Organ donation: psychosocial factors of the decision-making process

Determination and Comparison of the Attitudes of Nursing and Theology Students Toward Organ Donation: Descriptive and Cross-Sectional Study

This study was conducted to determine and compare the attitudes of nursing and Theology students toward organ donation. This descriptive and cross-sectional study was conducted with 350 nursing and Theology students in Türkiye. An Information Form and the Organ Donation Attitudes Scale were used for data collection. Data were analyzed using the SPSS 26.0 software. The mean age of the students participating in the study was 22.59 ± 4.48 years, and 66% were female. 55.7% of the students were Theology students, and 44.3% were nursing students. The mean score for humanity and moral conviction was 92.43 ± 20.72, the mean score for fears of medical neglect was 28.89 ± 9.98, and the mean score for fears of bodily mutilation was 32.13 ± 10.21. It was found that nursing students' positive attitudes (humanity and moral conviction) toward organ donation were significantly higher, and negative attitudes (fears of medical neglect and fears of bodily mutilation) were significantly lower than Theology students (P < .05). The students' attitudes toward humanity and moral conviction regarding organ donation are positive, while their attitudes toward fears of medical neglect and bodily mutilation are negative. Nursing students' attitudes toward both humanity and moral conviction, and fears of medical neglect and bodily mutilation are more positive than the attitudes of Theology students. It is recommended that informative training on organ donation and transplantation processes should be organized in cooperation with nurses and religious leaders.

Barriers and willingness to express consent to organ donation among the Kazakhstani population

BACKGROUND

Organ donation is a critical component of healthcare, yet donation rates in Kazakhstan remain low. Understanding the socio-demographic factors, knowledge levels, and perceived barriers influencing individuals' willingness to consent to organ donation is essential for developing effective interventions.

METHODS

This cross-sectional study surveyed 1,294 participants across Kazakhstan. The sample was predominantly female (78.3%), urban (79.4%), and well-educated, with a significant proportion having medical backgrounds. Data were collected on socio-demographic characteristics, knowledge about organ donation, and perceived barriers. Comparison methods and binomial logistic regression analysis was used to identify significant predictors of willingness to express consent for organ donation.

RESULTS

Age, ethnicity, family status, and knowledge about organ donation were significant predictors of willingness to donate. Older participants and Russian ethnic group members were less likely to consent, while widowed individuals and those with higher knowledge levels were more likely to express consent. Although several factors did not have significant prediction with willingness to donate in the regression analysis, chi-square and U-tests revealed significant associations for residence, occupation, educational level, and religious affiliation. Key barriers to donation included distrust in the medical system, fears of organ trafficking, and insufficient awareness, particularly among non-medical participants. These barriers were significant deterrents and correlated with lower willingness to donate. However, due to the overrepresentation of urban, educated, and medical-affiliated participants in the sample, findings may not fully reflect the general population of Kazakhstan.

CONCLUSION

The findings highlight the need for targeted educational campaigns to increase public awareness and address misconceptions about organ donation. Building trust in the medical system and dispelling fears of unethical practices are essential for improving donation rates. The study underscores the complex interplay of socio-demographic factors, knowledge, and perceived barriers in shaping organ donation decisions in Kazakhstan, while also emphasizing the need for future research with a more representative sample.

Transforming organ donation and transplantation: Strategies for increasing donor participation and system efficiency

Organ transplantation is a critical medical procedure that saves and improves lives, yet the system faces significant challenges that result in many missed opportunities. This comprehensive review examines the factors contributing to these missed opportunities and the concerns of potential donors. The shortage of donors remains a major issue, exacerbated by low registration rates, family consent refusals, and strict medical and health criteria. Inefficiencies within the organ procurement and transplantation process, including logistical delays and suboptimal matching systems, further hinder the availability of organs. Public misconceptions and cultural and religious beliefs also negatively impact donor willingness. Moreover, potential donors and their families face ethical, psychological, and procedural concerns. Ethical dilemmas revolve around issues of autonomy and informed consent, while psychological concerns include fear and anxiety about the donation process and its impact on families. Procedural issues, such as transparency, legal hurdles, and post-donation follow-up, add to the complexities of organ donation. This review explores potential solutions to address these challenges, such as enhancing public education campaigns to dispel myths, and providing incentives for proactive registration. It also recommends improving the performance of organ procurement organizations, optimizing logistics for organ transport, and developing advanced matching algorithms to ensure equitable organ allocation. Addressing donor concerns through robust ethical standards, comprehensive psychological support, and clear communication strategies is essential. By adopting these multifaceted strategies, the organ transplantation system can be made more efficient and supportive, increasing the availability of organs and ultimately saving more lives. This review underscores the need for integrated and targeted approaches to overcome the existing barriers in organ transplantation.

Bereaved family members' perspectives of their organ donation decision at 3 months post death of the donor-eligible patient in critical care: A dual-method study

BACKGROUND

Offering organ donation is part of routine end-of-life care in critical care. Families describe feeling emotionally overwhelmed, which reduces their ability to understand complex medical information necessary to make informed decisions about organ donation. Late decisional regret is more common among families who decline donation. Thus, it is vital to investigate whether the organ donation decision choices that families make in hospital endure unchanged and what factors affect their perspectives.

OBJECTIVES

The objective of this study was to explore family members' perspectives of their final organ donation decision in hospital, either to consent or to decline donation, at around 90 d later.

METHODS

This dual-method study comprised semistructured interviews of family members of donor-eligible patients who experienced care in seven metropolitan teaching hospitals, a tertiary paediatric hospital, and a major regional hospital in New South Wales, Australia. Interviews were audio recorded and transcribed verbatim. Descriptive quantitative analysis and thematic analysis were used.

FINDINGS

Participants overwhelmingly agreed that their organ donation decision remained unchanged at 3 months after the death of their relative (n = 127, 97%). The remainder (n = 3, 2%) were unsure or stated "possibly not" (n = 1, 1%); in these cases, the eligible donor was certified dead via circulatory criteria. Five themes were synthesised in relation to the organ donation decision: Knowledge of the donor-eligible patient's prior wishes, Family members' prior decision to donate their own organs, Solace in the decision, Altruism, and Reality of the process.

CONCLUSIONS

The organ donation decision choice remained unchanged for the large majority. Further research is required to ascertain how people can be assisted to understand the organ donation process, particularly in the setting of certification of death by circulatory criteria, and how best to positively influence consent rates.

CLINICAL TRIAL REGISTRY NUMBER

Australian and New Zealand Clinical Trial Registration ACTRN12613000815763.

Gender disparity in living organ donation: a qualitative analysis of experiences and perceptions of female donors in Pakistan

OBJECTIVES

This study aims to explore and analyse the interplay of sociocultural, psychological and institutional factors, gender roles and power dynamics in shaping the decision-making processes and experiences of living kidney and liver donors in Punjab, specifically focusing on women.

DESIGN

This study employed a qualitative approach, using in-depth interviews to delve into the narratives and experiences of living kidney and liver donors in Punjab.

SETTING

Punjab Human Organ Transplantation Authority (PHOTA), Lahore, Punjab, Pakistan.

PARTICIPANTS

17 participants registered at the PHOTA for kidney or liver donation.

RESULTS

Interviews with living donors at PHOTA, Lahore, provided qualitative data, which was then systematically coded and analysed to identify recurring themes that explore the underlying social and cultural reasons for the observed gender disparity. The qualitative research yielded 17 interviews to include in the analysis, representing the voices of living kidney and liver donors. The study resulted in the following themes emerging: (1) female donation as a consequence of economic vulnerability; (2) comorbidities impacting donor eligibility; (3) altruism among female donors; (4) social and self-benefit of the donors and (5) social obligation on the female donors. These themes transcended the medical considerations and highlighted the interplay between social norms, family dynamics and gendered expectations surrounding caregiving and self-sacrifice.

CONCLUSION

The findings of this study underscore the significant relationship between gender roles, economic pressures and social expectations in the context of living organ donation. The study's results highlight the urgent need for targeted interventions to address the gender gap in living kidney and liver donation. By acknowledging the influence of social and economic factors, strategies to create a more equitable landscape for living kidney and liver donors can be created.

Organ Donation Conversations on X and Development of the OrgReach Social Media Marketing Strategy: Social Network Analysis

BACKGROUND

The digital landscape has become a vital platform for public health discourse, particularly concerning important topics like organ donation. With a global rise in organ transplant needs, fostering public understanding and positive attitudes toward organ donation is critical. Social media platforms, such as X, contain conversations from the public, and key stakeholders maintain an active presence on the platform.

OBJECTIVE

The goal is to develop insights into organ donation discussions on a popular social media platform (X) and understand the context in which users discussed organ donation advocacy. We investigate the influence of prominent profiles on X and meta-level accounts, including those seeking health information. We use credibility theory to explore the construction and impact of credibility within social media contexts in organ donation discussions.

METHODS

Data were retrieved from X between October 2023 and May 2024, covering a 7-month period. The study was able to retrieve a dataset with 20,124 unique users and 33,830 posts. The posts were analyzed using social network analysis and qualitative thematic analysis. NodeXL Pro was used to retrieve and analyze the data, and a network visualization was created by drawing upon the Clauset-Newman-Moore cluster algorithm and the Harel-Koren Fast Multiscale layout algorithm.

RESULTS

This analysis reveals an "elite tier" shaping the conversation, with themes reflecting existing societal sensitivities around organ donation. We demonstrate how prominent social media profiles act as information intermediaries, navigating the tension between open dialogue and negative perceptions. We use our findings, social credibility theory, and review of existing literature to develop the OrgReach Social Media Marketing Strategy for Organ Donation Awareness. The OrgReach strategy developed is based on 5 C's (Create, Connect, Collaborate, Correct, and Curate), 2 A's (Access and Analyse), and 3 R's (Recognize, Respond, and Reevaluate).

CONCLUSIONS

The study highlights the crucial role of analyzing social media data by drawing upon social networks and topic analysis to understand influence and network communication patterns. By doing so, the study proposes the OrgReach strategy that can feed into the marketing strategies for organ donation outreach and awareness.

Reasons for organ and tissue donation refusal and opposition: a scoping review

Objective

To map the reasons why individuals oppose or refuse organ and tissue donation, from an international perspective.

Methods

A scoping review was conducted from May 2022 to February 2024 using a three-stage search strategy across five databases and Google Scholar. Data analysis involved categorizing information based on similarities and populations studied.

Results

The analysis included 92 articles and national reports. The data collected were classified into two categories. Category 1 included the reasons why individuals oppose deceased donation: lack of knowledge about the donation process, 22 (16.5%); religious beliefs, 21 (15.8%); fear of mutilation or damage to body integrity, 17 (12.8%); conflicts with health care professionals during hospitalization or distrust of professionals or the organ donation process, 11 (8.3%); and unknown reasons, 11 (8.3%). Category 2 included the reasons why individuals refuse to donate a deceased relative's organs and tissues after the family interview for deceased donation: previous written or verbal expression by the potential donor, 42 (10.1%); fear of mutilation or damage to body integrity, 41 (9.9%); conflicts with health care professionals during hospitalization or distrust of professionals or the organ donation process, 38 (9.2%); religious beliefs, 37 (8.9%); and individual motivations, 36 (8.7%).

Conclusions

This scoping review found that there were two main categories of reasons behind being opposed to or declining organ and tissue donation, with 23 subcategories. By mapping these reasons across international contexts, these findings provide insights for future research and can be used to inform the development of educational initiatives on organ and tissue donation.

Barriers in Body Donations for Anatomy Teaching: Lessons Learned From Students and Donors

Introduction Cadaveric dissection has remained the mainstay of anatomy teaching. However, there is an acute shortage of cadavers for teaching undergraduate students, postgraduates, and specialists, and to supplement the gap, voluntary body donation is gaining momentum. The present study aims to explore the barriers to body donations for anatomical dissection. Methods A descriptive study was undertaken among medical students and registered voluntary body donors at a medical college in the Upper Assam region of India from January 2024 to March 2024. Results The majority of the first-year MBBS medical students (129 out of 161; 80.1%) were found to be not willing to donate their bodies for anatomical dissection. There was no statistically significant difference in the age, gender, and religion of the participants. The primary reasons for students' reluctance to donate were emotional attachments to themselves, their family members, their religion, and their preferences on social customs for the disposal of the dead. Among the registered voluntary body donors, the most common source of information for the body donation program was an awareness program conducted by NGOs involved in the promotion of body donation. Altruism was the most common motivation for getting registered for body donation. Provision of cadavers for research and training was the most common reason for registration for donation, whereas lack of information was the most common barrier. All the participants wanted due respect for the donated bodies from the doctors, students, and staff during handling. Conclusion The mere possession of knowledge regarding body donation does not increase participation in the actual process. Personal beliefs, repeated motivations by voluntary organizations and registered donors, proper utilization of the bodies, and setting examples in ethical handling of the donated bodies in the dissection hall may greatly improve the body donation program.

Public Acceptance of Living Donor Liver Transplant for Colorectal Liver Metastases: A Web-Based Survey

BACKGROUND

Recent advancements in cancer treatment and post-transplant management have expanded the population of living donor liver transplant (LDLT) candidates. We aimed to examine variations in public acceptance of LDLT based on patient diagnosis, including unresectable colorectal liver metastases (uCRLM).

METHODS

A web-based survey collected demographic information and general perceptions about organ donation in different settings. Respondents indicated their likelihood of being a living liver donor for a family member with genetic liver disease, alcohol-related liver disease (ALD), and uCRLM. Differences in the likelihood of donation between scenarios were compared.

RESULTS

There were 491 survey respondents (female [76.5%], Caucasians [87.4%], and had at least a college degree [98.2%]). Most (82.4%) were aware of the option of living liver donation before the study and 95% supported living organ donation in general. Over 80% were registered as organ donors. Ninety percent indicated that they would be likely to donate to a family member with a genetic liver disease if they qualified as a living donor; significantly more than ALD (59%) and uCRLM (71%) (p < 0.001). Willingness to donate to patients with uCRLM was significantly higher (p < 0.001) than the hypothetical patient with ALD with a clinically accepted recovery period of 6 months.

CONCLUSIONS

This study is the first of its kind to assess the public acceptance of living liver donation for uCRLM. Respondents were as or more supportive of donating to uCRLM as they were of generally accepted indications for LT. Further surveys with a broader respondent pool are warranted.

Organ donation and HIV: Awareness and willingness to be a living donor among people with HIV in Uganda

BACKGROUND

HIV+-to-HIV+ organ transplantation has demonstrated promise and is now authorized for research purposes in certain countries. However, organ transplantation is dependent on the availability of organ donors. We assessed the awareness and willingness to donate organs among people with HIV (PWH) in Uganda.

METHODS

We conducted a multicenter cross-sectional study between October 2023 and January 2024 in four large HIV clinics in Northern Uganda. The study population consisted of PWH. A structured questionnaire was used to collect data regarding awareness, willingness, and beliefs regarding organ donation. Organ donation was defined as the willingness to be a living donor of a solid organ. We conducted multivariable logistic regression to assess for an association between willingness to donate organs and selected exposures. Data were analyzed in Stata version 15.0. Results are expressed as adjusted odds ratio (AOR) with 95% confidence intervals (CI).

RESULTS

A total of 232 participants were recruited. The mean age ± standard deviation of the participants was 42.2±11.8 years. All participants were on antiretroviral therapy. Sixty-two (26.7%) had a CD4 count less than or equal to 200 cells/mm3. The majority (80.6%, n = 187) had ever heard of organ donation. Slightly more than a third (34.9%, n = 81) were willing to donate organs. Factors associated with willingness to be a living organ donor included being female (AOR: 1.56; 95% CI: 1.15-2.11), having a tertiary education level (AOR: 1.79; 95% CI: 1.03-3.11), average monthly income >500 000 UGX (135.1USD) (AOR: 5.5; 95% CI: 1.97-15.40), ever heard about organ donation (AOR: 5.4; 95% CI: 1.67-17.8), and attending an organ donation campaign (AOR: 2.0; 95% CI: 1.07-3.74).

CONCLUSIONS

Awareness about organ donation was high but the willingness to be a living organ donor was low among PWH in Uganda. There is a need to sensitize the community about the need and benefits of organ donation with the involvement of media and the healthcare workers.

Views of admitted palliative care patients and their clinicians on corneal donation discussions: a qualitative content analysis of semi-structured interviews

BACKGROUND

There is a severe shortage of corneas for donation, globally, for transplantation and research purposes. One group of individuals who could potentially be donors are those who die within the inpatient palliative care unit. The aim of the study was to understand clinician and patient perceptions of corneal donations and discussion of donation in palliative care units.

METHODS

A qualitative design was utilised with data collected through semi-structured interviews and analysed using qualitative content analysis. A total of 46 interviews were undertaken involving inpatient palliative care unit patients (19) and clinicians (27) in three major inpatient palliative care units in South Australia.

RESULTS

Very few patient participants reported being asked about corneal donations during their time in palliative care. Most inpatient palliative care unit clinicians did not raise the topic as they felt other areas of care took precedence. Inpatient palliative care unit patients thought if inpatient palliative care unit clinicians did not raise the topic, then it was not important. There were some differences between patient and clinician views, such as preference about who raises the possibility of donation and when the discussion might occur.

CONCLUSIONS

Findings suggest that patients are receptive to discussing corneal donations, but clinicians are not initiating these. This is a missed opportunity for donors and potential recipients. We recommend that clinicians routinely discuss eye donation as part of palliative care.

Parents' attitudes towards children's transplantology

Introduction

Pediatric transplantation is an extremely complex and emotionally difficult area of pediatric medicine. The process of obtaining a pediatric donor by the staff is an extremely delicate topic, and for the family of the deceased child, often an unimaginable and painful process. The aim of the study was to analyze parents' opinions on pediatric transplantology.Methods: The research survey method was applied using an original survey questionnaire made available electronically using a Google form. The group analyzed included 203 respondents.

Results

The attitude towards making transplant decisions among the respondents was positive. Education, age of parents and number of children did not influence attitudes towards pediatric transplantology.

Conclusions

There is a need for social education in the field of pediatric transplantation and to facilitate access to professional psychological care for pediatric patients and/or their caregivers.