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Secombe P, Lankin E, Beadle R, McAnulty G, Brown A, Bailey M, Schultz R, Pilcher D. Aboriginal and Torres Strait Islander Attitudes to Organ Donation in Central Australia: A Qualitative Pilot Study. Transplant Direct 2024; 10:e1692. [PMID: 39220219 PMCID: PMC11365648 DOI: 10.1097/txd.0000000000001692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/05/2024] [Accepted: 06/26/2024] [Indexed: 09/04/2024] Open
Abstract
Background Organ transplantation is a well-established intervention but is reliant on the donation of organs and tissues, mostly from deceased donors. The proportion of Australians proceeding to organ donation (OD) has increased, but the proportion of Indigenous Australians proceeding remains two-thirds that of non-Indigenous Australians. We sought to explore perceived barriers and enablers for the involvement of Indigenous peoples in the OD process. Methods Qualitative methodology centered around focus groups was used to capture the experiences and perspectives of Indigenous people regarding OD. A purposively sampled group of Aboriginal Liaison Officers working within the Alice Springs Hospital Intensive Care Unit (ASH ICU) participated in up to 6 focus groups during 2021 with subsequent thematic analysis of the enablers and barriers to Indigenous participation in the OD process. The ASH ICU is the only ICU servicing Central Australia, and 70% of admissions are Indigenous patients. Results Four primary themes emerged: OD is a new and culturally taboo topic; conversations related to OD are confronting; education is needed (both about OD and cultural education for clinicians); and lack of trust in the healthcare system. Conclusions There are cultural barriers to engaging in the OD process and clinicians need more training on the delivery of culturally safe communication is needed. Despite this, there was a recognition that OD is important. Education about OD needs to be place based, culturally and linguistically appropriate, informed by local knowledge, delivered in community, and occur before a family member is admitted to ICU.
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Affiliation(s)
- Paul Secombe
- Intensive Care Unit, Alice Springs Hospital, Alice Springs (Mparntwe), NT, Australia
- School of Medicine, Flinders University, Bedford Park, SA, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
- Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Prahran, Vic, Australia
| | - Emslie Lankin
- Intensive Care Unit, Alice Springs Hospital, Alice Springs (Mparntwe), NT, Australia
| | - Rosalind Beadle
- Centre for Remote Health, Flinders University, Alice Springs (Mparntwe), NT, Australia
| | - Greg McAnulty
- Intensive Care Unit, Alice Springs Hospital, Alice Springs (Mparntwe), NT, Australia
- School of Medicine, Flinders University, Bedford Park, SA, Australia
| | - Alex Brown
- National Centre For Indigenous Genomics, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
- Aboriginal Health Equity, South Australian Health and Medical Research Institute (SAHMRI), SA, Australia
| | - Michael Bailey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Rebecca Schultz
- Public and Primary Health Care, Alice Springs (Mparntwe), NT, Australia
| | - David Pilcher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
- Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Prahran, Vic, Australia
- Department of Intensive Care, The Alfred Hospital, Prahran, Melbourne, Vic, Australia
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Wada Y, Ueno T, Umeshita K, Hagiwara K. Challenges in decision-making support processes regarding living kidney donation: A qualitative study. J Ren Care 2024. [PMID: 38597794 DOI: 10.1111/jorc.12494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/11/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Previous studies on decision-making of living kidney donors have indicated issues regarding donors' autonomy is inherent in decision-making to donate their kidney. Establishing effective decision-making support that guarantees autonomy of living kidney donor candidates is important. OBJECTIVES The aim of this study was to identify the difficulties in the decision-making support when clinical transplant coordinators advocating for the autonomy of donor candidates of living donor kidney transplantation and to identify the methods to deal with these difficulties. DESIGN A qualitative descriptive study. PARTICIPANTS Ten clinical transplant coordinators supporting living kidney donors. APPROACH Semi-structured interviews were conducted using an interview guide. The modified grounded theory approach was utilised to analyse. RESULTS Three categories related to difficulties were as follows: issues inherent to the interaction between coordinators, donor candidates and their families; issues regarding the environment and institutional background in which coordinators operate; and emotional labour undertaken by coordinators in the decision-making support process. Additionally, five categories related to methods were as follows: assessing the autonomy of donor candidates based on the coordinators nursing experience; interventions for the donor candidates and their family members based on the coordinators nursing experience; smooth coordination with medical staff; clarifying and asserting their views as coordinators; and readiness to protect the donor candidates. CONCLUSION The involvement of highly experienced coordinators with excellent and assertive communication skills as well as the ability to reflect on their own practices is essential. Moreover, we may need to fundamentally review the transplant community, where power domination is inherent.
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Affiliation(s)
- Yuri Wada
- Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Takayoshi Ueno
- Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Koji Umeshita
- Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kuniko Hagiwara
- Division of Health Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Gonen LD, Bokek-Cohen Y, Tarabeih M. The general public's attitude towards accepting payment for kidney donation. Front Med (Lausanne) 2023; 10:1282065. [PMID: 38162890 PMCID: PMC10756681 DOI: 10.3389/fmed.2023.1282065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Kidney transplantation has become the most cost-effective treatment for patients with end-stage kidney disease (ESKD) and offers them the highest quality of life. Yet, kidney donation is often inaccessible due to cultural and traditional beliefs about organ donation. The goal of our study is to assess the value of kidney donation using the Willingness to Accept (WTA) technique. We also aim to understand the factors influencing an individual's willingness to donate an organ. Methods A self-administered survey was completed by 985 participants from the general public. The quantitative method and survey design that were chosen used descriptive, correlational, nonparametric, and multivariate statistical tests. Results Most of the respondents, 895 (90.9%) are not willing to donate a kidney while alive. Four hundred and five (41.1%) of the respondents are not willing to donate a kidney after their death, while the rest are willing to donate their kidney after their death without financial compensation. The same attitude applies to the donation of a kidney from their relatives. Significant predictors from the results of the logistic regression model in predicting the lowest (minimal) amount that will encourage donation of one kidney after death were: Marital status; Nationality; Adi card holder; Knowing people who need a kidney donation; confidence in the medical staff; and consideration of the family's opinions regarding organ donation. Discussion Using cost benefit analysis (CBA), with the aim of evaluating the willingness of individuals to accept payment for innovative medical procedures, such as kidney donation, allows an assessment of the perceived value of the medical procedure and enables policymakers to decide whether to allocate funds or offer subsidies for kidney donation, given the limited healthcare resources available. During our research, we found that most participants did not support the commercialization of organs. Our recommendation for policymakers and health professionals is to continue providing adequate funding for kidney donations and to implement educational programs aimed at improving attitudes towards organ donation.
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Affiliation(s)
| | | | - Mahdi Tarabeih
- School of Nursing, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
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4
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Umair S, Ho JA, Ng SSI, Basha NK. 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. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:216-244. [PMID: 34505539 DOI: 10.1177/00302228211045170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Sonia Umair
- School of Business & Economics, Universiti Putra Malaysia, Selangor, Malaysia
| | - Jo-Ann Ho
- School of Business & Economics, Universiti Putra Malaysia, Selangor, Malaysia
| | - Serene Siew Imm Ng
- School of Business & Economics, Universiti Putra Malaysia, Selangor, Malaysia
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Ugur ZB, Molina Pérez A. The toll of COVID-19 on organ donation and kidney transplantation in Europe: Do legislative defaults matter? Health Policy 2023; 136:104890. [PMID: 37573724 DOI: 10.1016/j.healthpol.2023.104890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
This study investigates the cascading effects of COVID-19 pandemic on organ donation and transplantation in Europe. We also check whether legislative defaults for organ donation have a role in these outcomes. For this purpose, we used data from 32 European countries, between 2010 and 2021, and estimated pooled OLS regressions. We find that COVID-19 pandemic reduced deceased organ donation rates by 23.4%, deceased kidney transplantation rates by 27.9% and live kidney transplantation rates by 31.1% after accounting for health system capacity indicators. While our study finds that presumed consent legislation under normal circumstances leads to notable benefits in terms of deceased kidney transplantation and organ donation rates, the legislative defaults did not have a significant impact during the pandemic. Additionally, our findings indicate a trade-off between living and deceased transplantation that is influenced by the legislative default.
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Affiliation(s)
- Zeynep B Ugur
- Department of Economics, Social Sciences University of Ankara, Ulus, Ankara C421, Turkey.
| | - Alberto Molina Pérez
- Spanish National Research Council (CSIC), Institute of Advanced Social Studies, Córdoba, Spain
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6
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Torgbenu E, Luckett T, Buhagiar M, Phillips JL. Practice points for lymphoedema care in low- and middle- income countries developed by nominal group technique. BMC Health Serv Res 2023; 23:740. [PMID: 37422616 DOI: 10.1186/s12913-023-09786-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/05/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Lymphoedema is a common, distressing, and debilitating condition affecting more than 200 million people globally. There is a small body of evidence to guide lymphoedema care which underpins several lymphoedema clinical practice guidelines developed for high-income countries (HIC). Some of these recommendations are unlikely to be feasible in low-resource settings. AIM To develop practice points for healthcare workers that optimise lymphoedema care in low- and middle-income countries (LMIC). METHODS A nominal group technique (NGT) was undertaken to gain consensus on which content from HIC guidelines was important and feasible to include in practice points for LMIC, and other important advice or recommendations. Participants included experts, clinicians, and volunteers involved in lymphoedema care in LMIC. The NGT followed five key stages: silent 'ideas' generation, round-robin rationale, clarification, refinement and verification. The first, fourth and fifth stages were completed via email, and the second and third during a video meeting in order to generate a series of consensus based prevention, assessment, diagnosis, and management of lymphoedema in LMIC practice points. RESULTS Of sixteen participants invited, ten members completed stage 1 of the NGT (ideas generation), of whom six contributed to stages 2 (round-robin) and 3 (clarification). All those who completed stage 1 also completed stages 4 (refinement) and 5 (verification). Practice points unanimously agreed on included Complex Decongestive Therapy (CDT) and good skin care, with management to be determined by lymphoedema stage. For podoconiosis-endemic areas, the use of socks and shoes was identified as very important in the prevention of non-filarial lymphoedema and other lymphoedema-causing conditions. Participants indicated that diagnosing lymphoedema using the lymphoscintigraphy and Indocyanine green (ICG) fluorescent lymphography was not possible due to unavailability and cost in LMIC. Surgical procedures for lymphoedema management were unanimously eliminated due to the unavailability of technology, limited workforce, and expensive cost in LMIC. CONCLUSION The consensus-based practice points generated by this project provide healthcare workers with guidance on caring for people with lymphoedema in LMIC. Further development of workforce capacity is needed.
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Affiliation(s)
- Eric Torgbenu
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Tim Luckett
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Mark Buhagiar
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Catholic Diocese of Parramatta, Parramatta, NSW, Australia
| | - Jane L Phillips
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Nursing, Queensland University of Technology, Brisbane, Australia
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7
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Jenkin RA, Garrett SA, Keay KA. Altruism in death: Attitudes to body and organ donation in Australian students. ANATOMICAL SCIENCES EDUCATION 2023; 16:27-46. [PMID: 35344291 PMCID: PMC10084255 DOI: 10.1002/ase.2180] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 05/25/2023]
Abstract
Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next-of-kin agreement to donation, irrespective of the deceased's pre-death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self-body donation (26.5%) was much lower than support for self-organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one-to-two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate.
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Affiliation(s)
- Rebekah A. Jenkin
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
| | - Samuel A. Garrett
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- University of SydneyCamperdownNew South WalesAustralia
| | - Kevin A. Keay
- Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
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AbuAlhommos AK, AlSaeed AA, AlMutayib M, Althuwaini RF, Alshehab SS, Alsuwailem NS. Assessment of Community Knowledge of and Attitude Toward Organ Donation in Saudi Arabia. Transplant Proc 2023; 55:7-12. [PMID: 36522223 DOI: 10.1016/j.transproceed.2022.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The demand for organ donation has increased because of the sharp rise in the number of transplant candidates worldwide. The main influences on the organ donation rate in Saudi Arabia were religious considerations and a lack of knowledge. The aim of this study was to explore community knowledge of and attitude toward organ donation in Saudi Arabia. METHODS An online cross-sectional survey study was conducted to assess community knowledge of and attitude toward organ donation in Saudi Arabia in January 2022. The study population consisted of everyone who is currently residing in Saudi Arabia and is aged ≥18 years. The participants were questioned regarding the types of organs that might be donated, the potential health risks associated with organ donation, and the Saudi Arabian system for organ donation. Logistic regression was used to identify predictors of better knowledge of and attitude toward organ donation. RESULTS The study involved 1208 participants, of which 63% reported that they would be willing to donate their organs for a family member. The most reported organs for which the participants reported they are willing to donate were the kidneys (48%), liver (25%), and heart (21%). Most reported that they would donate their organs to save someone's life (93%). The study participants showed mild to moderate level of knowledge about organ donation with a mean score of 5.4 (standard deviation [SD] 1.6), which is equal to 68% of the maximum obtainable score (which is 8). The study participants showed a mild positive attitude toward organ donation with a mean score of 3.3 (SD 1.3), which is equal to 47% of the maximum obtainable score (which is 7). Younger participants (aged 19-30 years) and those who work in the health care sector were more likely than others to be knowledgeable about organ donation (P ≤ .01). At the same time, participants aged 31 to 40 years were more likely than others to have positive attitudes toward organ donation (P ≤ .01). CONCLUSIONS The present study participants showed mild to moderate level of knowledge of and mild positive attitude toward organs donation. Awareness campaigns should be directed toward the elderly population to enhance their awareness and attitude toward this important lifesaving practice.
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Affiliation(s)
- Amal Khaleel AbuAlhommos
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia.
| | - Amnah Ahmed AlSaeed
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | - Marwah AlMutayib
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | - Rimah Fahad Althuwaini
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | - Sarah Sami Alshehab
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | - Naseem Salman Alsuwailem
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
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Boduç E, Allahverdi TD. Medical Students’ Views on Cadaver and Organ Donation. Transplant Proc 2022; 54:2057-2062. [DOI: 10.1016/j.transproceed.2022.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
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Zhang Z, Jin J, Luo C, Chen A. Excavating the social representations and perceived barriers of organ donation in China over the past decade: A hybrid text analysis approach. Front Public Health 2022; 10:998737. [PMID: 36225769 PMCID: PMC9549352 DOI: 10.3389/fpubh.2022.998737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/06/2022] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Zizhong Zhang
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Jing Jin
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Chen Luo
- School of Journalism and Communication, Wuhan University, Wuhan, China,*Correspondence: Chen Luo
| | - Anfan Chen
- School of Journalism and Communication, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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11
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Majchrowska A, Wiechetek M, Domaradzki J, Pawlikowski J. Social differentiation of the perception and human tissues donation for research purposes. Front Genet 2022; 13:989252. [PMID: 36186428 PMCID: PMC9521191 DOI: 10.3389/fgene.2022.989252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/01/2022] [Indexed: 11/18/2022] Open
Abstract
The willingness to donate human biological material for research purposes is shaped by socio-cultural factors; however, there is a lack of studies analysing the social perception of different human tissues, which may affect such willingness. This study aimed to distinguish different sociocultural categories of human tissues and types of potential donors based on their willingness to donate material. Quantitative research was conducted on a sample of 1,100 adult Poles representative in terms of sex, place of residence and education. According to the study, people were most willing to donate urine (73.9%), blood (69.7%), hair and tears (69.6%) and the least willing to donate post-mortem brain fragments (20%), sperm (males; 36.4%) and egg cells (females; 39.6%). A factor analysis revealed four sociocultural categories of donated tissues: irrelevant, redundant, ordinary and sensitive. Based on these sociocultural categories of tissues, four types of donors were identified: reluctant, highly cooperative, average cooperative and selectively cooperative. The willingness to donate human samples for research is shaped by the sociocultural perception of different body parts and tissues. The lower the sense of “personal relationship” with a specific type of tissue, organ or part of the body, the higher the motivation to donate such biological material for research purposes. Additionally, the willingness to donate is mostly shaped by social trust in physicians and scientists, and potential donors’ engagement in charity activities.
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Affiliation(s)
- Anita Majchrowska
- Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
| | - Michał Wiechetek
- Institute of Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Jan Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, Poznań, Poland
- *Correspondence: Jan Domaradzki,
| | - Jakub Pawlikowski
- Chair and Department of Humanities and Social Medicine, Medical University of Lublin, Lublin, Poland
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12
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Majchrowska A, Wiechetek M, Domaradzki J, Pawlikowski J. Social differentiation of the perception and human tissues donation for research purposes. Front Genet 2022; 13. [DOI: http:/doi.org/10.3389/fgene.2022.989252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023] Open
Abstract
The willingness to donate human biological material for research purposes is shaped by socio-cultural factors; however, there is a lack of studies analysing the social perception of different human tissues, which may affect such willingness. This study aimed to distinguish different sociocultural categories of human tissues and types of potential donors based on their willingness to donate material. Quantitative research was conducted on a sample of 1,100 adult Poles representative in terms of sex, place of residence and education. According to the study, people were most willing to donate urine (73.9%), blood (69.7%), hair and tears (69.6%) and the least willing to donate post-mortem brain fragments (20%), sperm (males; 36.4%) and egg cells (females; 39.6%). A factor analysis revealed four sociocultural categories of donated tissues: irrelevant, redundant, ordinary and sensitive. Based on these sociocultural categories of tissues, four types of donors were identified: reluctant, highly cooperative, average cooperative and selectively cooperative. The willingness to donate human samples for research is shaped by the sociocultural perception of different body parts and tissues. The lower the sense of “personal relationship” with a specific type of tissue, organ or part of the body, the higher the motivation to donate such biological material for research purposes. Additionally, the willingness to donate is mostly shaped by social trust in physicians and scientists, and potential donors’ engagement in charity activities.
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13
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Padoan CS, Garcia LF, Crespo KC, Longaray VK, Martini M, Contessa JC, Kapczinski F, de Oliveira FH, Goldim JR, Vs Magalhães P. A qualitative study exploring the process of postmortem brain tissue donation after suicide. Sci Rep 2022; 12:4710. [PMID: 35304551 PMCID: PMC8933424 DOI: 10.1038/s41598-022-08729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Access to postmortem brain tissue can be valuable in refining knowledge on the pathophysiology and genetics of neuropsychiatric disorders. Obtaining postmortem consent for the donation after death by suicide can be difficult, as families may be overwhelmed by a violent and unexpected death. Examining the process of brain donation can inform on how the request can best be conducted. This is a qualitative study with in-depth interviews with forty-one people that were asked to consider brain donation-32 who had consented to donation and 9 who refused it. Data collection and analyses were carried out according to grounded theory. Five key themes emerged from data analysis: the context of the families, the invitation to talk to the research team, the experience with the request protocol, the participants' assessment of the experience, and their participation in the study as an opportunity to heal. The participants indicated that a brain donation request that is respectful and tactful can be made without adding to the family distress brought on by suicide and pondering brain donation was seen as an opportunity to transform the meaning of the death and invest it with a modicum of solace for being able to contribute to research.
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Affiliation(s)
- Carolina Stopinski Padoan
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
| | - Lucas França Garcia
- Graduate Program in Health Promotion, Cesumar University, Maringá, Paraná, Brazil
| | - Kleber Cardoso Crespo
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
| | - Vanessa Kenne Longaray
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
| | - Murilo Martini
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
| | - Júlia Camargo Contessa
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
| | - Flávio Kapczinski
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
- St. Joseph's Healthcare Hamilton McMaster University, Hamilton, ON, Canada
| | - Francine Hehn de Oliveira
- Serviço de Patologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - José Roberto Goldim
- Bioethics Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pedro Vs Magalhães
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Centro de Pesquisa Clínica, Faculty of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil.
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14
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Moloney G, Sutherland M, Upcroft L, Clark R, Punjabi-Jagdish P, Rienks S, Bowling A, Walker I. Respect, interaction, immediacy and the role community plays in registering an organ donation decision. PLoS One 2022; 17:e0263096. [PMID: 35081162 PMCID: PMC8791491 DOI: 10.1371/journal.pone.0263096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Registering a donation decision is fundamental to increasing the number of people who donate the organs and tissues essential for transplantation, but the number of registered organ donors is insufficient to meet this demand. Most people in Australia support organ donation, but only a third have registered their decision on the Australian Organ Donor Register (AODR). We addressed this paradox by investigating how feelings of community, engendered through an ethic of hospitality and care and a non-proselytizing dialogue about organ donation, facilitated the decision to register. Methods An Immediate Registration Opportunity was set up in a large public hospital in NSW, Australia. The public was approached and invited to engage in an open, respectful dialogic interaction that met people where their beliefs were and allowed their concerns and fears about donation to be discussed. This included a survey that measured positive and negative beliefs about organ donation, mood, atmosphere, and feelings of community coupled with an on-the-spot opportunity to register their donation decision. Results Over four days, we interacted with 357 participants; 75.5% (210) of eligible-to-register participants registered on the AODR. Generalized Structural Equation Modelling highlighted that as connection to community increased, so did the salience of positive beliefs about organ donation. Positive beliefs, in turn, were negatively correlated with negative beliefs about donation and, as the strength of negative beliefs decreased, the probability of registration on the AODR increased. Participants who registered on the AODR reported stronger connection to the broader community than participants who did not register. Conclusion A respectful non-judgmental interaction that allows beliefs and concerns about organ donation to be discussed, coupled with an immediate opportunity to register, encouraged registration. Within this framework, feelings of belonging to a community were a key determinant that enabled many to make the decision to register.
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Affiliation(s)
- Gail Moloney
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
- * E-mail:
| | - Michael Sutherland
- Intensive Care Unit, Mid North Coast Local Health District, NSW, Australia
| | - Leah Upcroft
- NSW Organ and Tissue Donation Service, South Eastern Sydney Local Health District, NSW Australia
| | - Rachel Clark
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Parul Punjabi-Jagdish
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Suzanne Rienks
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Alison Bowling
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Iain Walker
- Research School of Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
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15
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Gonen LD, Bokek-Cohen Y, Azuri P, Tarabeih M. Differential Willingness to Pay for Kidney Transplantation From Living and Deceased Donors: Empirical Study Among End-Stage Kidney Disease (ESKD) Patients. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221139368. [PMID: 36484339 DOI: 10.1177/00469580221139368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Kidney transplantation has developed to the stage where it is currently the most cost-effective treatment for patients suffering from end-stage kidney disease (ESKD) and, when available, offers them the highest quality of life. Yet, kidney transplantation is challenged by cultural and traditional beliefs; thus, this study sought to evaluate the willingness to pay for a kidney transplant in a culturally sensitive population. A self-administered survey was completed by 734 end-stage kidney disease (ESKD) patients. A quantitative method and survey design were chosen and employed descriptive, correlational, nonparametric, and multivariate statistical tests. Participants were willing to pay a mean amount of $40 751.36 for a living donor kidney transplant, whereas the mean is considerably lower, $18 350.51, for a deceased donor kidney. Significant predictors of the willingness to pay (WTP) for a kidney transplant from a living donor and a deceased donor were found, among them: religiosity and ethnicity. The participants' willingness to pay for a kidney transplant could attest to significant benefits in enhancing patient well-being. The willingness to pay differentially for a donation from a deceased or a living donor stems from the higher chances of success with a living-donor organ as well as from moral and religious motives. In Israel kidney transplantation is not tradable in the free market and is fully funded by the state. The average cost of kidney transplantation in Israel is $61 714.50. Since the cost exceeds the utility and since the economic literature suggests that the funding of healthcare interventions should be provided up to the point where the costs of that funding equal the benefits that society derives from it, crucial revisions in public health policy should be made. Education may have a significant impact on the approach to kidney donation and organ donation in general.
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Affiliation(s)
- Limor Dina Gonen
- Department of Economics and Business Administration, Ariel University, Ariel, Israel
| | - Ya'arit Bokek-Cohen
- Department of behavioral sciences, Academic College of Israel, Ramat-Gan, Israel
| | - Pazit Azuri
- Tel Aviv-Yafo Academic College, Tel Aviv, Israel
| | - Mahdi Tarabeih
- School of Nursing Science, Tel Aviv-Yafo Academic College, Tel Aviv, Israel
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16
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Hyde MK, Masser BM, Edwards ARA, Ferguson E. Australian Perspectives on Opt-In and Opt-Out Consent Systems for Deceased Organ Donation. Prog Transplant 2021; 31:357-367. [PMID: 34806919 DOI: 10.1177/15269248211046023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: As many countries change to opt-out systems to address organ shortages, calls for similar reform in Australia persist. Community perspectives on consent systems for donation remain under-researched, therefore Australian perspectives on consent systems and their effectiveness in increasing donation rates were explored. Design: In this descriptive cross-sectional study, participants completed a survey presenting opt-in, soft opt-out, and hard opt-out systems, with corresponding descriptions. Participants chose the system they perceived as most effective and described their reasoning. Results: Participants (N = 509) designated soft opt-out as the most effective system (52.3%; hard opt-out 33.7%; opt-in 13.7%). Those who identified with an ethnic/cultural group or were not registered had greater odds of choosing opt-out. Six themes identified in thematic analysis reflected their reasoning: (1) who decides (individual, shared decision with family); (2) right to choose; (3) acceptability (ethics, fairness); and utility in overcoming barriers for (4) individuals (apathy, awareness, ease of donating, fear/avoidance of death); (5) family (easier family experience, family veto); (6) society (normalizing donation, donation as default, expanding donor pool). Choice and overcoming individual barriers were more frequently endorsed themes for opt-in and opt-out, respectively. Discussion: Results suggested the following insights regarding system effectiveness: uphold/prioritize individual's recorded donation decision above family wishes; involve family in decision making if no donation preference is recorded; retain a register enabling opt-in and opt-out for unequivocal decisions and promoting individual control; and maximize ease of registering. Future research should establish whether systems considered effective are also acceptable to the community to address organ shortages.
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Affiliation(s)
- Melissa K Hyde
- 1974The University of Queensland, Brisbane, QLD, Australia
| | - Barbara M Masser
- 1974The University of Queensland, Brisbane, QLD, Australia.,Australian Red Cross Lifeblood, Sydney, NSW, Australia
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17
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Yee E, Hosseini SM, Duarte B, Knapp SM, Carnes M, Young B, Sweitzer NK, Breathett K. Sex Disparities in Organ Donation: Finding an Equitable Donor Pool. J Am Heart Assoc 2021; 10:e020820. [PMID: 34558313 PMCID: PMC8649146 DOI: 10.1161/jaha.121.020820] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background The majority of living organ donors are women, but few are deceased organ donors, which increases risks associated with sex mismatched organs. We sought to identify reasons for sex disparities in organ donation and strategies for equity. Methods and Results Using Amazon's Mechanical Turk, we examined US adults' perceptions regarding donation in a mixed‐methods survey study. Results were compared by sex with Fisher's exact test and T‐tests for quantitative results and qualitative descriptive analyses for write‐in responses. Among 667 participants (55% women), the majority of men (64.8%) and women (63.4%) self‐identified as registered donors. Women's willingness to donate their own organs to family members (P=0.03) or strangers (P=0.03) was significantly higher than men. Donors from both sexes were guided by: desire to help, personal experience, and believing organs would be useless to deceased donors. Non‐donors from both sexes were guided by: no reason, medical mistrust, contemplating donation. When considering whether to donate organs of a deceased family member, women were equally guided by a family member's wishes and believing the family member had no further use for organs. Men had similar themes but valued the family member's wishes more. Among non‐donors, both sexes would consider donation if more information was provided. Conclusions In a national survey, both sexes had similar reasons for becoming and not becoming an organ donor. However, compared with men, women were more willing to donate their organs to family members and strangers. Improving education and communicating wishes regarding organ donation with direct relatives may increase sex equity in deceased organ donation.
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Affiliation(s)
- Erika Yee
- School of Medicine and Sarver Heart Center Clinical Research Office University of Arizona Tucson AZ
| | | | | | - Shannon M Knapp
- Statistics Consulting Lab Bio5 InstituteUniversity of Arizona Tucson AZ
| | - Molly Carnes
- Department of Medicine University of Wisconsin Madison WI
| | - Bessie Young
- Division of Nephrology Department of Medicine University of Washington Seattle WA
| | - Nancy K Sweitzer
- Division of Cardiology Department of Medicine Sarver Heart Center University of Arizona Tucson AZ
| | - Khadijah Breathett
- Division of Cardiology Department of Medicine Sarver Heart Center University of Arizona Tucson AZ
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18
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Heitland L, von Hirschhausen E, Fischer F. Effects of humorous interventions on the willingness to donate organs: a quasi-experimental study in the context of medical cabaret. BMC Public Health 2020; 20:288. [PMID: 32131795 PMCID: PMC7057630 DOI: 10.1186/s12889-020-8400-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background It has been shown that fears and misconceptions negatively affect the willingness to donate organs. Empirical studies have examined health communication strategies that serve to debunk these fears. There are promising indications that humor has the potential to influence health-related attitudes and behaviors. This study examines empirically whether medical cabaret, as a specific format for delivering health-related information in a humorous way, affects the willingness to donate organs. Methods A quasi-experimental study was conducted among the audience of a medical cabaret live show. Participants in two intervention groups and one control group were interviewed just before the start of the live show (t0) and about 6 weeks later (t1). Intervention group 1 (I1) witnessed a ten-minute sequence by the cabaret artist about organ donation. Participants in I2 witnessed the sequence and, in addition, received an organ donor card. Descriptive statistics and t-tests were used to investigate changes in attitudes and the willingness to donate organs from t0 to t1. Results A significant increase in the willingness to donate organs and an improvement in general attitude was observed in the intervention groups. Moreover, significantly more participants in I2 carried an organ donor card after the intervention. Some fears could be reduced, while understanding of the reasons for organ donation could be increased via the intervention. Conclusions The study confirms that medical cabaret is able to affect respondents’ attitudes and behaviors even in the context of organ donation. Medical cabaret can enhance the willingness to donate organs and dispel negative concerns.
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Affiliation(s)
- Lisa Heitland
- Bielefeld University, School of Public Health, P.O. Box 100 131, 33501, Bielefeld, Germany
| | | | - Florian Fischer
- Bielefeld University, School of Public Health, P.O. Box 100 131, 33501, Bielefeld, Germany.
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19
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Cignarella A, Redley B, Bucknall T. Organ donation within the intensive care unit: A retrospective audit. Aust Crit Care 2020; 33:167-174. [DOI: 10.1016/j.aucc.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/18/2018] [Accepted: 12/28/2018] [Indexed: 10/27/2022] Open
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20
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Sakallı GD, Sucu Dağ G. Organ Transplantation and Donation From the Point of View of College Students. Transplant Proc 2020; 52:26-31. [PMID: 31901318 DOI: 10.1016/j.transproceed.2019.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 11/02/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The organ transplantation saves the life of individuals whose life is in danger due to organ/tissue failure. The presence of negative and positive attitudes toward tissue and organ donation is a determinant factor in the donation of tissue and organ donation. PURPOSE This study has aimed to explore the opinion of senior students studying at the undergraduate level toward organ transplantation and donation. BASIC PROCEDURE The study employed a descriptive and cross-sectional research design using a reliable questionnaire, which was distributed among 317 undergraduate students at the Faculty of Health Sciences (Physiotherapy and Rehabilitation, Nutrition, Nursing, Sports Sciences, Health Management Department) during the fall semester of the 2016-2017 academic year. A total of 240 responses were analyzed using χ2 test with SPSS software. MAIN FINDINGS The results of the study showed that 57.4% of the students were willing to donate their organs after their death, 62.7% of the students' relatives wanted to donate their organs, 57.3% were willing to donate it to their deceased relatives, whereas 96.7% did not have any relative waiting for a transplantation. Families' negative opinions on tissue and organ transplantation and donation, status of getting information about tissue and organ transplantation and donation, and presence of a person waiting for tissue and organ transplantation in the family or in the environment were not effective in students' opinions about tissue and organ transplantation and donation (P > .05). PRINCIPAL CONCLUSIONS The results of this study contribute to determination of multicultural features of health sciences students that are likely to affect organ donation.
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Affiliation(s)
- Gülcan Dürüst Sakallı
- Nursing Department, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, Turkey
| | - Gülten Sucu Dağ
- Nursing Department, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, Turkey.
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21
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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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22
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Miller J, Currie S, O'Carroll RE. 'If I donate my organs it's a gift, if you take them it's theft': a qualitative study of planned donor decisions under opt-out legislation. BMC Public Health 2019; 19:1463. [PMID: 31694604 PMCID: PMC6836540 DOI: 10.1186/s12889-019-7774-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 10/14/2019] [Indexed: 11/25/2022] Open
Abstract
Background There is a worldwide shortage of donor organs for transplantation. To overcome this, several countries have introduced an opt-out donor consent system. This system, soon planned for Scotland and England means individuals are automatically deemed to consent for organ donation unless they register an opt-out decision. This study was designed to explore the reasons underpinning donor choices for people who plan to actively opt-in to the register, take no action and be on the register via deemed consent, opt-out, and those who are unsure of their decision. Methods This study reports the analysis of free-text responses obtained from a large survey of intentions towards opt-out legislation in Scotland, England and Northern Ireland (n = 1202). Of the n = 1202 participants who completed the questionnaire, n = 923 provided a free text response explaining their views. Thematic analysis was used to explore the reasons why participants plan to: opt-in (n = 646), follow deemed consent (n = 205), opt-out (n = 32) and those who were not sure (n = 40). Results A key theme for people planning to opt-in is that it ensures one’s donor choice is explicitly clear and unequivocal. Some regarded deemed consent as unclear and open to ambiguity, thus actively opting-in was viewed as a way of protecting against family uncertainty and interference. For the deemed consent group, a key theme is that it represents a simple effortless choice. This is important from both a pragmatic time-saving point of view and because it protects ambivalent participants from making a challenging emotive choice about organ donation. Key themes for those planning to opt-out relate to fears around medical mistrust and bodily integrity. Notably, both participants who plan to opt-out and opt-in perceived presumed consent as “authoritarian” and a method of increasing Government control of organs. In response, registering an active decision protected their freedom of choice. Conclusions The findings highlight the importance of registering deliberate active consent for people who choose opt-in, due to concerns over possible family refusal under deemed consent. These findings could inform the development of communication campaigns that encourage family communication before the implementation of opt-out legislation.
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Affiliation(s)
- Jordan Miller
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland.
| | - Sinéad Currie
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland
| | - Ronan E O'Carroll
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland
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23
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Mahat-Shamir M, Hamama-Raz Y, Leichtentritt RD. Body Perception and Organ Donation: Bereaved Parents' Perspectives. QUALITATIVE HEALTH RESEARCH 2019; 29:1623-1633. [PMID: 31140363 DOI: 10.1177/1049732319848405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The view of the body in sociological, psychological, and gender studies may be broadly summarized to three metaphors: (a) the body as a machine, (b) the body as Self, and (c) the body as sacred and sanctified entity. Each of these philosophical views has an impact on organ donation. The current study aimed at revealing body perception of bereaved Israeli parents who agreed to donate organs of their deceased child. A deductive and inductive thematic analysis captured an ongoing perceptual change that bereaved donor parents experienced in their view of the child's body. Parents' ability to move between two positions (the body as Self, the body as a machine) allowed them to agree with and protect their decision to donate as well as to maintain an ongoing bond with their deceased child. The view of the body as scared entity was not evident in the bereaved parents' narratives.
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24
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Cho Y, Sautenet B, Gutman T, Rangan G, Craig JC, Ong AC, Chapman A, Ahn C, Coolican H, Kao JT, Gansevoort R, Perrone RD, Harris T, Torres V, Pei Y, Kerr PG, Ryan J, Johnson DW, Viecelli AK, Geneste C, Kim H, Kim Y, Oh YK, Teixeira‐Pinto A, Logeman C, Howell M, Ju A, Manera KE, Tong A. Identifying patient‐important outcomes in polycystic kidney disease: An international nominal group technique study. Nephrology (Carlton) 2019; 24:1214-1224. [DOI: 10.1111/nep.13566] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Yeoungjee Cho
- Department of NephrologyPrincess Alexandra Hospital
- Australasian Kidney Trials NetworkUniversity of Queensland
- Translational Research Institute Brisbane Queensland Australia
| | - Benedicte Sautenet
- Department of Nephrology Hypertension, Dialysis, Kidney TransplantationTours Hospital, SPHERE – INSERM 1246, University of Tours and Nantes Tours France
| | - Talia Gutman
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
| | - Gopala Rangan
- Centre for Transplant and Renal Research, Westmead Institute for Medical ResearchThe University of Sydney
- Department of Renal Medicine, Westmead HospitalWestern Sydney Local Health District Sydney New South Wales Australia
| | - Jonathan C Craig
- College of Medicine and Public HealthFlinders University Adelaide South Australia Australia
| | - Albert C Ong
- Academic Nephrology Unit, Department of Infection Immunity & Cardiovascular DiseaseUniversity of Sheffield Sheffield UK
| | - Arlene Chapman
- Department of MedicineThe University of Chicago Chicago Illinois USA
| | - Curie Ahn
- Division of NephrologySeoul National University Hospital Seoul South Korea
| | - Helen Coolican
- Polycystic Kidney Disease Foundation of Australia Sydney Australia
| | - Juliana T‐W Kao
- School of MedicineFu Jen Catholic University and Fu Jen Catholic University Hospital
- Department of Internal MedicineNational Taiwan University Hospital Taipei Taiwan
| | - Ron Gansevoort
- Faculty of Medical SciencesUniversity Medical Center Gronigen Gronigen the Netherlands
| | - Ronald D Perrone
- Division of Nephrology, Tufts Medical CenterTufts University School of Medicine Boston Massachusetts US
| | - Tess Harris
- Polycystic Kidney Disease International London UK
| | - Vicente Torres
- Department of Nephrology and HypertensionMayo Clinic Rochester Minnestota USA
| | - York Pei
- Division of Nephrology and Division of Genomic MedicineUniversity of Toronto Toronto Canada
| | - Peter G Kerr
- Department of NephrologyMonash Medical Centre and Monash University Melbourne Victoria Australia
| | - Jessica Ryan
- Department of NephrologyMonash Medical Centre and Monash University Melbourne Victoria Australia
| | - David W Johnson
- Department of NephrologyPrincess Alexandra Hospital
- Australasian Kidney Trials NetworkUniversity of Queensland
- Translational Research Institute Brisbane Queensland Australia
| | | | - Claire Geneste
- Department of Nephrology Hypertension, Dialysis, Kidney TransplantationTours Hospital, SPHERE – INSERM 1246, University of Tours and Nantes Tours France
| | - Hyunsuk Kim
- Division of NephrologySeoul National University Hospital Seoul South Korea
| | - Yaerim Kim
- Division of NephrologySeoul National University Hospital Seoul South Korea
| | - Yun Kyu Oh
- Division of NephrologySeoul National University Hospital Seoul South Korea
| | - Armando Teixeira‐Pinto
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
| | - Charlotte Logeman
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
| | - Martin Howell
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
| | - Angela Ju
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
| | - Karine E Manera
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
| | - Allison Tong
- Sydney School of Public HealthThe University of Sydney Sydney New South Wales Australia
- Centre for Kidney ResearchThe Children's Hospital at Westmead
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25
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Systematic Review of Public Preferences for the Allocation of Donor Organs for Transplantation: Principles of Distributive Justice. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2019; 12:475-489. [DOI: 10.1007/s40271-019-00363-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Keel I, Schürch R, Weiss J, Zwahlen M, Immer FF. Is there an association between consent rates in Swiss hospitals and critical care staffs' attitudes towards organ donation, their knowledge and confidence in the donation process? PLoS One 2019; 14:e0211614. [PMID: 30735508 PMCID: PMC6368376 DOI: 10.1371/journal.pone.0211614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 01/17/2019] [Indexed: 11/19/2022] Open
Abstract
This study investigated the critical care staff’s attitude, knowledge and involvement with donation, skills and confidence with donation-related tasks and their association with consent rates at the hospital level. In 2015, we conducted a cross-sectional survey among critical care staff of hospitals involved in organ donation using an anonymous online questionnaire with a response rate of 56.4% (n = 2799). The hospital level consent rate was obtained from the Swiss Monitoring of Potential Donors database (2013–2015). For each hospital, we calculated a mean score for each predictor of interest of the Hospital Attitude Survey and investigated the association with hospital consent rates with generalized linear mixed-effect models. In univariable analysis, one score point increase in doctors' confidence resulted in a 66% (95% CI: 45%–80%) reduction in the odds to consent, and one score point increase in nurses' attitudes resulted in a 223% (95% CI: 84%–472%) increase in the odds to consent. After simultaneously adjusting for all major predictors found in the crude models, only levels of education of medical and nursing staff remained as significant predictors for hospital consent rates. In Switzerland, efforts are needed to increase consent rates for organ donation and should concentrate on continuous support as well as specific training of the hospital staff involved in the donation process.
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Affiliation(s)
- Isabelle Keel
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Roger Schürch
- CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Julius Weiss
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Franz F. Immer
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
- * E-mail:
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Vorstius Kruijff PE, Witjes M, Jansen NE, Slappendel R. Barriers to Registration in the National Donor Registry in Nations Using the Opt-In System: A Review of the Literature. Transplant Proc 2018; 50:2997-3009. [PMID: 30577159 DOI: 10.1016/j.transproceed.2018.01.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND To increase the number of postmortem organ and tissue donors, donor registries (DRs) have been introduced. The aim of this review was to understand why people in nations with an Opt-in system, who are for or against donation after death, do not register in the DR. Knowing these barriers will help in developing policies to increase the registration rate in the DR. METHODS For this review, 2 authors independently assessed the eligibility of the identified studies from 2000 to 2015 in the Pubmed- Medline database. Included were observational and interventional studies concerned with reported barriers to residents joining the national DR in Denmark, The Netherlands, and the United Kingdom. RESULTS We included 15 relevant articles for the review. The main barriers to signing the DR in nations using the Opt-in system were: religion; medical mistrust, anxiety, and affective emotions; lack of information; concern about insufficient time to mourn, and that the funeral may be delayed and the deceased not look presentable; physical integrity; ignorance about how to register in the DR; own benefit; and social status. CONCLUSIONS The outcome suggests that the main barriers to enrolling in the DR are based on people's doubts about their own ability to perform the registration and cope with the consequences, knowledge, outcome expectations, and concerns about what others will think of them for agreeing to donation. However, not all barriers are easily modifiable, owing to their association with affect or emotions.
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Affiliation(s)
- P E Vorstius Kruijff
- Department of Quality and Safety, Amphia Teaching Hospital, Breda, The Netherlands.
| | - M Witjes
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Organ Procurement, Dutch Transplant Foundation, Leiden, The Netherlands
| | - N E Jansen
- Department of Organ Procurement, Dutch Transplant Foundation, Leiden, The Netherlands
| | - R Slappendel
- Department of Anesthesia, University of Antwerp, Antwerpen, Belgium
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Harrison TG, Tam-Tham H, Hemmelgarn BR, James MT, Sinnarajah A, Thomas CM. Identification and Prioritization of Quality Indicators for Conservative Kidney Management. Am J Kidney Dis 2018; 73:174-183. [PMID: 30482578 DOI: 10.1053/j.ajkd.2018.08.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/29/2018] [Indexed: 01/28/2023]
Abstract
RATIONALE & OBJECTIVE Conservative kidney management is holistic patient-centered care for patients with kidney failure that focuses on delaying the progression of kidney disease and symptom management, without the provision of renal replacement therapy. Currently there is no consensus as to what constitutes high-quality conservative kidney management. We aimed to develop a set of quality indicators for the conservative management of kidney failure. STUDY DESIGN Nominal group technique and Delphi survey process. SETTING & PARTICIPANTS 16 patients and caregivers from Calgary, Canada, participated in 2 nominal group meetings. 91 multidisciplinary health care professionals from 10 countries took part in a Delphi process. ANALYTICAL APPROACH Nominal group technique study of patients and caregivers was used to identify and prioritize a list of quality indicators. A 4-round Delphi process with health care professionals was used to rate the quality indicators until consensus was reached (defined as a mean rating on the Likert scale ≥7.0 and percent agreement >75%). Quality indicators that met criteria for consensus inclusion in the Delphi survey were ranked, and comparisons were made with nominal group priorities. RESULTS 99 quality indicators met consensus criteria for inclusion. The most highly rated quality indicator in the Delphi process was the "percentage of patients that die in the place they desire." There was significant discordance between priorities of the nominal groups with that of the Delphi survey, with only 1 quality indicator being shared on each groups' top 10 list of quality indicators. LIMITATIONS Participants were largely from high-income English-speaking countries, and most already had structured conservative kidney management programs in place, all potentially limiting generalizability. CONCLUSIONS Quality of conservative kidney management care is important to patients, caregivers, and health care professionals. However, discordant quality indicator priorities between groups suggested that care providers delivering conservative kidney management may not prioritize what is most important to those receiving this care. Conservative kidney management programs and health care providers can improve the applicability of this consensus-based quality indicator list to their program by further developing and evaluating it for use in their program.
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Affiliation(s)
- Tyrone G Harrison
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Helen Tam-Tham
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Brenda R Hemmelgarn
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Matthew T James
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Aynharan Sinnarajah
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Chandra M Thomas
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Oedingen C, Bartling T, Krauth C. Public, medical professionals' and patients' preferences for the allocation of donor organs for transplantation: study protocol for discrete choice experiments. BMJ Open 2018; 8:e026040. [PMID: 30337317 PMCID: PMC6196962 DOI: 10.1136/bmjopen-2018-026040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Organ transplantation is the treatment of choice for patients with severe organ failure. Nevertheless, donor organs are a scarce resource resulting in a large mismatch between supply and demand. Therefore, priority-setting leads to the dilemma of how these scarce organs should be allocated and who should be considered eligible to receive a suitable organ. In order to improve the supply-demand mismatch in transplantation medicine, this study explores preferences of different stakeholders (general public, medical professionals and patients) for the allocation of donor organs for transplantation in Germany. The aims are (1) to determine criteria and preferences, which are relevant for the allocation of scarce donor organs and (2) to compare the results between the three target groups to derive strategies for health policy. METHODS AND ANALYSIS We outline the study protocol for discrete choice experiments, where respondents are presented with different choices including attributes with varied attribute levels. They were asked to choose between these choice sets. First, systematic reviews will be conducted to identify the state of art. Subsequently, focus group discussions with the public and patients as well as expert interviews with medical professionals will follow to establish the attributes that are going to be included in the experiments and to verify the results of the systematic reviews. Using this qualitative exploratory work, discrete choice studies will be designed to quantitatively assess preferences. We will use a D-efficient fractional factorial design to survey a total sample of 600 respondents according to the public, medical professionals and patients each. Multinomial conditional logit model and latent class model will be analysed to estimate the final results. ETHICS AND DISSEMINATION This study has received Ethics Approval from the Hannover Medical School Human Ethics Committee (Vote number: 7921_BO_K_2018). Findings will be disseminated through conference presentations, workshops with stakeholders and peer-reviewed journal articles.
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Affiliation(s)
- Carina Oedingen
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover, Germany
| | - Tim Bartling
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover, Germany
| | - Christian Krauth
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover, Germany
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Complexity of Organ Donation Registration: Determinants of Registration Behavior Among Lower-educated Adolescents. Transplant Proc 2018; 50:2911-2923. [PMID: 30577148 DOI: 10.1016/j.transproceed.2018.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/19/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Registration rates are low for organ donation among lower educated adolescents in The Netherlands. This could be improved by preparing them for making a decision regarding donation when they become 18 years old. To do so, more insight is needed into their beliefs about organ donation and registration. METHODS A cross-sectional quantitative study was conducted among students in intermediate vocational education schools. Data were gathered my means of self-administrated questionnaires. The outcome measurements included current registration status, being an organ donor, intention to register, and intention to become a donor. Correlation coefficients were used to assess the strength of associations between beliefs and each of the 4 outcome measurements. RESULTS A total of 405 participants (mean age, 18.86 years) were included, of whom 26.6% had already registered a decision. Most beliefs showed a significant correlation with one or more of the outcomes. In general, the correlations were of small to medium size and participants scored around the middle of the scales on the beliefs. CONCLUSION Means and correlations need to be combined to gain insight into the importance of certain beliefs for future interventions. However, it is plausible that, in addition to these explicit beliefs, implicit factors play a role in registration behavior. This could be explored in future research. Results could support intervention development for increasing registration rates.
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Wongboonsin K, Jindahra P, Teerakapibal S. The Influence of Neighbor Effect and Urbanization Toward Organ Donation in Thailand. Prog Transplant 2017; 28:49-55. [PMID: 29243539 DOI: 10.1177/1526924817746684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Toward population wellness, an extreme scarcity of organ supply is proven to be an enormous hindrance. Preferences toward organ donation are vital to raise the organ donation rate. Notably, the area people live in can address the social influence on individual preference toward organ donation. RESEARCH QUESTIONS This article studies the impact of the neighbor effect on organ donation decisions, addressing the social influence of urbanization on preferences. How neighborhood-specific variables, population density, and socioeconomic status drive the neighbor effect is investigated. The pursuit of organ donor traits is to be answered. DESIGN The study uses organ donation interview survey data and neighborhood-specific data from Thailand to estimate a series of logistic regression models. RESULTS Individuals residing in urban areas exhibit a greater likelihood to sign the donor card than those in rural areas. The neighborhood socioeconomic status is the key driver. An individual is more willing to be an organ donor when having neighbors with higher socioeconomic statuses. Results also reveal positive influences of males and education on the organ donation rate. DISCUSSION This article documents the "neighbor effect" on the organ donation decision via living area type, offering an alternative exposition in raising the organ donation rate. In shifting the society norm toward organ donation consent, policy-makers should acknowledge the benefit of urbanization on organ donation decision derived from resourceful urban areas. Moreover, raising education levels does improve not only citizens' well-being but also their tendency to exhibit an altruistic act toward others.
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Affiliation(s)
- Kua Wongboonsin
- 1 Sasin Graduate Institute of Business Administration, Chulalongkorn University, Bangkok, Thailand
| | - Pavitra Jindahra
- 2 Sasin Graduate Institute of Business Administration, Chulalongkorn University, Bangkok, Thailand
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Schmidt S, Schulte A, Schwarz S, Hofmann N, Tietz S, Boergel M, Sixt SU. [Attitude towards organ and tissue donation in Europe : Prerequisite for osteochondral allograft treatment]. Unfallchirurg 2017; 120:927-931. [PMID: 28956078 DOI: 10.1007/s00113-017-0416-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The biggest obstacle to overcome for routine treatment of various pathologies with fresh osteochondral allograft is the availability of tissue for transplantation. Large fresh osteochondral allografts are usually harvested from organ donors, but in contrast to organs, tissues can be procured after cardiac arrest. OBJECTIVE Medical staff as well the general public are much less aware of the possibilities and requirements of tissue donation compared to organ donation. This review aims to highlight the current situation of organ and tissue donation in Europe and to raise this much needed awareness. MATERIAL AND METHODS For this research, PubMed database was scanned using the terms "tissue/organ donation", "bone donation/transplantation", "cartilage transplantation/allografts" and "osteochrondral allografts". RESULTS Relatives of potential donors are often not approached because physicians and nurses do not feel sufficiently prepared for this task and, thus, are reluctant to address this topic. Different options could alleviate the pressure medical staff is feeling. Furthermore, there are different factors influencing consent that can be addressed to increase donation rates. CONCLUSION Currently, a lot of potential concerning musculoskeletal tissue grafts remains unused. Most importantly, families should be encouraged to speak about their potenzial will to donate and educational programs should be established to increase trust in organ and tissue donation and the allocation system and to increase knowledge about the importance of transplantation medicine. But joined efforts of different parts of the medical systems and different organizations involved in tissue transplantation should improve the situation for patients waiting for much needed transplants.
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Affiliation(s)
- S Schmidt
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland.
| | - A Schulte
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland
| | - S Schwarz
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland
| | - N Hofmann
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland
| | - S Tietz
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland
| | - M Boergel
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland
| | - S U Sixt
- Deutsche Gesellschaft für Gewebetransplantation, Feodor-Lynen-Str. 21, 30625, Hannover, Deutschland
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Pauli J, Basso K, Ruffatto J. The influence of beliefs on organ donation intention. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2017. [DOI: 10.1108/ijphm-08-2016-0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Recent technological developments in healthcare have enabled an increased number of organ transplantation surgeries. At the same time, there is an increase in the number of people awaiting organ transplant, coupled with the difficulty in donation. To bridge this gap, this study aims to propose to evaluate the effect of three types of beliefs (clinical beliefs, financial incentive beliefs and beliefs on the social benefits of altruism and solidarity) on the intention to donate organs. Moreover, this paper uses the attitudes in relation to donation to explain the effect of these beliefs on the intention to donate organs.
Design/methodology/approach
The research was conducted using a survey of 422 Brazilian participants and a mediation analysis to test the mediation hypotheses.
Findings
The results suggest that the effect of three types of beliefs (clinical, economic order and social solidarity) influence the intention to donate organs indirectly through the formation of attitudes concerning organ donation.
Research limitations/implications
This article contributes to the understanding of the formation of organ donation intentions and the role of different types of beliefs in the formation of such intentions.
Originality/value
The findings extend the discussions regarding the role of beliefs in the formation of attitudes and intentions of organ donation and have significant value in creating public policies that further promote organ donation.
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Cunningham S. Evaluating a nursing erasmus exchange experience: Reflections on the use and value of the Nominal Group Technique for evaluation. Nurse Educ Pract 2017; 26:68-73. [DOI: 10.1016/j.nepr.2017.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 12/21/2016] [Accepted: 07/11/2017] [Indexed: 11/28/2022]
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Schmidt S, Schulte A, Schwarz S, Hofmann N, Tietz S, Boergel M, Sixt SU. Fresh osteochondral allografts-procurement and tissue donation in Europe. Injury 2017; 48:1296-1301. [PMID: 28551055 DOI: 10.1016/j.injury.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Fresh osteochondral allografts are a well-established treatment for large, full-thickness cartilage defects. The clinical outcome for carefully selected patients is very favorable, especially for the young and active and graft survival up to 25 years has been described in the literature. Furthermore, a high patient satisfaction rate has been reported, but the biggest obstacle to overcome is the availability of tissue for transplantation. Large fresh bone allografts for cartilage damage repair only can be harvested from organ donors following organ removal or cadaveric donors, preferably in the setting of an operation room to minimize possible contamination of the tissue. Apart from the logistic challenges this entails, an experienced recovery team is needed. Furthermore, the public as well as medical staff is much less aware of the possibility and requirements of tissue donation than organ donation and families of deceased are rarely approached for bone and cartilage donation. This review aims to highlight the current situation of organ and tissue donation in Europe with special focus on the processing of bones and possible safety and quality concerns. We analyze what may prevent consent and what might be done to improve the situation of tissue donation.
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Affiliation(s)
- S Schmidt
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany.
| | - A Schulte
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S Schwarz
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - N Hofmann
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S Tietz
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - M Boergel
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S U Sixt
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany; Clinic for Anesthesiology, University Hospital of Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
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36
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Tong A, Sautenet B, Chapman JR, Harper C, MacDonald P, Shackel N, Crowe S, Hanson C, Hill S, Synnot A, Craig JC. Research priority setting in organ transplantation: a systematic review. Transpl Int 2017; 30:327-343. [PMID: 28120462 DOI: 10.1111/tri.12924] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/16/2017] [Accepted: 01/19/2017] [Indexed: 02/06/2023]
Abstract
Barriers to access and long-term complications remain a challenge in transplantation. Further advancements may be achieved through research priority setting with patient engagement to strengthen its relevance. We evaluated research priority setting in solid organ transplantation and described stakeholder priorities. Databases were searched to October 2016. We synthesized the findings descriptively. The 28 studies (n = 2071 participants) addressed kidney [9 (32%)], heart [7 (25%)], liver [3 (11%)], lung [1 (4%)], pancreas [1 (4%)], and nonspecified organ transplantation [7 (25%)] using consensus conferences, expert panel meetings, workshops, surveys, focus groups, interviews, and the Delphi technique. Nine (32%) reported patient involvement. The 336 research priorities addressed the following: organ donation [43 priorities (14 studies)]; waitlisting and allocation [43 (10 studies)]; histocompatibility and immunology [31 (8 studies)]; immunosuppression [21 (10 studies)]; graft-related complications [38 (13 studies)]; recipient (non-graft-related) complications [86 (14 studies)]; reproduction [14 (1 study)], psychosocial and lifestyle [49 (7 studies)]; and disparities in access and outcomes [10 (4 studies)]. The priorities identified were broad but only one-third of initiatives engaged patients/caregivers, and details of the process were lacking. Setting research priorities in an explicit manner with patient involvement can guide investment toward the shared priorities of patients and health professionals.
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Affiliation(s)
- Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Benedicte Sautenet
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Jeremy R Chapman
- Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia
| | - Claudia Harper
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Peter MacDonald
- Heart Transplant Unit, St Vincent's Hospital, Sydney, NSW, Australia.,Transplantation Research Laboratory, Victor Chang, Cardiac Research Institute, Sydney, NSW, Australia
| | - Nicholas Shackel
- Department of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Camilla Hanson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Vic., Australia
| | - Anneliese Synnot
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Vic., Australia.,School of Preventive Medicine and Public Health, Monash University, Melbourne, Vic., Australia
| | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Sharpe E, Moloney G, Sutherland M, Judd A. The Power of an Immediate Donor Registration Opportunity: Translating Organ Donation Attitudes Into Registration Behavior. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2016. [DOI: 10.1080/01973533.2016.1249792] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - Anne Judd
- Mid North Coast Local Health District
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Krupic F, Sayed-Noor AS, Fatahi N. The impact of knowledge and religion on organ donation as seen by immigrants in Sweden. Scand J Caring Sci 2016; 31:687-694. [DOI: 10.1111/scs.12379] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ferid Krupic
- Department of Orthopaedics; Institute of Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Arkan S. Sayed-Noor
- Department of Surgical and Perioperative Sciences; Umeå University; Umeå Sweden
| | - Nabi Fatahi
- University of Gothenburg; Institute of Health and Caring Sciences; Gothenburg Sweden
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Zhang L, Zeng L, Gao X, Wang H, Zhu Y. Transformation of organ donation in China. Transpl Int 2015; 28:410-5. [PMID: 25267538 DOI: 10.1111/tri.12467] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 06/02/2014] [Accepted: 09/21/2014] [Indexed: 11/28/2022]
Abstract
The organ donation system in China has far lagged behind international levels. Transformation of this situation began in July 2005. A complete organ donation system that ensures fairness, impartiality, transparency, and respect for life has now been developed. This system is composed of regulations and policies, an organizational structure, operational guidelines, organ procurement organizations, registration of donors and recipients, and an organ allocation system. Since March 2010, pilot trials on donation after circulatory death (DCD) have been carried out. In 4 years, organ donation has started in 25 of 32 provinces in the country. From 2010 to 2013, the ratio of DCD liver transplantation to total case numbers in China rose from 1.38% to 26.1%, whereas for kidney, the ratio were 0.59% and 24.6%, respectively. The total number of DCD in China has accumulated to 1564 cases, and 4243 organs were transplanted. To alleviate the further difficulties of donation, establishment of professional organ procurement organizations in transplant hospitals, legislation of brain death, and promulgation of legal guidelines on DCD will be the main targets of organ donation development in China.
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Affiliation(s)
- Lei Zhang
- Shanghai Changzheng Hospital, Shanghai, China; Shanghai Organ Donation Office, Shanghai, China
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40
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Radunz S, Benkö T, Stern S, Saner FH, Paul A, Kaiser GM. Medical students' education on organ donation and its evaluation during six consecutive years: results of a voluntary, anonymous educational intervention study. Eur J Med Res 2015; 20:23. [PMID: 25880285 PMCID: PMC4359403 DOI: 10.1186/s40001-015-0116-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/24/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND One of the main reasons for organ shortage is insufficient education on organ donation. Knowledgeable medical students could share the information with friends and families resulting in a positive attitude to organ donation of the general public. METHODS During six consecutive years (2009 to 2014), we conducted a voluntary, anonymous educational intervention study on organ donation among fourth year medical students in the course of the main surgery lecture at the University of Essen, Germany. RESULTS Questionnaires of 383 students were analyzed. Prior to the specific lecture on organ donation, 64% of the students carried a signed organ donor card with the intention to donate. Further information regarding organ donation was required by 37% of the students. The request for further information was statistically significantly higher among students without a donor card compared to organ donor card carriers (P < 0.0001). After the lecture, the number of students requiring further information decreased statistically significantly to 19% (P < 0.0001). CONCLUSIONS Already a 45-minute lecture for fourth year medical students significantly decreases their request for further information on organ donation and improves their attitude to organ donation. Continued training on organ donation will help medical students to become disseminators for this important topic in our society.
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Affiliation(s)
- Sonia Radunz
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Tamás Benkö
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Sabrina Stern
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Fuat H Saner
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Andreas Paul
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Gernot M Kaiser
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
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Ríos A, López-Navas AI, Navalón JC, Martínez-Alarcón L, Ayala-García MA, Sebastián-Ruiz MJ, Moya-Faz F, Garrido G, Ramirez P, Parrilla P. The Latin American population in Spain and organ donation. Attitude toward deceased organ donation and organ donation rates. Transpl Int 2015; 28:437-47. [PMID: 25557362 DOI: 10.1111/tri.12511] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/17/2014] [Accepted: 12/30/2014] [Indexed: 12/20/2022]
Abstract
UNLABELLED 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.
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Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante ('International Collaborative Donor Project'), Murica, Spain; Regional Transplant Center, Consejería de Sanidad, Servicio Murciano de Salud, Murcia, Spain; Department of Surgery, Faculty of Medicine, University of Murcia, Murcia, Spain; Surgery Service, Murcia Health Service, Virgen de la Arrixaca University Hospital, Murcia, Spain
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Abstract
Numbers of deceased organ donors in Australia have increased, but rates of consent to donation remain at around 60%. Increasing family consent is a key target for the Australian Organ and Tissue Authority. Reasons for donation decisions have been reported in the international literature, but little is known of reasons for Australian families’ decisions. Potential organ donors in four Melbourne hospitals were identified and 49 participants from 40 families (23 consenting and 17 non-consenting) were interviewed to understand reasons for consent decisions. Themes for consent to organ donation included that: donation was consistent with the deceased's explicit wishes or known values, the desire to help others or self—including themes of altruism, pragmatism, preventing others from being in the same position, consolation received from donation and aspects of the donation conversation and care that led families to believe donation was right for them. Themes for non-consent included: lack of knowledge of wishes, social, cultural and religious beliefs; factors related to the donation process and family exhaustion; and conversation factors where negative events influenced decisions. While reasons for consent were similar to those described in international literature, reasons for non-consent differed in that there was little emphasis on lack of trust of the medical profession, concerns regarding level of care provided to the potential donor, preserving the deceased's body, fears of body invasion or organ allocation fairness.
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EXP CLIN TRANSPLANTExp Clin Transplant 2014; 12. [DOI: 10.6002/ect.2014.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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