Are personnel in transplant hospitals in favor of cadaveric organ donation? Multivariate attitudinal study in a hospital with a solid organ transplant program

The Anchor of Traditional Culture and Medical Students' Knowledge, Attitudes, and Willingness Towards Organ Donation during Internships: A Cross-Sectional Descriptive Study

OBJECTIVES

The purpose of this study was to understand the knowledge, attitudes, and willingness of medical students in their clinical internships towards organ donation and to assess how traditional oriental culture plays a role.

METHODS

This study conducted an online cross-sectional survey using a cell phone application with a self-designed questionnaire based on the Delphi method. This study was conducted among medical students in their internships in hospitals in nearly 20 provinces of China. The questionnaire consisted of 17 main questions and a knowledge quiz. The results were analyzed with descriptive statistics using the software Microsoft Excel 2021 and SPSS 26.

RESULTS

A total of 225 medical students participated in this study, distributed among college, undergraduate, and postgraduate clinical internships. 96% of the medical students agreed with the value of organ donation, but the highest willingness to donate the whole body was only 38.22%. Among them, traditional culture, family values, and religious factors played important both positive and negative roles.

CONCLUSION

Medical students have better knowledge about organ donation, but it rarely comes from professional education. Traditional concepts, family values, and religious factors play both a facilitating and hindering role, which can easily lead to moral dilemmas. Although it is not possible to make productive changes in the short term, we could still make improvements through educational changes, research breakthroughs, and institutional improvements.

Awareness, Attitudes, and Willingness: A Cross-Sectional Study of Organ Donation in Saudi Arabia

BACKGROUND

Organ transplantation is inherently dependent on the availability of organ donors. There is a noticeable paucity of literature addressing the rates of organ donation registration and the awareness of Islamic regulations (Fatwa) regarding organ donation within Saudi Arabia. Our study aimed to evaluate the level of organ donation registration, awareness of Islamic regulations, and knowledge of the Saudi Center for Organ Transplantation (SCOT) within the Saudi society.

METHODS

We conducted a cross-sectional survey from 30 March to 9 April 2023. This survey aimed to assess the awareness of Islamic (Fatwa) guidance on organ donation, the role of SCOT, and the rate of organ donation registration facilitated through the Tawakkalna app, the official health passport application in Saudi Arabia.

RESULTS

Out of 2329 respondents, 21% had registered as potential deceased organ donors, despite 87% acknowledging the importance of organ donation. Awareness of the Islamic Fatwa regarding organ donation was reported by 54.7% of respondents, and 37% recognized the Fatwa's acceptance of brain death criteria. The likelihood of registration as organ donors was higher among Saudi citizens under 45 years of age, females, healthcare workers (HCWs), individuals with higher education, relatives of patients awaiting organ donations, those informed about the Islamic Fatwas, and those willing to donate organs to friends. Conversely, being over the age of 25, Saudi nationality, employment as an HCW, awareness of SCOT, and prior organ donation registration were predictive of a heightened awareness of Islamic Fatwas. However, perceiving the importance of organ donation correlated with a lower awareness of the Fatwas. Significant positive correlations were found between awareness of SCOT, awareness of Fatwas, and registration for organ donation.

CONCLUSIONS

While the Saudi population exhibits a high regard for the importance of organ donation, this recognition is not adequately translated into registration rates. The discrepancy may be attributable to limited awareness of SCOT and the relevant Islamic Fatwas. It is imperative to initiate organ donation awareness campaigns that focus on religious authorization to boost organ donation rates and rectify prevalent misconceptions.

The Willingness to Donate Organs in Medical Students From an International Perspective: A Meta-Analysis

Attitude toward organ donation mobilizes donation behavior and makes transplant surgery possible. As future health professionals, medical students will be a relevant generating opinion group and will have an important role in the organ requesting process. The goals of this meta-analysis were to obtain polled rates of medical students who are in favor, against, or indecisive toward cadaveric organ donation in the studies conducted around the world, and to explore sociocultural variables influencing the willingness to donate. Electronic search and revision of references from previous literature allowed us to locate 57 studies fulfilling the inclusion criteria. Data extraction and risk of bias assessment were performed by two independent investigators. Pooled estimations were computed assuming a random-effects model. Despite the fact that willingness to donate was elevated in medical students, estimated rates in studies from different geographical areas and sociocultural backgrounds exhibited significant differences. The age and the grade of the students also influenced the rate of students in favor. Donation campaigns should take into account cultural factors, especially in countries where certain beliefs and values could hamper organ donation. Also, knowledge and skills related to organ donation and transplant should be acquired early in the medical curriculum when a negative attitude is less resistant to change.

Usefulness of an organ donation opinion survey as a tool to promote organ donation among the adolescent population

Opinion surveys on health issues are considered health promotion tools. However, no studies have confirmed this in deceased organ donation for transplantation. This study aimed to analyse the impact of completing an opinion questionnaire about deceased organ donation on the attitude towards organ donation among the adolescent population. This longitudinal study with repeated measurements of attitude towards deceased organ donation was conducted with an adolescent population. The measurement instrument was a validated questionnaire of the attitude towards organ donation (PCID-DTO-Ríos). The study process involved the application of the questionnaire at an initial time, 1 month later, and 6 months later. A total of 1374 adolescents participated in this study. The favourable attitude towards donation was 43.1%, which fell to 41.4% at 1 month (P = 0.145), and to 39.7% at 6 months (P = 0.019). Changes in the attitude were observed in all groups, both 1 and 6 months after the questionnaire was completed. There was no objective relationship between the adolescent's socio-family environment and the effect of completing the questionnaire on their attitude towards deceased organ donation. In conclusion, the opinion questionnaire was not useful for promoting organ donation and did not have a positive effect on adolescents' attitudes towards organ donation in the medium or long term.

Knowledge and attitudes of healthcare professionals and the impact on willingness to donate organs: a tertiary hospital survey

INTRODUCTION

Healthcare professionals (HCPs) working in critical care areas play an important role in the organ donation (OD) process. We studied HCPs' own willingness to be organ donors and its association with sociodemographic factors as well as their knowledge and attitudes about OD and transplantation.

METHODS

A cross-sectional survey of HCPs working in four critical care units in a major transplant centre in Malaysia was undertaken using a validated structured questionnaire. Responses were analysed using multivariable analysis with willingness to donate as the dependent variable.

RESULTS

Of the 412 respondents (response rate 98.1%), the majority were nurses (60.4%), Malay (71.1%) and female (77.2%). Overall, 68.0% were willing to donate. The independent predictors of willingness to donate were profession (p < 0.001) and the Hindu religion (p = 0.001). Ethnicity (p = 0.003), religious belief (p < 0.001), knowledge (p = 0.016), belief in brain death (p = 0.018) and confidence in transplantation (p < 0.001) also independently correlated with willingness to donate, while attitudes to OD did not. Of those willing to donate, only 37.3% were carrying a donor card and only 63.1% had informed their family of their intention to donate.

CONCLUSION

Although willingness to donate was higher in critical care HCPs than HCPs in general, significant knowledge gaps as well as certain beliefs and perceptions that could pose a barrier to OD were identified in this group. Measures to improve OD rates in Malaysia should include targeted educational programmes for HCPs working in critical care areas.

Ecuadorian Population Residing in Spain and Their Knowledge of Brain Death Concept

BACKGROUND

The Ecuadorian population forms the largest Latin American immigrant group in Spain. However, their knowledge about the brain death (BD) concept and the relationship with the attitude toward organ donation has been little analyzed. The objective of the study is to analyze the knowledge of the BD concept among the Ecuadorian population resident in Spain.

METHODS

The population under study was the population born in Ecuador and resident in Spain. Inclusion criterion was age older than 15 years stratified by age and sex. The assessment instrument was PCID-DTO-Ríos, a validated questionnaire of attitude toward donation and organ transplantation. Field work involved random selection of respondents based on stratification. The support of immigration support associations was required to obtain sample locations. The completion was anonymous and self-administered.

RESULTS

Of the 461 respondents, 22% (n =102) know the BD concept and accept it as the death of the person; 61% (n = 283) do not know it; and for 17% (n = 76) it does not mean the death of the person. The variables related to the correct knowledge of BD are age (P = .007) and marital status (P = .028), with age persisting in the multivariate study (odds ratio, 1.036; P = .008). There is no objective relationship with the attitude toward organ donation. Thus, 60% of those who know the concept are in favor of donating (n = 61), and 59% of those who do not know it are in favor (n = 210; P = .813).

CONCLUSIONS

The BD concept is little known among Ecuadorians residing in Spain, and it is not associated with the attitude toward donation.

Accounting for organ donation decision-making: Analyzing interview discourse of the donors' relatives and intensive care unit physicians in Greece

The study casts light on the organ donation decision-making process by exploring the experiences of families and physicians involved. Specifically, semi-structured interviews were conducted with 11 family members of 11 different donors and with 13 intensive care unit physicians. Data collection and analysis draws on the principles of Grounded Theory Methodology. Analysis indicated that in the accounts of both groups, organ donation is represented as a multi-faceted process that includes various social and ideological dilemmas. Overlap and mutual influence was found connecting the experiences of family members and those of physicians, highlighting the need for further education and training for physicians and aftercare for families.

A Multicentre and stratified study of the attitude of medical students towards organ donation in Spain

INTRODUCTION

Medical students represent a new generation of medical thought, and if they have a favourable attitude towards organ donation this will greatly encourage its promotion.

OBJECTIVE

To analyse the attitude of medical students in Spanish universities towards the donation of their own organs and to determine the factors affecting this attitude.

MATERIAL AND METHODS

Type of study: A sociological, interdisciplinary, multicentre, and observational study in Spain.

STUDY POPULATION

Students studying a degree in medicine enrolled in Spain (n = 34,000).

SAMPLE SIZE

A sample of 9598 students (confidence of 99% and precision of ±1%), stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ donation and transplantation (PCID-DTO RIOS) was self-administered and completed anonymously.

RESULTS

The questionnaire completion rate was 95.7% (n = 9.275). 80% were in favour of donation, 2% against and 18% were undecided. The following main variables were related to a favourable attitude: being of the female sex (Odds Ratio = 1.739); being in the sixth year of the degree (OR = 2.506); knowing a donor (OR = 1.346); having spoken about the subject with one's family (OR = 2.132) and friends (OR = 1.333); having a family circle that is in favour, more specifically, having a father (OR = 1.841), mother (OR = 2.538) or partner in favour (OR = 2.192); being a blood donor (OR = 2.824); acceptance of the mutilation of the body if it were necessary (OR = 2.958); and being an atheist or an agnostic (OR = 1.766).

CONCLUSIONS

Spanish medical students generally have a favourable attitude towards organ donation, although 20% are not in favour.

Knowledge of the Concept of Brain Death Among the Latin-American Population Residing in Spain

OBJECTIVES

The knowledge of brain death is fundamental for being able to understand the organ donation process and for ensuring its acceptance or rejection. Here, we analyzed the level of knowledge of the concept of brain death among Latin-American individuals who are residents of Spain to determine the factors affecting this knowledge.

MATERIALS AND METHODS

Our patient group was a sample of 1314 Latin-American residents of Spain, obtained randomly and stratified according to the respondent's nationality, age, and sex. Their attitude was assessed using a validated questionnaire. The survey was self-administered and completed anonymously.

RESULTS

The questionnaire completion rate was 94% (n = 1237). Of total respondents, 25% (n = 313) knew the concept of brain death, which they considered to be an individual's death, 56% (n = 697) did not know the term, and 19% (n = 227) believed that it did not mean death. The variables related to knowledge of the brain death concept included (1) country of origin, with a better knowledge among those with Mexican nationality (P < .001); (2) male sex (30% vs 23%; P = .003); (3) having university-level education (35% vs 23%; P = .044); (4) having discussed the matter within the family (29% vs 23%; P = .044); (5) having a partner with a favorable attitude toward donation (39% vs 21%; P = .001); and (6) the respondent's religion (47% vs 7%; P < .001). The following factors persisted in the multivariate analysis: country of origin (odds ratio of 2.972), sex (odds ratio of 1.416), education level (odds ratio of 2.228), attitude of the respondent's partner (odds ratio of 1.835), and religion (odds ratio of 4.490).

CONCLUSIONS

Knowledge of the concept of brain death is limited among Latin-American residents of Spain, with marked differences among country of origin and other socio-personal factors.

Assessment of Attitude and Knowledge of Personnel in the Intensive Care Unit of Tabriz University of Medical Sciences Hospitals Toward Organ Donation

BACKGROUND

The increasing gap between organ supply and demand remains a worldwide problem and can be attributed to several reasons. Because health care workers play an important role in management of brain dead patients, we performed a survey to evaluate the attitude and knowledge of personnel in the intensive care unit (ICU) at Tabriz University of Medical Sciences hospitals toward organ donation.

MATERIALS AND METHODS

This cross-sectional study was included personnel from 8 university affiliated ICUs in Northwest of Iran from May to July 2014. The questionnaire included parts of demographic data and socioeconomic situations as well as status of knowledge and attitude of personnel regarding organ donation.

RESULTS

Gender, age, marital status, and type of department in which personnel work did not affect attitude toward organ donation. The most common reasons for disagreement for organ donation were religious considerations, fear of surgery, and body mutilation. Nurses have a better acceptance rate than assistants and nonmedical personnel.

CONCLUSIONS

Increasing the knowledge of health care workers in ICUs has strong impact on transplantation rate. The most important thing that should be clarified for this group is the concept of brain death to achieve a multidisciplinary team that believes in organ donation and transplantation.

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude.

METHODS: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student´s t test, χ² test and logistic regression analysis.

RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001).

CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

Knowledge Attıtudes and Behavıors About Organ Donatıon Among Fırst- and Sıxth-class Medıcal Students: A Study From Turkey

OBJECTIVES

The aim of this study is to determine the knowledge, attitude, and behaviors of Erciyes University School of Medicine students regarding organ donation.

MATERIALS AND METHODS

This descriptive study was conducted in 2014 on Erciyes University School of Medicine first- and sixth-grade students via questionnaire. It was to be conducted on all 490 students; in total, 464 students were enrolled-304 from first grade and 160 from sixth grade. Data were analyzed using descriptive statistics, χ(2) test, and binary logistic regression analysis.

RESULTS

The mean age was 20.9 ± 2.8 years and it was found that 48.9% were male, 65.5% were in first grade; 50.0% of the students who participated in the study were considering donating their organs and this rate is 45.4% in the first grade and 58.8% at sixth grade. Those who donated their organs were 3.4% in the entire group and were 1.6% and 6.9% consequently in first and sixth grades. Those who are; at the sixth grade, female gender, those who feel themselves responsible for the donation of society, who think organ donation is appropriate in terms of religion and conversations within family about organ donations significantly want organ donation more statistically. However, grade and gender had no effect on wishing donating organs according to binary logistic regression analysis. The rate of feeling themselves responsible from the donation in society was 73.9% and finding organ donation appropriate in terms of religion was 75.6% and there wasn't significant difference between first and sixth grades.

CONCLUSION

Although there are increases in many variables about this issue at sixth grade, students are unable to gain sufficient attitude and behavior about organ donation. Training can be planned during medical educations in terms of gaining attitudes and behaviors about the issue.

[Hospital-based multicenter study in Spain, Mexico and Cuba on attitudes to living liver donation]

INTRODUCTION

Given the lack of a sufficient number of livers available for transplantation, living liver donation (LLD) is being developed in the Spanish-speaking world. To do this, it is essential that health workers in hospitals are in favor of such donation, given that they are a key component in this treatment and that their attitudes influence public opinion.

OBJECTIVE

To analyze attitude toward LLD among hospital personnel from healthcare centers in Spain and Latin America.

MATERIAL AND METHOD

Ten hospitals were selected from the «International Donor Collaborative Project»: 3 from Spain, 5 from Mexico and 2 from Cuba. Random sampling stratified by type of service and job category was used. Attitudes to LLD were evaluated through a validated questionnaire on psychosocial aspects. The questionnaire was anonymous and self-administered. Statistical tests consisted of Student's T test, the chi-square test and logistic regression analysis.

RESULTS

Of the 2,618 employees surveyed, 85% (n=2,231) were in favor of related LLD; of these, 31% (n=804) were in favor of unrelated LLD. No association was found between the country of the interviewed, personal-social variables or work-related variables. The following factors were associated with a favorable attitude toward related LLD donation: having had personal experience of donation and transplantation (P<.001); being in favor of deceased donation (P<.001); believing that one might need a possible transplant (P<.001); being in favor of living kidney donation (P<.001); being willing to accept a liver from a living donor (P<.001); having discussed the matter of donation and transplantation within the family (P<.001) and with one's partner (P<.001); carrying out pro-social type activities (P<.001); being Catholic (P=.040); believing that one's religion is in favor of donation and transplantation (P<.001); and not being concerned about the possible mutilation of the body after donation (P<.001).

CONCLUSIONS

Hospital personnel from Spain and Latin America had a favorable attitude toward LLD, which was associated with factors directly and indirectly related to donation and transplantation, family and religious factors, and attitudes toward the body.

The Latin American population in Spain and organ donation. Attitude toward deceased organ donation and organ donation rates

The Latin American (LA) population has similarities with the Spanish population which makes its integration into Spanish society easier.

OBJECTIVE

to analyze the attitude toward organ donation among Latin American citizens residing in Spain, to determine the psychosocial variables which affect this attitude, and to examine the correlation between donation rates of LA citizens in Spain and in their countries of origin. A random sample of LA residents in Spain was taken and stratified according to the respondent's nationality (n = 1.314), in the year 2010. Attitude was assessed using a validated questionnaire (PCID-DTO Dr Rios). The survey was self-administered and completed anonymously.

STATISTICAL ANALYSIS

Student's t-test, the χ(2) test, and logistic regression analysis. There was a 94% completion rate (n = 1.237). Attitude toward donation was favorable in 60% of cases (n = 745), 12% (n = 145) were against, and 28% (n = 347) were undecided. The following variables were associated with attitude toward donation: sex (P = 0.038), level of formal education (P < 0.001), country of origin (P = 0.002), attitude toward the donation of a family member's organs (P < 0.001), having discussed donation with the family (P < 0.001), carrying out prosocial activities (P = 0.025), attitude toward cremation of the body (P < 0.001), attitude toward burial of the body (P < 0.001), attitude toward having an autopsy carried out (P < 0.001), previous experience of the organ donation and transplantation process (P < 0.001), fear of mutilation after donation (P < 0.001), knowledge that the Church has a positive attitude toward organ donation and transplantation (P < 0.001), knowledge of one's partner's attitude toward organ donation (P < 0.001), and a belief that one might need a transplant in the future (P < 0.001). The donation rates in this population group in Spain are higher than those recorded in their countries of origin (55.76 vs. <10 pmp; P < 0.001). The attitude toward organ donation among LA citizens residing in Spain is slightly worse than that reported in the native Spanish population and is determined by many psychosocial factors. The donation rates of LA citizens in Spain are higher than those in their countries of origin.

Opinion toward living liver donation of hospital personnel from units related to organ donation and transplantation: a multicenter study from Spain and latin-america

BACKGROUND

Hospital personnel of services related to donation and transplantation process play a fundamental role in the development of transplantation.

OBJECTIVES

The aim of this study was to investigate the attitude toward living liver donation (LLD) among hospital personnel from services related to donation and transplantation in hospital centers in Spain and Latin America.

MATERIALS AND METHODS

Eight hospitals within the "International Donor Collaborative Project" were selected, three in Spain, three in Mexico and two in Cuba. The study was performed in transplant-related services, using a randomized sample, which was stratified by the type of service and job category.

RESULTS

In total, 878 workers were surveyed of which 82% (n = 720) were in favor of related LLD, 10% (n = 90) were against and 8% (n = 68) undecided. Attitudes toward related LLD were more favorable in the following groups: the Latin Americans (86% in favor vs. 77% among the Spanish; P = 0.007); younger people (37 vs. 40 years, P = 0.002); those in favor of either deceased donation (P < 0.001) or living kidney donation (P < 0.001); those who believed that they might need a transplant in the future (P < 0.001); those who would accept a liver from a living donor (P < 0.001); those who discussed the subject of donation and transplantation with their families (P = 0.040); and those whose partner was in favor of donation and transplantation (P = 0.044).

CONCLUSIONS

Personnel from donation and transplantation-related units had a favorable attitude toward LLD. This attitude was not affected by psychosocial factors, although it was influenced by factors directly and indirectly related to the donation and transplantation process.

Knowledge of the Brain Death Concept by Personnel in Spanish and Latin-American Healthcare Centers

Background

The knowledge and acceptance of the concept of brain death (BD) among health care personnel is fundamental.

Objective

To analyze the level of understanding of the BD concept among personnel in Spanish and Latin American healthcare centers and to determine the factors affecting this attitude.

Material and methods

Data from 12 hospitals and 32 primary care centers in 4 countries within the International Collaborative Donor Project were selected (Spain, Mexico, Cuba and Costa Rica (n = 4378)).

Results

62% of the personnel (n = 2714) understood BD and believed that this was the death of an individual. Of the rest, 30% (n = 1 333) did not understand it and the remaining 8% (n = 331) believed it did not mean the death of a patient. 83% (n = 931) of physicians understood BD, compared to 75% (n = 895) of nurses, 55% (n = 299) of healthcare assistants, 53% (n = 108) of non-healthcare university-educated personnel and 36% (n = 481) of those without a university education (p<0.001). 68% (n = 1084) of Mexicans understood BD compared to 66% (n = 134) of Cubans, 58% (n = 1411) of Spaniards, and 52% (n = 85) (p<0.001) of Costa Ricans. There were significant relationships between knowledge of the concept and the following: type of healthcare center (p<0.001), clinical service (p<0.001), having spoken about organ donation within the family (p<0.001) and one's partner's attitude to the subject (p<0.001). A direct relationship has been found between understanding the concept and attitude toward deceased donation (p<0.001).

Conclusions

The understanding of BD by personnel from healthcare centers was not as good as expected. There were marked differences depending on job category.

Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers

INTRODUCTION

Hospital personnel are a group which has an influence on the opinion of the rest of the population about healthcare matters. Any unfavorable attitude of this group would be an obstacle to an increase in organ donation.

OBJECTIVE

To analyze the attitude of hospital workers toward the donation of one's own organs in Spanish and Latin American hospitals and to determine the factors affecting this attitude.

MATERIAL AND METHOD

Eleven hospitals from the "International Collaborative Donor Project" were selected, 3 in Spain, 5 in Mexico, 2 in Cuba and one in Costa Rica. A random sample was stratified by the type of service and job category. Attitude toward donation and transplantation was assessed using a validated survey. The questionnaire was completed anonymously and was self-administered.

STATISTICAL ANALYSIS

Student's t-test, the χ2 test and logistic regression analysis.

RESULTS

Of the 2,785 workers surveyed, 822 were from Spain, 1,595 from Mexico, 202 from Cuba and 166 from Costa Rica and 79% (n=2,191) were in favor of deceased organ donation. According to country, 94% (n=189) of Cubans were in favor, compared to 82% (n=1,313) of the Mexicans, 73% (n=121) of the Costa Ricans and 69% (n=568) of the Spanish (P<.001). In the multivariate analysis, the following variables had the most specific weight: 1) originating from Cuba (odds ratio=8.196; P<.001); 2) being a physician (OR= 2.544; P<.001); 3) performing a job related to transplantation (OR = 1.610; P=.005); 4) having discussed the subject of donation and transplantation within the family (OR= 3.690; P<.001); 5) having a partner with a favorable attitude toward donation and transplantation (OR= 3.289; P<.001); 6) a respondent's belief that his or her religion is in favor of donation and transplantation (OR= 3.021; P=.001); 7) not being concerned about the possible mutilation of the body after donation (OR= 2.994; P<.001); 8) the preference for other options apart from burial for treating the body after death (OR= 2.770; P<.001); and 9) acceptance of carrying out an autopsy if one were needed (OR= 2.808; P<.001).

CONCLUSIONS

Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors.

A multicenter study of the attitude of secondary school teachers toward solid organ donation and transplantation in the southeast of Spain

BACKGROUND

Teachers play a fundamental role in providing information to adolescents and could influence their attitudes.

OBJECTIVES

To analyze the attitude of teachers toward organ donation and the concept of brain death (BD); the psychosocial variables related to attitude; and the information provided to pupils.

METHODS

A multicenter study was carried out using a random sample of secondary school teaching staff from 10 schools (n = 327) in the southeast of Spain. Attitude toward organ donation was assessed using a validated questionnaire that was self-administered and completed anonymously.

RESULTS

The questionnaire completion rate was 88% (n = 288), with 75% (n = 215) in favor of organ donation, 23% had doubts, and 2% were not in favor. Regarding the knowledge of BD, 62% (n = 179) accepted that this meant a person's death. The variables associated with a more favorable attitude included conversations with family and friends (p < 0.05); a partner's favorable opinion (OR 3.194); knowledge of the concept of BD (p = 0.006); being a blood donor (OR 8.264); and a favorable attitude toward autopsy (OR 4.716). Teachers provided information about organ donation to pupils in 16% of cases (n = 47).

CONCLUSIONS

Seventy-five percent of teachers are in favor of organ donation. Their attitude is affected by psychosocial factors.

[Attitudes among Spanish and Latin American non-medical health professionals to living donor liver transplantation]

INTRODUCTION

Hospital professionals are an opinion group that influences the general population.

OBJECTIVE

To analyze attitudes to living donor liver transplantation (LDLT) among non-medical professionals working in Spanish and Latin American hospitals and to determine the variables that influence these attitudes.

MATERIAL AND METHOD

A random sample, stratified by department, was selected from non-medical staff in the "International Donor Collaborative Project": there were three hospitals in Spain, five in Mexico and two in Cuba. Attitudes were evaluated through a validated, anonymous, self-administered questionnaire.

RESULTS

There were 951 non-medical professionals: 277 from Spain, 632 from Mexico and 42 from Cuba. A total of 86% (n = 818) were in favor of related living donation and 31% (n = 299) were in favor of unrelated living donation. This attitude was associated with the following: country (Mexico 88%, Cuba 83%, Spain 81%) (p =0.016), female sex (p =0.026), having experience of donation and transplantation (p =0.001), having a favorable attitude to donation (P <0.001), considering the possibility of needing a transplant (P <0.001), being in favor of living kidney donation (P <0.001), being willing to accept a transplant from a living donor if necessary (P <0.001), discussing donation and transplantation with the family and partner (P <0.001), carrying out pro-social activities (P <0.001), believing that one's religion was in favor of donation and transplantation (P<0.001), and not worrying about bodily mutilation after donation (P <0.001).

CONCLUSIONS

Attitudes toward related LDLT among non-medical staff in various Spanish, Mexican and Cuban hospitals are favorable. In 86% of those surveyed, this attitude was not influenced by classical psychosocial factors.

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.

Knowledge and attitudes toward organ/tissue donation and transplantation among health care professionals working in organ transplantation or dialysis units

OBJECTIVE

To evaluate the awareness and attitudes of health care professionals toward organ/tissue donation and transplantation.

METHODS

We included 309 health care professionals from 27 dialysis centers and eight organ transplantation centers in Istanbul in the present study conducted from April 2008 to August 2008. The 24-item questionnaire, including items concerning sociodemographic features and knowledge about and attitudes toward organ/tissue donation and transplantation, was applied by face-to-face interviews.

RESULTS

An organ/tissue donation card was completed among 77% of subjects, while 90% were identified as supporting transplantation. The main reasons identified for lack of donation were lack of confidence (59.7%), fear of procurement (31.5%), and inappropriate use of harvested organs (18.1%).

CONCLUSION

In conclusion, targeting health care professionals in the first place and development of nationwide media and educational campaigns on the ethical, moral, as well as religious dimensions of transplantation and donation seem crucial to increase the number of individuals who can act as role models via their positive impact on the general public's attitudes toward organ donation.

Secondary school teachers' assessment of the introduction of an educational program about organ donation and transplantation

INTRODUCTION

It is essential to provide information about organ donation and transplantation (ODT) to encourage school pupils to have favorable attitudes toward this matter in the future. The role of the teacher is crucial in this respect. The objective of this study was to determine acceptance by secondary school teachers of an educational program about ODT.

MATERIALS AND METHODS

A random sample of secondary school teachers was taken from 10 secondary schools in the southeast of Spain. A total of 288 teachers were surveyed using a questionnaire that assessed the following; (1) acceptance of the educational program; (2) who should carry it out; and (3) some psychosocial variables related to ODT.

RESULTS

Of the 288 secondary teachers surveyed, 283 of them responded to the acceptance of an educational program on ODT. Approximately half (54%) of the respondents believed that it would be appropriate to introduce an educational program about ODT in secondary schools, 22% believed that there were currently other more important educational considerations, 20% had doubts, and 4% believed that it would not be useful. The vast majority (71%) believed that a collaborator from the Regional Transplant Team would be the best person to carry out the program followed by any teacher (11%) or a teacher of ethics (9%). The remaining 9% were not sure. There was greater acceptance of an educational program about ODT among teachers who had a favorable attitude toward the matter (P = .003).

CONCLUSIONS

An educational program about ODT in secondary education was not equally accepted by all teachers. Most teachers believed that the program should be delivered by the Transplant Coordination Center rather than teachers themselves.

Donation and transplantation among personnel in the hospital emergency department: a multicenter study conducted in Spain and Mexico

INTRODUCTION

The promotion of different means of procuring both deceased and living organs (kidney and liver) is a necessity given the current organ shortage. Emergency department personnel are involved in the donation and transplantation process. Our objective was to analyze the attitude to the different kinds of organ donation of emergency services personnel in hospital centers in Spain and Mexico.

MATERIALS AND METHODS

A randomized sample was obtained from the "International Collaborative Donor Project" and was stratified according to emergency services and job category in nine hospitals, in Spain and in Mexico (n = 22). Attitude was evaluated using a validated survey.

RESULTS

Of the respondents, 76% were in favor of deceased organ donation and 24% were not in favor. This attitude toward deceased donation was associated with the respondent's country of origin, age, and job category; Mexicans (P = .036), younger respondents (P = .023), and physicians were most in favor (P < .001). With regard to attitude toward living kidney donation, 89% were in favor of related donation. Regarding living liver donation, 85% were in favor of related donation. In attitude toward living kidney and liver donation, relevant factors were related to donation and transplantation.

CONCLUSIONS

Professionals in emergency departments in hospital centers in Spain and Mexico had a favorable attitude toward the different kinds of donation, although it was less favorable than the attitude reported in other professional hospital groups.

Evaluation of the law of presumed consent after brain death by Spanish journalism students

INTRODUCTION

Information provided by journalists is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), wherein the participation of the general public is essential to obtain organs.

OBJECTIVE

The objective of this study was to determine the knowledge of students taking a degree in journalism about the concept of brain death and the law of presumed consent.

MATERIALS AND METHODS

The study involved 129 journalism degree students in the 2005-2006 academic year from a university in the south-east of Spain. Attitudes on the psychosocial aspects of ODT were evaluated using a validated questionnaire. The self-administered survey was completed anonymously in classes and compulsory practical sessions.

RESULTS

The questionnaire completion rate was 98% (n=126). Of the students surveyed, 43% (n=54) understood the concept of brain death, 44% (n=56) stated that they had doubts, whereas 13% (n=16) believed that a person with brain death can recover and lead a normal life. Their knowledge was more accurate in the final than in the first year (54% vs 47%; P=.016). Most students 66% (n=83) believed that it would be interesting to receive an informative talk about ODT. Concerning legislation, 75% of students were against the law of presumed consent, whereas 25% were in favor.

CONCLUSION

More than 50% of journalism students do not understand the concept of brain death. Furthermore, up to 75% do not accept the law of presumed consent that donation must be made.

From where do our children receive information about organ donation and transplantation?

INTRODUCTION

The information provided about organ donation and transplantation (ODT) affects whether it is viewed favorably or unfavorably.

OBJECTIVES

The objective of this study was to determine the means by which each source of information about ODT influenced attitudes of children.

MATERIAL AND METHODS

Ten secondary schools from the south-east of Spain were stratified geographically. We performed a random selection of pupils from the first 4 years of compulsory secondary range, education (age 11-15 years). A validated self-administered questionnaire about attitudes toward ODT was completed anonymously.

RESULTS

The adolescents had received information about ODT through several sources. The most frequent sources were television (86%), films (59%), and magazines (56%). Positive information from information sources was associated with more favorable attitudes toward ODT (P<.05); those who received negative information had more unfavorable attitudes (P<.05).

CONCLUSIONS

Most information about ODT that reaches our children is through audiovisual means. Attitudes were more favorable among adolescents who have received positive information through the mass media, with more negative attitudes among those who received negative information.

Attitudes toward living kidney donation in transplant hospitals: a Spanish, Mexican, and Cuban multicenter study

INTRODUCTION

Living donor kidney (LKD) transplantation provides better results than deceased donor donation, involving minimum risk for the donor. However, LKD donation rates are low in most countries. We analyzed attitudes toward LKD in transplant hospitals in Spain, Mexico, and Cuba.

MATERIALS AND METHODS

Data were obtained from five transplant hospitals through the International Collaborative Program "Proyecto Donante Vivo, Murcia" in three countries: Spain (n = 1168), Mexico (n = 903), and Cuba (n = 202). The random sample (2273 employees) was stratified according to job category. The instrument used to evaluate attitude was a validated questionnaire. Statistical analysis included Student t test, the chi(2) test, and multivariate analysis.

RESULTS

Eighty eight percent (n = 2002) of Spanish, Mexican, and Cuban transplant hospital personnel were in favor of related LKD and 24% nonrelated LKD (n = 555). Attitudes were more favorable among centers in Cuba 97% (n = 195), followed by Mexico 88% (n = 793) and by Spain 87% (n = 1014; P < .001). According to job category, 91% (n = 617) of physicians were in favor, 88% (n = 543) of nurses, 85% (n = 198) of health care assistants, and 85% (n = 198) of auxiliary personnel. Attitudes were related to variables of: attitude toward deceased donation (P < .001), discussion about organ donation and transplantation (P < .001), concern about body mutilation after donation (P = .001), a possible need for a transplant in the future (P < .001), and attitude toward living liver donation (P < .001).

CONCLUSIONS

Attitudes toward LKD in Hispanic/Latin Transplant Hospitals were favorable and could encourage an increase in LKD in the coming years assuming suitable sociopolitical and economic condition, as well as support from nephrologists.

Evaluation of organ donor card holders among public officials of a major German city

INTRODUCTION

Each year in Germany, the lack of donor organs results in more than 1000 patients dying while on the transplant waiting list. At the same time, there is an organ donor potential that is not being exploited. The objective of this study was to collect the rate of holders of organ donor cards among public officials in a major German city.

METHODS

In 2007, a survey was conducted among public officials in Essen, North Rhine-Westphalia, Germany, regarding the topic of organ donation. Gender, age, and the "indicator for organ donation willingness" were stratified and analyzed according to the holding of organ donor cards.

RESULTS

A total of 1582 completely answered questionnaires were evaluated; 20.92% of the respondents had an organ donor card. No statistically significant association between gender (P = .0691), age (P = .8513), or possession of a donor card could be determined. We observed a significant correlation (P < .0001) between the indicator for organ donation willingness and possession of an organ donor card.

DISCUSSION

Based on current research, we consider an up-to-date, broader-reaching, representative inquiry necessary for our society. Should this present similar results, then a special education campaign is necessary, which considers sociocultural backgrounds and responds to the indicator for organ donation willingness that we analyzed. In so doing, one individual goal is the promotion of health and body awareness and thus an increase in the associated potential organ donor willingness.