Influence of Scientific Worldviews on Attitudes toward Organ Transplants: National Survey Data from the United States

Healthcare students support opt-out organ donation for practical and moral reasons

BACKGROUND AND PURPOSE

Changes to deceased organ donation policy in the USA, including opt-out and priority systems, have been proposed to increase registration and donation rates. To study attitudes towards such policies, we surveyed healthcare students to assess support for opt-out and priority systems and reasons for support or opposition.

METHODS

We investigated associations with supporting opt-out, including organ donation knowledge, altruism, trust in the healthcare system, prioritising autonomy and participants' evaluation of the moral severity of incorrectly assuming consent in opt-in systems ('opt-in error') or opt-out systems ('opt-out error'), by conducting an online survey among healthcare students at a large academic institution.

RESULTS

Of 523 respondents, 86% supported opt-out, including 53% who strongly supported the policy. The most popular reason for supporting opt-out was the potential for increased donation rates, followed by convenience for those not registered but willing to donate. The most popular reason for opposing opt-out was the belief that presuming consent is morally wrong. Those strongly supporting opt-out viewed the opt-in error as more morally unacceptable, and had higher knowledge and altruism scores. Those opposing opt-out viewed the opt-out error as more unacceptable, and had higher autonomy scores. 48% of respondents supported priority within opt-in systems; 31% supported priority in opt-out.

CONCLUSIONS

There is strong support for opt-out organ donation among healthcare students, influenced by both practical and moral considerations.

Knowledge and Attitudes Toward Renal Transplantation in Individuals Undergoing Transplant Evaluation

INTRODUCTION

The underutilization of kidney transplant as the preferred treatment for end-stage kidney disease is influenced by a lack of knowledge, poor attitudes, and various socio-demographic characteristics. Negative attitudes toward renal transplant disengage patients from the evaluation process and often hinder their likelihood of receiving a transplant.

PURPOSE

Determine whether a standardized educational session successfully improves knowledge and attitudes toward kidney transplant. Explore which socio-demographic variables are associated with more negative baseline attitude scores.

DESIGN

The program evaluation utilized a pre-test/post-test design to assess attitudes and knowledge toward renal transplant before and after an educational session. The pre- and post-surveys were distributed to a convenience sample of 341 and 115 patients, respectively, between the months of September and December 2019.

RESULTS

Exposure to a kidney transplant education program resulted in greater levels of knowledge (P = 0.019, d = 0.334). Individuals with no college education were found to have more negative baseline attitudes toward renal transplantation (P = 0.048, d = 0.382).

CONCLUSION

More research is needed to explore how knowledge, attitudes, and certain socio-demographic characteristics impact a patient's intention to pursue kidney transplant. Uncovering reasons as to why certain populations of individuals have more negative baseline attitudes toward kidney transplant may also provide clinicians and transplant programs with valuable information on how pre-transplant education can be tailored to meet the needs of specific populations.

A Study on the Attitude Toward Kidney Transplantation and Factors Among Hemodialysis Patients in China

BACKGROUND

Kidney transplantation (KT) is the most effective treatment for patients with end-stage renal disease. However, objective data regarding the willingness of patients with end-stage renal disease to undergo transplantation are lacking in China. The purpose of this study was to examine the attitudes and impact factors regarding KT among patients with end-stage renal disease undergoing hemodialysis.

METHODS

This study used a cross-sectional approach. Between June and July 2015, a total of 326 hemodialysis outpatients completed a self-designed questionnaire to assess their attitudes toward KT and satisfaction with dialysis.

RESULTS

Patients' mean age was 49.47 years, and the mean duration of hemodialysis was 52 months. Among these patients, 34.9% would like to undergo transplantation, and 4.23% of patients have a potential related living donor. Among the patients wishing to undergo transplantation, 43.93% had started a procedure to be grafted. The minority of patients (45.93%) stated that KT offers a better quality of life; 78.5% believe that it is more expensive than hemodialysis. Overall, 13.36% of patients are willing to become organ donors after death. The main motivating factor for KT was because of study or work difficulties (56.1%). The effects of the following 7 independent variables on attitude were assessed: age, education level, monthly income, sex, duration of hemodialysis, dialysis satisfaction, and reimbursement level.

CONCLUSIONS

To improve hemodialysis patients' accessibility to KT, better information must be provided to patients, their families, and other support providers. Transplantation is the best treatment for patients undergoing hemodialysis, which should be given more attention and political support economically and publicly by the government and some closely related agencies.

Identifying the Best Times for Cognitive Functioning Using New Methods: Matching University Times to Undergraduate Chronotypes

University days generally start at fixed times in the morning, often early morning, without regard to optimal functioning times for students with different chronotypes. Research has shown that later starting times are crucial to high school students' sleep, health, and performance. Shifting the focus to university, this study used two new approaches to determine ranges of start times that optimize cognitive functioning for undergraduates. The first is a survey-based, empirical model (SM), and the second a neuroscience-based, theoretical model (NM). The SM focused on students' self-reported chronotype and times they feel at their best. Using this approach, data from 190 mostly first and second year university students were collected and analyzed to determine optimal times when cognitive performance can be expected to be at its peak. The NM synthesized research in sleep, circadian neuroscience, sleep deprivation's impact on cognition, and practical considerations to create a generalized solution to determine the best learning hours. Strikingly the SM and NM results align with each other and confirm other recent research in indicating later start times. They add several important points: (1) They extend our understanding by showing that much later starting times (after 11 a.m. or 12 noon) are optimal; (2) Every single start time disadvantages one or more chronotypes; and (3) The best practical model may involve three alternative starting times with one afternoon shared session. The implications are briefly considered.