Knowledge Does Not Correlate with Behavior toward Deceased Organ Donation: A Cross-Sectional Study in Japan. Ann Transplant 2020; 25:e918936. [PMID: 31896742 PMCID: PMC6977621 DOI: 10.12659/aot.918936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Although knowledge is an important factor that influences decisions regarding deceased organ donation, the associations of knowledge with attitude and behavior regarding organ donation remain uncertain in countries with low organ donation rates like Japan. Material/Methods We conducted a cross-sectional survey of hospital medical and non-medical staff in 15 Japanese medical facilities. The questionnaire included items on knowledge, attitude, and behavior toward deceased organ donation and transplantation. Participants were divided into 3 groups according to the tertile of knowledge score. Modified Poisson regression models were used for associations of knowledge score with organ donor registration and willingness to become an organ donor after death. Results Of the 1967 staff, 1275 returned the questionnaires (response rate, 64.8%). There were 1190 study subjects with complete data for analysis. For the lowest (n=512), middle (n=428), and highest (n=250) tertile knowledge groups, the proportions of participants who registered and expressed willingness to donate organs were 20.1%, 23.4%, and 28.4% and 31.1%, 38.3%, and 44.0%, respectively. The adjusted proportion ratios for organ donor registration were 0.90 (95% CI, 0.73–1.10) for the middle and 1.00 (0.80–1.26) for the highest tertile of knowledge, compared with the lowest tertile. However, participants with the highest tertile of knowledge score expressed higher willingness for organ donation than the lowest tertile (adjusted proportion ratio, 1.37; 95% CI, 1.13–1.66). Conclusions For hospital staff in Japanese medical facilities, high knowledge about organ donation and transplantation was not associated with donor registration, but was associated with willingness to become an organ donor.
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Affiliation(s)
- Minoru Murakami
- Department of Healthcare Epidemiology, School of Public Health in The Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Nephrology, Saku Central Hospital, Nagano, Japan
| | - Shingo Fukuma
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaya Ikezoe
- Department of Nephrology, Saku Central Hospital, Nagano, Japan
| | | | | | | | | | - Katsusada Takahashi
- Saku Central Hospital Health Services Facility for The Elderly, Nagano, Japan
| | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in The Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
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