Factors predictive of signed consent for posthumous organ donation

Development and Psychometric Testing of the Signed Donor Card (SDC) Scale in an Islamic Society

The signed donor card is an important method to overcome the shortage of organs for transplantation. A valid and reliable scale is necessary to have with the development of interventions to increase the signed donor card. This study aimed to develop and psychometric testing of the Signed Donor Card (SDC) in an Islamic society. This methodological study was conducted in Hamadan city, Iran in 2018 on 600 employees of offices. A 46-item scale was developed. It was assessed by face, content, and construct validities. Reliability was examined using the calculation of the Cronbach's α and test-retest method. The SPSS software version 22 and Mplus version 7.4 were used for data analysis. Our scale demonstrated acceptable internal consistency (α = 0.58-0.93) and good test-retest reliability (ICC = 0.76). The fitness indices for the confirmatory factor analysis (CFA) indicated that the model fit was good. CFA revealed nine standalone components including attitude, subjective norms, intention, anticipated regret, descriptive norms, perceived control, knowledge, non-cognitive beliefs, and religious beliefs. Convergent validity and discriminant validity were established. This study provided evidence concerning the validity and reliability of SDC scale. It can be used for the development and implementation of effective interventions for increasing signed donor card with the consideration of contextual and cultural situations.

Donating blood and organs: using an extended theory of planned behavior perspective to identify similarities and differences in individual motivations to donate

Due to the critical shortage and continued need of blood and organ donations (ODs), research exploring similarities and differences in the motivational determinants of these behaviors is needed. In a sample of 258 university students, we used a cross-sectional design to test the utility of an extended theory of planned behavior (TPB) including moral norm, self-identity and in-group altruism (family/close friends and ethnic group), to predict people's blood and OD intentions. Overall, the extended TPB explained 77.0% and 74.6% of variance in blood and OD intentions, respectively. In regression analyses, common contributors to intentions across donation contexts were attitude, self-efficacy and self-identity. Normative influences varied with subjective norm as a significant predictor related to OD intentions but not blood donation intentions at the final step of regression analyses. Moral norm did not contribute significantly to blood or OD intentions. In-group altruism (family/close friends) was significantly related to OD intentions only in regressions. Future donation strategies should increase confidence to donate, foster a perception of self as the type of person who donates blood and/or organs, and address preferences to donate organs to in-group members only.

Attitudes underlying corneal donation in a group of trainee allied health professionals

Background

The focus of this study was to investigate factors that may influence personal willingness to register consent to donate corneal tissue upon death using the theory of planned behaviour in a relatively ethnically homogenous group of trainee allied health professionals. The attainment of this knowledge will be of paramount importance in relation to potential interventions that are designed to change donation-related behaviour.

Methods

A questionnaire-based study was undertaken with 92 pre-registration nurses (mean age 24.0 years (standard deviation ±5.6 years); female:male  = 89:3) enrolled at a University in Northern Ireland. Intention to register consent to donate corneal tissue upon death was assessed using both direct and belief-based measures found in the theory of planned behaviour. Descriptive statistics were used to assess demographic information, with correlation and regression analyses being used to identify factors influencing intentions.

Results

The majority of participants were religious (94.6%, n = 87) and mostly Protestant (58.7%, n = 54) or Catholic (35.9%, n = 33). Generally speaking, the theory of planned behaviour accounted for 84% of the variance in intention to register consent. In relation to the constructs found in the theory of planned behaviour, attitude was found to be the strongest predictor of intention to register consent, with subjective norm being the second strongest predictor. Perceived behavioural control did not significantly predict intention to register consent.

Conclusions

The theory of planned behaviour has allowed an understanding of the factors that influence the personal intentions of a group of future allied health professionals from the same ethnic group to register consent to donate their corneal tissue.

Disclosing donation decisions: the role of organ donor prototypes in an extended theory of planned behaviour

This study explored the role of donor prototype evaluations (perceptions of the typical organ donor) in organ donation communication decisions using an extended theory of planned behaviour (TPB) model. The model incorporated attitude, subjective norm, perceived behavioural control, moral norm, self-identity, and donor prototype evaluations to predict intentions to record consent on an organ donor register and discuss the organ donation decision with significant others. Participants completed surveys assessing the extended TPB constructs related to registering (n = 359) and discussing (n = 282). Results supported a role for donor prototype evaluations in predicting discussing intentions only. Both extended TPB structural equation models were a good fit to the data, accounting for 74 and 76% of the variance in registering and discussing intentions, respectively. Participants' self-reported discussing behaviour (but not registering behaviour given low numbers of behavioural performers) was assessed 4 weeks later, with discussing intention as the only significant predictor of behaviour (Nagelkerke R(2) = 0.11). These findings highlight the impact of people's perceptions of a typical donor on their decisions to discuss their organ donation preference, assisting our understanding of the factors influencing individuals' communication processes in efforts to bridge the gap between organ supply and demand.