Impact Factors and Attitudes Toward Organ Donation Among Transplantation Patients and Their Caregivers in China

The Level of Knowledge of Organ Transplantation and Attitudes Toward Organ Donation of Carers of Patients Receiving Hemodialysis

Purpose: Renal transplantation is the most effective treatment method for chronic renal failure and helps improve the quality of life of patients and caregivers.In the present study, the purpose was to determine the knowledge level of the primary caregivers of patients receiving hemodialysis treatment about organ transplantation and their attitudes toward organ donation.Method: The study was conducted in a descriptive fashion with the relatives of 71 patients who were receiving treatment in the hemodialysis unit for the end-stage renal failure of a state hospital between 01.08.2022 and 15.10.2022. The data of the study were collected face to face with a questionnaire form, Organ Donation Attitude Scale, and Organ Tissue Donation and Transplantation Information Scale. The SPSS 24 package program was used in the analysis of the data. Descriptive statistics, numbers, percentages, and mean values were used in the analysis of the data. The One-Sample Kolmogorov-Smirnov Test was used to evaluate the homogeneity of the data. The Studentt test, the One-Way Analysis of Variance, the Kruskal-Wallis Test, and the Tukey Post-Hoc Test were used for the analysis between the groups. Statistical significance was taken as p < .05.Results: The benevolence and moral values/beliefs sub-dimension score average of the participants was found to be 98.44 ± 14.61, the fear of medical neglect was 32.10 ± 10.09, and the mean bodily injury sub-dimension score was 30.45 ± 11.28. It was also found that the mean score of the Organ-Tissue Donation and Transplant Information Scale was 11.41 ± 2.59. A statistically significant and negative relationship was detected between the participants' medical neglect and bodily injury attitudes and the Organ-Tissue Donation and Transplant Information Scale score averages (p < .05).Conclusion and Suggestions: As a result, it was found that the positive attitudes of the caregivers of individuals receiving hemodialysis treatment about organ donation were at a good level, and as the level of organ transplantation knowledge increased, negative attitudes towards organ donation decreased. In this context, it can be suggested that healthcare professionals provide training on organ transplantation and donation to the relatives of patients receiving hemodialysis treatment.

Organ donation information scanning, seeking, and discussing: Impacts on knowledge, attitudes, and donation intentions

The disparity between the demand for organ donation and individuals' intention to donate in China is substantial. Media plays an increasingly pivotal role in bridging this gap by shaping public attitudes and intentions toward organ donation. This study aims to explore the differential impacts of various information acquisition modes on this dynamic. Utilizing an online survey with 420 quota sampling among mainland Chinese residents, we constructed a serial mediation model to test the proposed model. The findings reveal that information scanning, seeking, and discussion regarding organ donation are positively associated with the intention to donate organs through improving knowledge and increasing consent for organ donation. Moreover, information seeking is directly associated with a positive attitude toward organ donation, while information discussing directly increases the intention to donate organs.

Factors affecting acceptance of organ donation in mainland China: A national cross-sectional study

AIMS AND OBJECTIVES

To explore the acceptances and associated influences of organ donation in mainland China.

BACKGROUND

The shortage of organ donors has limited the development of organ transplantation in China. It is important to recognise the target population who has high intention to donate their organs may change the status.

DESIGN

We conducted a cross-sectional, multi-stage sampling study collected demographic data and individuals' willingness to accept organ donation.

METHODS

A stepwise linear regression analysis was adopted to evaluate the factors related to the attitudes toward organ donation.

RESULTS

We collected 11,031 valid samples for the survey. The willingness to donate organs among Chinese residents averaged 56.93 points. To be specific, males (β = -.03), religious believers (β = -.01) and parents with a different number of children (all: β = -.04) are less willing to donate their organs. Respondents who live in an urban area (β = .03), have higher education level (High school or junior college β = .04, Bachelor degree or above β = .09), feel anxious (mild, moderate β = .02), feel pressured (moderate, severe β = .08), have higher scores of the Short-Form Health Literacy Instrument (HLS-SF12) (β = .31), The Self-Management Scale (SHMS) (β = .16), EuroQol Five Dimensions Questionnaire (EQ-5D) (β = .04) and EuroQol Visual Analogue Scale (EQ-VAS) (β = .24), are more positive to donate.

CONCLUSIONS

This study firstly discusses the public acceptance of organ donation through a nationwide sample around China. In this study, we discovered that Chinese residents' acceptance level of organ donation and that gender, house, anxiety, pressure, social support and health literacy were the main influencing factors on residents' attitudes.

RELEVANCE TO CLINICAL PRACTICE

To figure out the Chinese public acceptance and its influencing factors of organ donation can help nurse transplant coordinators to recognise the target population and the obstacles of organ donation.

PATIENT OR PUBLIC CONTRIBUTION

At the phase of collecting data, participants were recruited to fill the questionnaires.

Attitudes That Might Impact upon Donation after Brain Death in Intensive Care Unit Settings: A Systematic Review

BACKGROUND

Organ donation and transplantation can save or improve the quality of life of people worldwide. However, there are many challenges associated with organ donation, as the demand for organs greatly outstrips supply. Additionally, there are brain-dead patients who could be potential organ donors. It is thus important to determine the attitudes affecting organ donation and transplantation in intensive care unit settings.

AIM

this study aimed to identify attitudes that might affect organ donation and transplantation in intensive care unit settings.

METHODOLOGY

Five electronic databases (CINAHL, Medline, PsycINFO, Scopus, and EMBASE) were searched systematically. A systematic search strategy was formulated. The quality of each study was assessed using the MMAT quality appraisal tool.

RESULTS

A total of seven studies were included. The findings of this systematic review demonstrate that education, policy, and continuing professional development could help to address barriers to donation.

CONCLUSIONS

therefore, to influence organ donation and transplantation positively, the main themes evaluated in this systematic review provide an opportunity to influence organ donation and transplantation attitudes in intensive care unit settings.

Organ donation: psychosocial factors of the decision-making process

Organ donation has a crucial impact on patient care and survival, of which the worldwide gap between organ demand and supply is currently one of the most challenging issues. Brain-dead patients are the main source of organs that can be donated, but donation requires the consent of family members-a choice that is often complex and stressful and leads to refusal of consent. This mini-review aims to provide an overview of the current knowledge on the impact of certain psychosocial factors on the decision-making process with regard to organ donation by family members. In particular, the influence of several aspects is emphasized, such as sociodemographic factors, knowledge of the organ donation process, religious beliefs, concerns that are related to the choice to donate, and mode of communication. Consistent with this evidence, we emphasize the need to examine these aspects further through interventions and guidelines that improve the organ donation application process and ensure a positive experience for the family that has to make the decision.

Prevalence and Predictors of Knowledge and Attitudes Toward Eye Donation Among the General Population: A Systematic Review

PURPOSE

The purpose of this systematic review was to investigate knowledge and attitudes toward eye donation and sources of eye donation information among the general population.

METHODS

A search was conducted using MEDLINE through Ovid and Scopus; CINAHL through EBSCOhost and ProQuest; and Embase through Ovid database entries from January 2010 to March 2021. Quantitative studies were selected if they included participants aged 16 years or older from the general population (nonhealthcare) and had a sample size of >200. Studies were included if they measured knowledge and attitudes toward eye donation and sources of eye donation information. Methodological quality was assessed using JBI criteria, and the data were analyzed using SUMARI software.

RESULTS

A total of 25 studies were included in this review. Pooled data from 6 studies demonstrated that 30.8% of participants [95% confidence interval (CI) = 11.0-55.4] had some knowledge of eye donation. Seventeen studies reported that 40.6% (95% CI = 39.8-41.3) were willing to donate their eyes, and 5 of these studies found that 7.3% (95% CI = 6.5-8.3) had already pledged their eyes. Eleven studies reported on the source of eye donation information, indicating 50.9% of participants (95% CI = 49.8-52.1) received information from mass media.

CONCLUSIONS

The results of this review indicate that understanding eye donation knowledge and attitudes is crucial for developing interventions or tools to increase eye donation rates. Further studies in different populations are required.

A Survey of 1000 Respondents on the Polish Population's Knowledge and Attitudes about Tissue/Organ Donation and Transplantation in Times of Allogeneic Tissue Shortage

Tissue-engineered human allogeneic skin grafts retrieved from a deceased donor play an important role in the therapy of extensive and deeply burned patients. However, there is a vital deficit of allogeneic skin donors, and the reserves of human allogeneic skin grafts are not sufficient. The goal of this work was to analyze the level of knowledge and attitudes of Polish society in the field of transplantation, with particular emphasis on allogeneic skin transplantation. The study used a self-made questionnaire comprised of 23 questions. 1000 respondents took part in this research. The respondents were a diverse group in terms of age, sex, education, and place of residence. The obtained results show a general positive attitude of the respondents towards the idea of transplantology. However, people with lower education presented a more negative attitude towards the donation of tissues and organs. Additionally younger people were not able to clearly declare readiness for organ procurement. What is more data analysis revealed certain gaps in more detailed knowledge and surprising attitudes. In that respect, the lack of awareness about the criteria for determining brain death could be mentioned. There was also a lack of acceptance for skin procurement in specific population groups. It can therefore be concluded that a key role in the success of the idea of transplantation in Poland is the broad and systematic education of the society.

Knowledge, attitudes and willingness to organ donation among the general public: a cross-sectional survey in China

BACKGROUND

The purpose of this study is to assess the level of knowledge, attitudes, and willingness to organ donation among the general public in China.

METHODS

The study population consisted of 4274 participants from Eastern, Central and Western China. The participants' knowledge, attitudes and willingness to organ donation were collected by a self-designed questionnaire consisting of 30 items. Knowledge is measured by 10 items and presented as a 10 point score, attitudes is measured by 20 items using a 5-step Likert scale and total score ranged between 0 and 80; while the willingness to donate is assessed as binary variable (0 = No; 1 = Yes). A logistic regression model was used to assess the association of knowledge and attitudes with willingness to organ donation, controlling for demographic and socioeconomic confounders.

RESULTS

The questionnaire response rate was 94.98%. The mean score (± SD) of the general public's knowledge to organ donation was 6.84 ± 1.76, and the mean score (± SD) of attitudes to organ donation was 47.01 ± 9.07. The general public's knowledge and attitudes were the highest in Eastern China, followed by West and Central China. The logistic regression model indicated a positive association between knowledge and the willingness to organ donation (OR = 1.12, 95%CI: 1.08, 1.17; P < 0.001); attitudes were also positively potential determinant of more willingness to organ donation (OR = 1.08, 95%CI: 1.07, 1.09; P < 0.001).

CONCLUSIONS

Knowledge and attitudes were found to be positively associated with the Chinese general public's willingness to organ donation. Knowledge about the concept of brain death and the transplant procedure may help raise the rate of willingness to organ donation.

The impact of having a relative in a need for cornea: the Knowledge, Attitude, and Willingness for Corneal Donation (KAWCD) questionnaire

Despite the advancement in the field of corneal transplantation, corneal donation is still the only source for cornea. In our study, we aimed to find predictors for a person's willingness toward cornea donation, and the impact of having a relative in a need for cornea transplantation on the willingness to donate cornea. The study included two cohorts to be compared, first degree relatives of patients waiting for corneal transplantation, and general ophthalmology patients who do not have relatives waiting for corneal donation. We designed questionnaire on Knowledge, Attitude, and Willingness for Cornea Donation (KAWCD), a tool specifically designed to measure the knowledge about corneal donation, and the attitude towards it. A total of 269 participants were included in this study, with a mean age of 49.59 (± 17.24) years. We included 182 (67.7%) participants who did not have a relative with or in need for corneal transplantation, and 87 (32.3%) participants who are first degree relatives to patients on the waiting list for corneal transplantation. Upon assessing factors predicting willingness for corneal donation, we found that attitude (p < 0.001; OR 1.126 (95% CI 1.08 to 1.17)) and age (p = 0.022; OR 0.973 (95% CI 0.95 to 0.99)) are the only predictors for willingness to donate. We found that the willingness to donate cornea is related to the attitude, rather than the knowledge about corneal donation. We believe awareness campaigns should focus on encouragement to donate corneas, rather than providing information about it.

Willingness of caregivers to donate a kidney to a patient with end-stage renal disease: Findings from four dialysis providing health facilities in Uganda

Most patients with end-stage renal disease (ESRD) benefit from a kidney transplant but there is limited information from developing countries like Uganda about the willingness of caregivers for patients with end-stage kidney disease to donate a kidney. In this cross-sectional study, we examined the magnitude and factors associated with the willingness of caregivers to donate a kidney to their patient with ESRD in Kampala, Uganda. The study was conducted at four health facilities that provide kidney dialysis in Kampala, Uganda. We used a structured questionnaire to interview caregivers for patients with ESRD. Caregivers who reported they would consider donating a kidney to a patient with ESRD were considered willing and the rest as unwilling. We summarized data using descriptive statistics and used an adjusted prevalence risk ratio (aPRR) from a generalized linear model to establish factors independently associated with willingness to donate.We enrolled 125 participants with a mean age of 32.3±9.8 years and found 68 (54.4%) participants were willing to donate a kidney for transplant. Willingness to donate a kidney was more likely among older caregivers namely those aged 25-34 years (aPRR, 1.15; 95% CI, 1.01-1.31) and ≥35 years (aPRR 1.16; 95% CI, 1.05-1.29) compared to those aged 18-24 years, females compared to males (aPRR, 1.30; 95% CI, 1.19-1.42), those with a positive attitude towards organ donation (aPRR, 1.24; 95% CI, 1.13-1.36), and when organ kidney donation was permissible by the participant's religious faith (aPRR, 1.11; 95% CI, 1.01-1.22). Conversely, willingness to donate a kidney was less likely when the family did not approve of kidney donation (aPRR, 0.80; 95% CI, 0.71-0.90). We concluded that more than half of caregivers to patients with ESRD are willing to donate a kidney for transplant. To improve the willingness of caregivers to patients with ESRD in donating a kidney, the social, religious, and personal barriers to kidney donation may need to be addressed.

Prioritizing Factors Affecting Deceased Organ Donation in Malaysia: Is a New Organ Donation System Required?

Purpose

The gap between the demand and the supply of human organs for transplantation is on the rise in Malaysia, despite the efforts of governments to promote donor registration. Factors affecting willingness to donate are contextual and vary from country to country. This research mainly focuses on the selection of most suitable organ donation system through factors affecting willingness to donate in Malaysia. The objectives of this study are to prioritize those factors acting as the pillars of the organ donation system and further to select the most suitable organ donation system for Malaysia.

Patients and Methods

The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors.

Results

Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent.

Conclusion

This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.

Willingness of Hemodialysis Patient's Family Members Toward Kidney Donation: A Cross-Sectional Study

BACKGROUND AND OBJECTIVES

There is a significant shortage of kidneys available for donation. Family members of hemodialysis (HD) patients are experiencing the suffering of their close relatives, which can be a factor toward better acceptance to kidney donation. Knowledge is also an important factor that might affect willingness. In this study, we aimed to estimate the rate of willingness to donate kidneys as live donors (LD) and identify related potential barriers among family members of HD patients.

METHODS

This was a cross-sectional observational study involving family members of adult HD patients from King Abdulaziz Medical City and the King Abdullah International Foundation dialysis project in Jeddah, Saudi Arabia. Participants were interviewed through phone calls using a pretested questionnaire. Calculated sample size was 385.

RESULTS

A total of 370 family members of HD patients were included. Median age was 37 (interquartile range: 33-44) years and 64% were male. All participants were first-degree relatives to HD Patients. The majority reported willingness to donate kidneys as LD (n = 300, 81%), a proportion 0.81% with 95% confidence interval (CI; 0.77-0.85). Only 42 (11%) graded their knowledge about kidney transplantation as high or very high. On multivariable analysis, less willingness was shown with age >40 years (adjusted odds ratio [AOR] 0.459; 95% CI 0.266-0.792; P = .005), and female gender (AOR 0.496; 95% CI 0.287-0.856; P = .012).

CONCLUSION

The majority of family members of HD patients were willing to donate kidneys. The willingness rate was lower among participants 40 years of age and older, as well as among women. The majority of patients graded their knowledge about kidney transplantation as average or lower. Therefore, education targeting of relatives of HD patients may help optimize knowledge and hence improve acceptance of kidney donation.

Can financial rewards complement altruism to raise deceased organ donation rates?

BACKGROUND

Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.

METHODS

Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.

ETHICAL CONSIDERATIONS

The study was approved by the University of Malaya ethics committee.

RESULTS

The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.

CONCLUSION

Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

Knowledge, attitude and willingness of different ethnicities to participate in cadaver donation programs

Knowledge, attitude and willingness of ethnic minorities in China towards cadaver donation programs were assessed. Questionnaire and interviews were conducted to investigate Yi, Bai, Hani, Dai and Han ethnicities. Educational level and per capita income of ethnic minorities were lesser than those of Han ethnicity (p<0.01). Agriculture was the primary occupation and proportions of technical personnel and public officials was lesser among ethnic minorities (p<0.01). Surveyed ethnic minorities universally practice religious traditions, Bai and Dai ethnicities practice Buddhist beliefs also (p<0.01). Knowledge of Yi, Bai, Hani and Dai ethnic respondents was lesser than those of Han ethnicity (p<0.01). Over 83.8% of Yi, Bai, Hani and Dai ethnicity residents were unwilling to register for body donation programs with receiving a driver's license (p<0.01). Less than 46.9% of ethnic minorities supported use of honorary certificates (p<0.01). Ethnic minorities were supportive of financial compensation for body donations and denied that financial compensation led to the commercialization of cadaver donation (p<0.01, p<0.01). Willingness of ethnic minorities to participate in cadaver donation programs was primarily related to religious beliefs (p<0.01), economic status (p<0.01). Knowledge, attitude and willingness of ethnic minorities to participate in cadaver donation programs were markedly different from those of Han ethnicity, and the religious belief and economic status played a decisive role. To increase participation, programs based on respecting religious belief should be developed to support improvements in economy, education, medical care and social security system.

Diagnosis and Treatment of Renal Artery Stenosis in China in the Era of Donation After Cardiac Death

Background

The aim of this study was to investigate the clinical features and treatment strategies of transplant renal artery stenosis (TRAS) with kidneys from donation after cardiac death (DCD).

Material/Methods

We collected the clinical data of donors and recipients of single-center DCD-induced TRAS from January 2015 to June 2017.

Results

All the 8 cases of TRAS were from hypertensive cerebrovascular accident DCD-originated kidneys. The mean donor age was 53.5 (45~57) years, with mean BMI 27.8 (26.4~32.3) kg/m², atherosclerosis index 5.8 (4.9~7.0), and renal atherosclerotic plaque. Clinical features of TRAS were: refractory hypertension with elevated serum creatinine >50%, and negative urine protein and occult blood. Ultrasound of transplanted kidneys showed renal blood flow index 0.49 (0.43~0.55). Angiography confirmed the diagnosis of renal artery trunk or secondary branch stenosis. There were 2 cases of moderate stenosis and 6 cases of severe stenosis. Six patients underwent stent implantation and 2 patients underwent balloon dilatation. Seven patients had serum creatinine recovery after interventional therapy during follow-up. The transplanted kidney of 1 patient ruptured 6 h after interventional therapy and was then resected.

Conclusions

The incidence of TRAS with hypertensive cerebrovascular accident DCD-originated kidneys is relatively high, which is a warning to kidney transplant physicians. Digital subtraction angiography (DSA) is the most reliable diagnostic means of TRAS and can be performed concurrently with intervention therapy. If the donor has severe atherosclerosis, plaques that are visible to the unaided eye in the renal artery trunk should be removed as completely as possible.

Perceptions and Attitudes toward Brain Donation among the Chinese People

Postmortem human brain donation is crucial to both anatomy education and research. The China Human Brain Banking Consortium was established recently to foster brain donation in China. The purpose of this study was to gain information about the public perception of and attitudes toward brain donation and to identify factors that may impact the willingness to participate in brain donation among the Chinese people. A specifically designed questionnaire was delivered to community residents in Changsha (the capital city of Hunan province) with a total of 1,249 completed forms returned and statistically analyzed. The majority of the participants considered that brain donation would help medical research and education, and 32.0% of respondents agreed that the brain donation would help change the traditional Chinese funeral belief in keeping the body intact after death. However, participants aged over 60 years old were less supportive of this concept. Among all participants, 63.7% stated that they were not knowledgeable about brain donation, while 26.4% explicitly expressed a willingness to participate in brain donation. Age, gender, monthly household income, and knowledge about brain donation significantly affected the willingness. Compared with other age groups, a higher proportion of participants aged over 60 years old preferred to be informed by a medical college. To promote brain donation in China, especially among the elderly, better communication of its medical benefits and a reinterpretation of the Confucius view of the human body should be provided. Efforts are also needed to provide appropriate forums and sources of brain donation information to targeted communities and society in general.

Educate, Re-educate, Then Re-educate: Organ Donation-centered Attitudes Should Be Established in Society

OBJECTIVE

The objectives of the study are to evaluate knowledge and attitudes toward organ and tissue donation, to pursue a deeper understanding of attitudes toward organ donation, and to gain an understanding of the underlying, personal reasoning for the desired action in organ donation among the adult population.

METHODS

Four thousand people were interviewed who were selected by the simple random sample type. A survey was conducted by voluntary, face-to-face interviews using a printed 25-item questionnaire form presented to street-recruited individuals over 18 years of age.

RESULTS

In the study, where male/female distribution was represented equally, the majority of participants consisted of young and middle-aged, primary school graduates between the ages of 25 to 44 years. Although 91.1% of the respondents stated that they support organ donation, only 75.3% stated they wanted to donate organs. Organ donation-centeredness rates were low in those who did not finish a primary school education, people with a low household income, and those ≥65 years age group. A majority of the respondents (91.2%) were found to be against financial incentives for organ donation. Although 91.4% of the participants stated that organ donation is important if the recipient is a relative, this ratio decreased to 86.7% for a nonrelative. In our study, the level of accepting an organ as a recipient from an unknown person was 9.1% higher than the rate of willingness to donate to an unknown person. Surprisingly, despite 84% saying their religion is not against organ donation, 38.4% of the respondents cited religious concerns as the main reason for unwillingness and 58% of them indicated that they were reluctant to donate organs due to religious beliefs.

CONCLUSIONS

It is important to know that it is not certain that anyone who is hypothetically in favor of organ donation will donate when faced with a real choice. Increasing the number of donors is the most important issue in order to benefit more patients in transplantation, which has achieved a very important success level through serious efforts. The majority of Turkey's population know about organ donation, support transplantation, and would be willing to donate their organs. Most of the respondents find it religiously correct and believe that it is an acceptable lifesaving procedure. However, a high percentage did not know how to donate, and they indicated that the information available on the subject is insufficient. Mass media campaigns and educational activities could resolve this matter and increase organ donation. According to the results of our study, when considering the number of patients who died while waiting for transplantation, organ donation awareness projects that are focused on converting knowledge to behavior are believed to be very critical. It is important to provide organ donation-oriented training at every educational level.

Specific Needs of Medical Students for Organ Donation Courses: A Qualitative Study in China

BACKGROUND

Global promotion of organ transplantation is contingent upon continuous improvement of the donation rate. Organ donation education is an important measure for changing public awareness and promoting organ donation. Therefore, it is important and urgent to conduct a systematic study of the organ donation courses offered in China and around the world. The aim of this study was to learn the views and needs of Chinese medical students and provide a reference for international peers.

METHODS

Semistructured, in-depth interviews and purposive sampling were used in this study. A total of 18 university students majoring in medicine and nursing were selected according to the principle of data saturation and interviewed. The data were sorted and analyzed with phenomenology.

RESULTS

These interviewees generally agreed that an organ donation course should be offered. They were in urgent need of knowledge regarding organ donation procedures and relevant policies and eager for a practical and experience-based teaching method design. The Chinese medical students surveyed also believed that the course should also be available to clinical practitioners, nonmedical students, and the public.

CONCLUSION

Medical students' demand for an organ donation course should be considered. To fully stimulate their interest in learning and to provide support and a guarantee for continuous improvement of transplant operations promotion and donation rate worldwide, specific organ donation courses and flexible training should be created.

Cultural barriers to organ donation among Chinese and Korean individuals in the United States: a systematic review

Asian Americans have the lowest organ donation registration rates in the United States, and the reason for this is incompletely understood. Aiming to understand the reasons for low organ donation registration rate among Asian Americans, more specifically Chinese and Korean Americans, we conducted a systematic search of databases, websites, and gray literature. Altogether, 34 papers were retained after the assessment of relevance and quality. Commonly reported barriers to organ donation registration among Chinese and Koreans in the literature included lack of knowledge about organ donation, distrust of health-care and allocation system, cultural avoidance of discussion of death-related topics, and desire for intact body mainly stemming from the Confucian concept of filial piety. Strong family values coupled with a cultural reluctance to discuss death-related topics among family members appear to underscore the reluctance to organ donation among Chinese and Koreans. Notably, improved knowledge negatively impacted organ donation intent and religion seemed to play a more important role when making decision about organ donation among Koreans, and the distrust of the allocation system is more prominent among Chinese. This information should be used to inform the development of culturally competent organ donation educational materials.