Public attitudes toward organ donation

A survey of public attitudes toward organ donation and transplantation was conducted in a Turkish community. The 1030 subjects were chosen using a random, stratified method. Some 50.5% of those interviewed were willing to donate their organs while 33.7% refused and 15.8% were uncertain. A total of 53.6% said they would consent to donate a deceased relative's organs. Reasons for refusal to donate organs were as follows: fear that their body would be cut into pieces (43.8%), religious beliefs (26.2%), no reason (23.1%) and the belief that they would need their body and organs for their second life (6.9%). Attitudes toward organ donation were clearly related to level of education, age, sex, and socioeconomic status.     

Factors related to attitudes toward organ donation after death in the immigrant population in Spain

Considering the relevance of the migratory processes in Western societies, the attitudes toward organ donation after death are analyzed by means of a survey applied to a representative random sample of the resident immigrant population in Spain, comprising 1202 subjects (estimated margin of error of ± 2.88%, p = q, p < 0.05). Considered variables were disposition toward own organ donation, disposition toward deceased relatives' donation in different situations, arguments against donation, socio-demographic indicators, religious beliefs, social integration, and information about organ donation and transplantation. Predisposition to donate varies strongly across geographical origin and religious beliefs and also shows relationships with additional socio-demographic, social integration, and informative variables. In turn, the relationship between religious beliefs and attitude toward donation varies as a function of the degree of social integration. In Spain, the immigrant population is a heterogeneous collective that requires differential strategies to promote donation. Such strategies should be aimed at reinforcing the existing positive attitudes of citizens from West Europe and Latin America, and at familiarizing and informing about donation in citizens from the East, and at making specific efforts to break down the cultural and religious barriers toward donation in African citizens, with special emphasis on people of the Muslim faith.     

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

The Latin American (LA) population has similarities with the Spanish population which makes its integration into Spanish society easier. Objective: to analyze the attitude toward organ donation among Latin American citizens residing in Spain, to determine the psychosocial variables which affect this attitude, and to examine the correlation between donation rates of LA citizens in Spain and in their countries of origin. A random sample of LA residents in Spain was taken and stratified according to the respondent's nationality (n = 1.314), in the year 2010. Attitude was assessed using a validated questionnaire (PCID‐DTO Dr Rios). The survey was self‐administered and completed anonymously. Statistical analysis: Student's t‐test, the χ² 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.     

Knowledge and opinions about organ donation and transplantation among Vietnamese Americans in Seattle, Washington: a pilot study

BACKGROUND: Racial/ethnic minorities comprise almost 50% of registrants on national waiting lists for organ transplantation in the USA. As the list continues to expand, organ shortage becomes a bigger problem. Increasing donation rates especially among racial minority groups would lower the waiting times for these groups. PURPOSE: Asian Americans are among the fastest growing and most diverse ethnic group in the USA, but research on their knowledge or opinions about organ donation is rare. POPULATION: A non-random sample of 350 Vietnamese American church attendees and students attending a major university in Seattle (Washington), was drawn. METHODS: A self-administered 39-item knowledge/opinion-based survey was conducted during June to August 2003. Results: Of 278 respondents (a 79.7% response rate), 69.1% knew blood-type made a difference in donation (p = 0.000), 61.6% knew transplant survival rates were high (p = 0.000), and 75.9% knew transplants could come from living donors (p = 0.000). But 53.4% also thought organs could be sold for money in the USA (p = 0.000), and 49.8% thought more people died of auto accidents and gunshot wounds than from heart disease (p = 0.000). Those who answered correctly to more than 50% of the knowledge questions were also more likely to favor donation (p = 0.007). CONCLUSION: We found among this study population that having correct knowledge about organ donation related to a willingness to donate.     

Public attitudes toward organ donation: A survey in a Turkish community

Abstract. A survey of public attitudes toward organ donation and transplantation was conducted in a Turkish community. The 1030 subjects were chosen using a random, stratified method. Some 50.5% of those interviewed were willing to donate their organs while 33.7% refused and 15.8% were uncertain. A total of 53.6% said they would consent to donate a deceased relative's organs. Reasons for refusal to donate organs were as follows: fear that their body would be cut into pieces (43.8%), religious beliefs (26.2%), no reason (23.1%) and the belief that they would need their body and organs for their second life (6.9%). Attitudes toward organ donation were clearly related to level of education, age, sex, and socioeconomic status.     

Non‐organ donors' attitudes toward incentives

Malaysians indicating that they did not intend to become organ donors upon their death were surveyed regarding interest in non‐fungible financial incentives to be granted to surviving family members. Among the 730 (56% of the total sample of 1311) indicating unwillingness to be donors, 29.6% (216/730) subsequently indicated that they would be willing donors if the government introduced policies that, upon their death, “rewarded your (their) family with incentives for your (their) deeds.” Among the 69% (504/730) who insisted that they would not become organ donor even with incentive, nearly 80% (404/501) of them were able to identify relevant incentives they thought should be provided by the state to those who make organ donations upon death. The majority of both groups preferred the state provide medical benefits to a surviving family member, suggesting this may be an attractive policy option for the state to raise the deceased organ donation pool.     

Attitudes and opinions on organ donation: an opportunity to educate in a Canadian city

Lee E, Midodizi W, Gourishankar S. Attitudes and opinions on organ donation: an opportunity to educate in a Canadian city.
Clin Transplant 2010: 24: E223–E229. © 2010 John Wiley & Sons A/S. Abstract: Background:  Patients on organ transplant waiting lists continue to far exceed donor rates. We seek to understand the barriers preventing people in a Canadian city from donating organs for transplantation. Methods: One thousand adults were surveyed assessing knowledge, personal involvement, and attitudes about organ donation in an urban center in Canada. Primary outcomes of interest were a signed organ donor card and willingness to donate. Results: Of those surveyed, 64% did not realize that they possessed an organ donor card; 90% would consider being a donor if a friend was in need of an organ. Of the 36% who did know, 72% had signed it. Those who had misconceptions about the organ donation process were less likely to be donors. Interpretation: There is a tremendous lack of knowledge about organ donation. While the majority of people are interested in organ donation, they lack a means to express this interest – most do not even realize they possess an organ donor card. A significant proportion of people who were not supportive of donation were misinformed in critical areas of knowledge that likely influenced this decision including the rich being preferentially transplanted, the consent process, disfigurement, and donors receiving worse medical care.     

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

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

Deciding on cadaveric organ donation in Black African families

This study explores factors that have affected the decision of Black African families to donate cadaveric organs. Semi-structured interviews were conducted with ten families living in greater Cape Town, South Africa. Addresses were obtained from records of the transplant co-ordinators at Groote Schuur Hospital. The data were analysed according to broad themes emerging from the interviews. The most important themes were the influence of violent, criminal deaths; the need for a longer period of consultation among family members: belief in the integrity of the ancestor's body; lack of understanding of brain death; and experiences of grief and loss.     

Factors influencing the family consent rate for organ donation in the UK

The refusal rate for organ donation in the UK is 42%, among the highest in Europe. We extracted data on every family approach for donation in UK ICUs or Emergency Departments between 1st April 2012 and 30th September 2013, and performed multiple logistic regression to identify modifiable factors associated with consent. Complete data were available for 4703 of 4899 approaches during the study period. Consent for donation after brain death was 68.9%, and for donation after circulatory death 56.5% (p < 0.0001). Patient ethnicity, knowledge of a patient's wishes and involvement of a specialist nurse in organ donation in the approach were strongly associated with consent (p < 0.0001). The impact of the specialist nurse was stronger for donation after circulatory death than for donation after brain death, even after accounting for the impact of prior knowledge of patients' wishes. Involvement of the specialist nurse in the approach, encouraging family discussions about donation wishes and promotion of the organ donor register are key strategies to increase UK consent rates, and are supported by this study.     

The public's willingness to discuss their preference for organ donation with family members

We sought to assess the public's willingness to discuss their preference for organ donation with family members and to identify factors associated with willingness to discuss donation. We categorized individuals (N = 4365) with a preference for donation according to their willingness to discuss donation and used ordinal logistic regression analysis to identify factors related to their level of willingness. About half of those who want to donate have discussed this with a family member. Others were at various stages with respect to their commitment to discuss donation. Those in the more committed stages were more likely than others to have signed an organ donor card, to have seen information about organ donation, to be male, to be white or Hispanic, to know about donation issues, and to be comfortable with the idea of their own death. The decision to donate is ultimately made by family members of a suitable candidate for donation, yet nearly half of those who wish to donate have not made their wishes known. Interventions targeted to individuals at different stages of commitment are needed so that more family members can respond in accordance with their loved one's wishes.     

Faith leaders united in their support for organ donation: findings from the UK organ donation taskforce study

This article reports the findings from the one‐to‐one interviews with the main UK faith and belief leaders, which were commissioned by the Organ Donation Taskforce. Interviews were arranged with the main faith and belief organizations within the UK and covered a range of issues related to organ donation. No faith or belief groups were against organ donation in principle. The interviewees stated that the majority opinion in their faith or belief group is to permit organ donation, with some actively supporting it. Interviewees were keen to stress that there is a broad spectrum of opinions on organ transplantation within each faith and belief group, and that consequently it is difficult to speak on behalf of an entire group. One complication mentioned by interviewees is that as organ transplantation is a relatively new medical procedure, there is no explicit reference to it in many original religious texts. Consequently positions on the receipt and donation of organs are based on interpretation. It was felt that a much greater level of engagement is needed, as organ donation is currently not a priority for many faith and belief groups.     

Analysis of the attitudes and motivations of the Spanish population towards organ donation after death

Starting with the relevance of the Spanish experience, this study analyses the population’s disposition towards organ donation after death by means of a representative survey of the adult Spanish population (N = 1206, estimated error ±2.87%, P < 0.05). Of the participants, 8.1% were declared donors, 59.3% were likely to donate, 14.5% were against donating and 18.1% did not know or did not respond; 87.3% would donate relative’s organs if the deceased favoured donation, 50.2% if the deceased’s wishes were unknown and 13.1% even if the deceased opposed donation. Among people who were favourable towards donation, the main motives expressed were the will to save other people’s lives, solidarity and knowing they might someday need a donation. The most important motives for not donating among participants who were against it were the fear of premature organ extraction, of premature pronouncement of death and of mutilation. Reticence to donate is associated with low socio‐economic and cultural level, advanced age and high religious commitment; it is also associated with a low perception of transplant efficacy, not directly knowing any transplanted people and the lack of qualified information. The results support diverse potentially effective strategies for promoting donation in the general population.     

German citizens in southeastern Spain: a study of attitude toward organ donation

Ríos A, Martínez‐Alarcón L, Sánchez J, Jarvis N, Parrilla P, Ramírez P. German citizens in southeastern Spain: a study of attitude toward organ donation.
Clin Transplant 2010: 24: 349–357. © 2009 John Wiley & Sons A/S Abstract: Background: Spain is frequently a place of residence for a high percentage of the German population. Our aim is to analyze the attitude of the German population that is resident in Spain toward organ donation. Methods: A sample of German residents in the south east of Spain was obtained randomly between November 2005 and April 2006 (n = 227). Attitude was evaluated using a validated questionnaire. This survey was self‐administered and completed anonymously. Control group: a sample of 2000 Spanish citizens. Results: There is a favorable attitude toward donation in 64% of respondents, similar to the control group (64% vs. 63%; p = 0.8545). The most important factors that affect such attitude are: (i) having dependents (odds ratio = 4.569); (ii) having talked about donation within the family (OR = 4.132); (iii) being willing to accept an autopsy if one were necessary (OR = 5.952); (iv) having had previous experience of organ donation and transplantation (OR = 5.814); (v) not being concerned about mutilation of the cadaver (OR = 8.792); and (vi) the attitude of one’s partner toward donation, especially when this is negative (OR = 0.002). Conclusions: The attitude toward organ donation of Germans who usually reside in Spain is the same as that described in the native Spanish population, and is determined by many psychosocial factors.