Current Knowledge and Attitudes About Organ Donation and Transplantation Among Chinese University Students

How to effectively communicate health information on social media depending on the audience's personality traits: An experimental study in the context of organ donation in Germany

OBJECTIVE

The shortage of organs donated for transplantation is a global concern. Even though increasing awareness can boost organ donation registration rates (thus leading to a higher number of available organ transplants), public organ donation campaigns lack effectiveness and are rarely tailored to audiences. To further enhance the effectiveness of digital health (i.e., organ donation) communication, we assessed the perception of social media organ donation campaign strategies (i.e., transformational, informational, neutral) as a function of personality traits (i.e., Big Five).

METHOD

Data was collected through an online experiment with 1000 participants (i.e., German citizens between 18 and 70 years) who were recruited via Facebook and Prolific between Jun-Aug 2022. Perceived message effectiveness of the organ donation posts was measured on a 5-point Likert scale applying the AIDA model and consequently analyzed using multiple regression analyses.

RESULTS

Messaging strategy applied in the social media campaigns served as a predictor for message effectiveness depending on the personality traits of the audience when controlling for demographics and donor status. Extraversion was positively associated with higher message effectiveness of the transformational post while neuroticism showed a significant positive association with informational content. Agreeableness was positively correlated with transformational as well as informational post effectiveness. Furthermore, higher perceived post effectiveness increased the likelihood to sign-up for further organ donation information.

CONCLUSION

Our results show that Instagram in Germany is an underleveraged but potentially effective platform to spread organ donation knowledge. Based on our results, we urge public health authorities to revisit and start tailoring their (digital) health (i.e., organ donation) campaigns to audiences (i.e., personality traits) to increase their effectiveness.

Examining behavioural intention towards organ donation in Hong Kong

Although many people report favourable attitudes towards organ donation, Hong Kong has one of the lowest rates of organ donation globally. The present study examined behavioural intention towards organ donation. A convenience sample of 225 Hong Kong Chinese adults (118 = female) aged 18-82 years were recruited to an online survey. Behavioural intention, attitudes, subjective norms, self-efficacy, knowledge and altruism were examined. ANOVA was conducted to examine key differences based on behavioural intention, regression then examined predictors of behavioural intention to donate before exploratory analysis examined the mediating role of subjective norms on the relationship between self-efficacy and behavioural intention. Findings revealed over one third (38%) of respondents were actively registered as organ donors. Women were significantly more likely to be registered as organ donors. Subjective norms and self-efficacy were strong predictors of behavioural intention to donate, and subjective norms significantly mediated the relationship between self-efficacy and behavioural intention to donate.

Knowledge and attitude regarding organ donation among medical students in Hong Kong: a cross-sectional study

Objectives

The rate of organ donation in Hong Kong is among the lowest in developed regions. Since medical students will play an important role in counselling patients for organ donation and identifying potential donors in the future, their knowledge, attitudes and action for organ donation are important. This study aims to understand knowledge, attitudes and actions with regard to organ donation among medical students and investigate the factors determining the knowledge and attitudes.

Design

A cross-sectional study.

Setting and participants

Medical students in Hong Kong were invited to complete a questionnaire. 377 medical students participated in the study.

Methods

The questionnaire assessed their attitudes, knowledge, action of organ donation, belief and perception on organ donation, and other factors. Linear regression analyses and logistic regression were performed to analyse the effect of the variables on knowledge, attitudes and action for organ donation.

Results

Almost all medical students (99.5%) held a positive attitude towards organ donation, but only 28.1% have signed up as organ donors. Determinants of knowledge of organ donation included belief in preservation of intact body after death (β = –0.14, 95% CI = –0.24 to –0.04) and perceived confidence and competence of organ donation discussion (β = –0.12, 95% CI = –0.22 to –0.02). Predictors of organ donor registration status included knowledge of organ donation (OR=1.03, 95% CI=1.00 to 1.06), perceived convenience of organ donation registration (OR=3.75, 95% CI=1.62 to 8.71), commitment to organ donation (OR=3.81, 95% CI=2.01 to 7.21) and exposure to organ donation (OR=4.28, 95% CI=2.37 to 7.74).

Conclusions

Knowledge is positively associated with organ donation action. The above determinants of organ donation could be emphasised in medical education.

Investigation and Strategic Analysis of Family Barriers to Organ Donation in China

BACKGROUND

Families play a prominent role in the eventual organ donation decision. Because the deceased cannot directly express their wishes, their families become the actual decision makers. In China, families are permitted to make decisions regarding organ donation that may not be in accordance with the wishes of the deceased family member, and objections by families are a main bottleneck in the donation process.

METHODS

Face-to-face questioning was conducted with organ procurement organization coordinators. At the same time, questionnaires were distributed in 11 cities in Zhejiang Province.

RESULTS

Of the respondents, 69.9% considered family consent necessary and 77.1% thought that the view of their family had a great, even decisive, influence on them to decide to become donors. If the deceased family member had registered as an organ donor, 65.2% of families decided that they would respect the wishes of the deceased person. Adult children (58.6%) were more likely to donate than parents (37.4%; χ² = 123.009, P < .001). Those born after 2000 and after 1990 (62.5% and 52.8%, respectively) were much more likely to donate than those born after 1960 (18.1%; χ² = 191.485, P < .001). The interviews indicated that there were high rates of donation refusals within potential donation families. Most donor families chose to make hidden donations, and the majority of donor families had a simple family structure.

CONCLUSIONS

To promote organ donation, China needs to reconsider the role of families in the decision-making process. It is essential to increase organ donation awareness within the younger generation and encourage them to discuss with their families their willingness to donate.

From a terror management perspective: The efficacy of self-affirmation on organ donation-related thoughts and intentions in China

In 2015, the Chinese government officially abolished the practice of harvesting organs from executed prisoners. However, the voluntary donor registration rate among the Chinese population is approximately 2% as of January 2020. Guided by self-affirmation theory and terror management theory, the present investigation examined a number of variables that may be related to donor registration intentions and a method to mitigate death thoughts and misconceptions. An online experiment was conducted in which 352 Chinese participants were randomly assigned to either a self-affirmation (i.e., affirming values that are important to the participants) or a no-affirmation condition. Results revealed that self-affirmation lowered death thoughts among the participants, which in turn were positively related to organ donation misperceptions. Inconsistent with terror management theory, the level of death thoughts was not directly related to participants' intentions to register as organ donors. Instead, the relationship between the two was mediated by misperceptions toward organ donation.

The Impact of Religion and Provision of Information on Increasing Knowledge and Changing Attitudes to Organ Donation: An Intervention Study

One of the most significant developments in recent history has probably been organ donation and organ transplantation. They are frequently the only treatment available in certain cases. However, there is an ever-increasing discrepancy between the number of people needing transplantation and the organs available, because the decision to donate an organ is up to each individual. The study aims to assess the impact of the intervention on knowledge, attitudes and practices on organ donation among religious immigrants in Sweden. Data were collected through three group interviews using open-ended questions and qualitative content analysis. Thirty-six participants, 18 males and 18 females from six countries, participated in the focus group interviews. The analysis of the collected data resulted in two main categories: "Religion in theory and practice" and "More information-more knowledge about organ donation" including seven subcategories. Understanding of religion and religiosity, happiness by taking the class, the practice of religion in everyday life, the overcoming the prejudices in religion, having more information about organ donation and the donations process, as well as that the increased information changes people's minds, were some of things the informants emphasised as predictors of the decision of organ donation. A class dealing with religion, the religious aspects of organ donation and the way the Swedish healthcare system is organised increased people's knowledge and changed their attitudes so they became potential organ donors. More intervention studies are needed in every field of medicine to build confidence and give time to educate and discuss issues with potential organ donors in Sweden.

Medical Students' Attitudes Toward Deceased Organ Donation in China: A Cross Section Cohort Study

BACKGROUND

Influenced by traditional culture and lack of knowledge among Chinese, China has a low rate of organ donation after death. The aims of this study were to assess the attitude toward deceased organ donation among medical students in China and to identify the possible factors related with this attitude.

METHODS

An anonymous, self-administered questionnaire comprising 15 questions was distributed to 1500 first-to-fifth grade medical students, with 300 students in each grade.

RESULTS

The response rate was 90.9% (n = 1363). The level of knowledge about organ donation and the level of knowledge about the transplantation law were positively related with the seniority (P < .001). The attitude was favorable in 62.7% (n = 855) and against in 37.3% (n = 508) of the respondents. The attitude was related with family discussion about organ donation (P = .002), experience of blood donation (P = .004), willingness to accept a donated deceased organ (P < .001), and the decision of donating the organs of a family member (P < .001). No evidence of relation was detected for age, sex, grade, being an only child, coming from a city or village, knowledge of organ transplantation, knowledge of the transplantation law, and experience of organ donation and transplantation.

CONCLUSIONS

Most medical students in China had a favorable attitude toward deceased organ donation. This attitude was positively related with family factors, experience of blood donation, and willingness to accept a donated deceased organ. This attitude did not increase with seniority and a rising level of medical knowledge.

Organ Transplantation and Donation From the Point of View of College Students

BACKGROUND

The organ transplantation saves the life of individuals whose life is in danger due to organ/tissue failure. The presence of negative and positive attitudes toward tissue and organ donation is a determinant factor in the donation of tissue and organ donation.

PURPOSE

This study has aimed to explore the opinion of senior students studying at the undergraduate level toward organ transplantation and donation.

BASIC PROCEDURE

The study employed a descriptive and cross-sectional research design using a reliable questionnaire, which was distributed among 317 undergraduate students at the Faculty of Health Sciences (Physiotherapy and Rehabilitation, Nutrition, Nursing, Sports Sciences, Health Management Department) during the fall semester of the 2016-2017 academic year. A total of 240 responses were analyzed using χ² test with SPSS software.

MAIN FINDINGS

The results of the study showed that 57.4% of the students were willing to donate their organs after their death, 62.7% of the students' relatives wanted to donate their organs, 57.3% were willing to donate it to their deceased relatives, whereas 96.7% did not have any relative waiting for a transplantation. Families' negative opinions on tissue and organ transplantation and donation, status of getting information about tissue and organ transplantation and donation, and presence of a person waiting for tissue and organ transplantation in the family or in the environment were not effective in students' opinions about tissue and organ transplantation and donation (P > .05).

PRINCIPAL CONCLUSIONS

The results of this study contribute to determination of multicultural features of health sciences students that are likely to affect organ donation.

Confucianism and organ donation: moral duties from xiao (filial piety) to ren (humaneness)

There exists a serious shortage of organs for transplantation in China, more so than in most Western countries. Confucianism has been commonly used as the cultural and ethical reason to explain the reluctance of Chinese and other East-Asian people to donate organs for medical purposes. It is asserted that the Confucian emphasis on xiao (filial piety) requires individuals to ensure body intactness at death. However, based on the original texts of classical Confucianism and other primary materials, we refute this popular view. We base our position on the related Confucian norms of filial piety and ren (humaneness, humanity or benevolence), the tension between differentiated love and universal love, and belief in the goodness of human nature. In light of this, we argue that the Confucian ethical outlook actually calls for organ donation at an individual level, and supports an opt-out (presumed consent) system at the level of social policy. Furthermore, because the popular view is based on a number of dominant but misleading modes of thinking about cultural differences, our revisionist account of Confucian moral duties regarding organ donation has implications for developing a more adequate transcultural and global bioethics. These will be discussed and expanded upon.

Beyond Altruism: Framing Organ Donation in a 19-year Review of Chinese News Coverage

Despite a significant legal transformation of the organ donation system in China, the public's willingness to become organ donors remains low. This study provides the first empirical examination of how Chinese newspaper coverage reflects the complex interplay among multifaceted factors associated with the stagnant donation rate. Using framing as the primary theoretical lens, we analyzed 923 organ donation newspaper articles from 2000 to 2018 in terms of topics, facilitators and barriers, valence, and policy development. The three most common topics emphasized were: a new official information release regarding organ donation promotion; the challenges of promoting organ donation in social, cultural, and legal contexts; and the positive emotional appeals of organ donors, coordinators, and transplant surgeons. Findings suggest that the values that facilitators of and barriers to organ donation represent can be culturally favored but in conflict with each other. Sharp increases in the presence of policy development framing are associated with the official announcements of new legislation. A better understanding of trending topics and interacting influence from facilitators and barriers is imperative for developing culturally tailored messages to raise awareness about organ donation promotion.

The Influence of Age, Gender and Religion on Willingness to be an Organ Donor: Experience of Religious Muslims Living in Sweden

The transplantation of organs is one of the most successful medical advances in recent decades, and transplantation is the treatment of choice for severe organ failure worldwide. Despite this situation and the general acknowledgment of organ donation (OD) as a global priority, the demand for organs outstrips the supply in virtually every country in the world. The study aims to elucidate whether age, gender and religion influence decision-making about organ donation in religious Muslims living in Sweden Data were collected through three group interviews using open-ended questions and qualitative content analysis. Twenty-seven participants, 15 males and 12 females from four countries, participated in the focus group interviews. The analysis of the collected data resulted in three main categories: "Information and knowledge about organ donation," "The priorities when deciding about organ donation" and "The religious aspects of organ donation," including a number of subcategories. Good information about and knowledge of OD, priorities in OD, importance of the fact that religion must be studied and taught daily and religious education were only a few of the factors informants emphasized as predictors of the total and successful donation of organs. Age, gender or religion did not have an impact on organ donation. High levels of education through religious education and good information via various media, as well as a good knowledge of the Swedish language, are predictors of improved OD. In order to overcome religious ideology as a source of misinformation relating to OD and to promote increased OD in the future, specific intervention studies and the improved involvement of religious communities and education in schools and the healthcare system are vital and must be a starting point for improved OD.

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.

Development of a Multidimensional Attitude Scale for Organ Donation Research: An Example from China

This research refined the notion of attitude based on the reasoned action perspective of organ donation research at both the conceptual and the operational levels in the Chinese context. In Study 1, a multidimensional attitude scale was developed based on the salient beliefs of the Chinese toward registering to become an organ donor, and the scale's reliability, convergent validity, and discriminant validity were established. The results of Study 1 indicated that the attitudes toward registering to become an organ donor consisted of two statistically independent dimensions, namely, positive and negative attitudes. In Study 2, the predictive validity of the multidimensional attitude scale was confirmed, and the results indicated that negative attitudes, positive attitudes, and subjective norms significantly impacted behavioral intention, which, in turn, predicted organ donor registration behavior.

Theology and Nursing Students' Knowledge of Organ Donation and Transplantation

INTRODUCTION

The aim of the present study was to evaluate the knowledge level of nursing and theology students, who will deliver health care and religious services in the future, about organ donation.

METHODS

This cross-sectional study was conducted with 578 university students at Firat University Faculty of Health Science Nursing Department and Faculty of Theology.

RESULTS

Of the participants, 49.3% were nursing students and 50.7% were theology students. Although 3.8% of the students stated that a family member had donated an organ, only 0.5% of all students had a donation card. Among the nursing students, 34.4% stated that they had no reason for not having a donation card and that they might donate in the future. Among the theology students, the rate was 27.3%. In terms of reasons for wishing to be an organ donor, religious beliefs were more important to theology students than to nursing students (18.4% and 16.1%, respectively). The nursing students' total score on the Organ-Tissue Donation and Transplantation Knowledge Scale was significantly higher than that of the theology students (P < .05).

CONCLUSIONS

Although the current level of knowledge of nursing and theology students about organ donation and transplantation was adequate, the rate of organ donation was low. Therefore, not only health care professionals, but also religious officials have important roles to play in increasing the organ donation rate. Removing existing barriers to organ donation is important to resolve the current organ donation shortage in Turkey.

Does Confucianism allow for body donation?

Confucianism has been widely perceived as a major moral and cultural obstacle to the donation of bodies for anatomical purposes. The rationale for this is the Confucian stress on xiao (filial piety), whereby individuals' bodies are to be intact at death. In the view of many, the result is a prohibition on the donation of bodies to anatomy departments for the purpose of dissection. The role of dissection throughout the development of anatomy within a Confucian context is traced, and in contemporary China the establishment of donation programs and the appearance of memorial monuments is noted. In reassessing Confucian attitudes, the stress laid on a particular interpretation of filial piety is questioned, and an attempt is made to balance this with the Confucian emphasis on a moral duty to those outside one's immediate family. The authors argue that the fundamental Confucian norm ren (humaneness or benevolence) allows for body donation as people have a moral duty to help others. Moreover, the other central Confucian value, li (rites), offers important insights on how body donation should be performed as a communal activity, particularly the necessity of developing ethically and culturally appropriate rituals for body donation. In seeking to learn from this from a Western perspective, it is contended that in all societies the voluntary donation of bodies is a deeply human activity that is to reflect the characteristics of the community within which it takes place. This is in large part because it has educational and personal repercussions for students. Anat Sci Educ 11: 525-531. © 2018 American Association of Anatomists.

Willingness toward organ and body donation among anatomy professors and students in Mexico

Most anatomists agree that cadaver dissection serves as a superior teaching tool in human anatomy education. However, attitudes toward body donation vary widely between different individuals. A questionnaire was developed to determine the attitudes toward body and organ donation among those who learn the most from cadavers: medical students, medical student teaching assistants, medical students involved in research, and anatomy professors. A cross-sectional, prospective study was designed in which the questionnaire was distributed among first-year human anatomy students before undertaking cadaver dissection at the beginning of the semester, and then again after a commemoration service at the end of the course. The questionnaire items included demographic data, as well as questions designed to characterize participants' attitudes regarding body/organ donation from strangers, family members, and whether participants would consider such practices with their own bodies. Out of a total of 517 students enrolled in the Human Anatomy course in the Medical School at the Universidad Autónoma de Nuevo León, Mexico during January to June 2016, 95% responded to the first (491) and second (490) surveys. Participants' opinions on their own organ donation was similar before and after exposure to cadaver dissection, with between 87% and 81% in favor of such practices, and only 3% against it, in both surveys. Participants' willingness to donate their own bodies, as well as those of family members, increased, while reluctance regarding such practices decreased by half (P < 0.0001 and P < 0.05). Professors had the highest rates of positive opinions regarding their own body donation (74.9%), with 18.8% undecided. Low opposition toward organ and body donation remains prevalent among both anatomists and physicians in training in Mexico. Anat Sci Educ 10: 589-597. © 2017 American Association of Anatomists.

Demographic Characteristics of Voluntary Donors Registered in Beijing Tongren Hospital Eye Bank of China: A Retrospective Study From 2007 to 2016

BACKGROUND

Lack of willingness to pledge eyes among the general population is the main cause for the shortage of cornea tissue in China. A few studies have implied that general-population adults with specific demographics showed more willingness to donate their eyes.

METHODS

In this study, we analyzed the demographic characteristics of 918 voluntary donors registered in Beijing Tongren Hospital Eye Bank in the past 10 years for possible predictors that might help us to identify potential donors in Beijing and increase the donation rate. All copies of voluntary eye donation application forms filled by the registrants from 2007 to 2016 were collected. Basic demographics listed in the application form were extracted for analysis. Demographics were described as proportions and compared by means of a χ² test. Besides that, donor counts and proportions of combining 2 demographics from the 4 main demographics were described and compared.

RESULTS

Voluntary donors greater than 50 years of age (n = 477, 53.0%) predominated the proportions. Regarding education level and occupation, donors with tertiary education (n = 484, 57.4%) were more numerous than donors with primary and secondary education (n = 355, 42.1%); office clerks, workers, and government officers were more willing to pledge eyes than were donors engaged in other occupations. In addition, donors of the Han race (n = 856, 94.9%) made up the majority and mainly were distributed in 5 central administrative districts of Beijing (n = 629, 77.5%).

CONCLUSIONS

The present study suggests that older women (>50 years of age), living in a central district, with higher education level and engaged in white-collar work, were possible predictors for potential donors.

Psychosocial barriers associated with organ donation in Mexico

INTRODUCTION

There is a severe shortage of organs for transplantation worldwide, and Mexico has one of the lowest organ donation rates. In this study, we explored the psychosocial barriers that prevent posthumous organ donation by Mexicans.

METHOD

We asked 218 adults who were not willing to be donors to complete the sentence "I don't want to donate my organs after death because organ donation is…" The data were analyzed using the Natural Semantic Networks Technique.

RESULTS

The most important answers given by the participants were related to mistrust. Older participants and those with limited education gave more answers that reflect misconceptions about organ donation. Many participants acknowledged its benefits, even though they did not want to be donors, especially the youngest and those with a higher education.

CONCLUSIONS

Mistrust and poor education are problems that urgently need to be addressed in order to increase acceptance of organ donation and transplantation.

An Exploratory Study on University Students' Perceptions of Posthumous Organ Donation Base on the Theory of Reasoned Action

In view of the general support for organ donation but low registration rate in Hong Kong, the present research attempted to understand the attitude-behavior inconsistency by identifying the underlying beliefs for organ donation through employing the theory of reasoned action. A qualitative approach using semi-structured focus groups was adopted and 19 students from three universities in Hong Kong participated; 10 constructs were identified: attitude, subjective norm, helping, continuation, contribution, body intact, distrust to the medical system, indifference to organ donation, negative affect, and family burden. Findings suggested that their attitudes toward organ donation were of both the cognitive and affective nature; subjective norm of family, friends, and people they respect were identified as influential to students' views on organ donation. The study provided insight in promoting organ donation, that the cognitive concerns about keeping the body intact, and the negative affects introduced should also be addressed.

Knowledge and Opinions of Deceased Organ Donation Among Middle and High School Students in Korea

BACKGROUND

Adolescents are an important target group for organ donation education. As yet, little is known about the attitude of Korean adolescents toward deceased organ donation, or the factors related to their decision. In this study, we explored the knowledge and opinions of deceased organ donation among middle and high school students in Korea.

METHODS

A self-reported survey was conducted among middle and high school students in Seoul, Korea. The questionnaire assessed knowledge, personal experience, and opinions of organ donation. Logistic regression analysis was performed to determine significant factors associated with willingness to become an organ donor.

RESULTS

Of the 323 students, 161 (49.8%) were willing to be a deceased donor, and the other 162 (50.2%) were unwilling or unsure. Neither level of knowledge nor experience of recent public information on organ donation affected students' decisions. Instead, a cohesive family environment and family discussion were strong predictors of the willingness of Korean middle and high school students to be an organ donor.

CONCLUSIONS

A donation education program that promotes family communication and discussion about organ donation could increase willingness to be an organ donor among Korean adolescents.

Knowledge Attıtudes and Behavıors About Organ Donatıon Among Fırst- and Sıxth-class Medıcal Students: A Study From Turkey

OBJECTIVES

The aim of this study is to determine the knowledge, attitude, and behaviors of Erciyes University School of Medicine students regarding organ donation.

MATERIALS AND METHODS

This descriptive study was conducted in 2014 on Erciyes University School of Medicine first- and sixth-grade students via questionnaire. It was to be conducted on all 490 students; in total, 464 students were enrolled-304 from first grade and 160 from sixth grade. Data were analyzed using descriptive statistics, χ(2) test, and binary logistic regression analysis.

RESULTS

The mean age was 20.9 ± 2.8 years and it was found that 48.9% were male, 65.5% were in first grade; 50.0% of the students who participated in the study were considering donating their organs and this rate is 45.4% in the first grade and 58.8% at sixth grade. Those who donated their organs were 3.4% in the entire group and were 1.6% and 6.9% consequently in first and sixth grades. Those who are; at the sixth grade, female gender, those who feel themselves responsible for the donation of society, who think organ donation is appropriate in terms of religion and conversations within family about organ donations significantly want organ donation more statistically. However, grade and gender had no effect on wishing donating organs according to binary logistic regression analysis. The rate of feeling themselves responsible from the donation in society was 73.9% and finding organ donation appropriate in terms of religion was 75.6% and there wasn't significant difference between first and sixth grades.

CONCLUSION

Although there are increases in many variables about this issue at sixth grade, students are unable to gain sufficient attitude and behavior about organ donation. Training can be planned during medical educations in terms of gaining attitudes and behaviors about the issue.

Historical development and current status of organ procurement from death-row prisoners in China

Background

In December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners.

Discussion

In the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to “voluntarily donate” organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards.

Conclusions

Organ sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with “consent” are now simply labelled as “voluntarily donations from citizens”. The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain.

Electronic supplementary material

The online version of this article (doi:10.1186/s12910-015-0074-0) contains supplementary material, which is available to authorized users.

Body Donation after Death: The Mental Setup of Educated People

INTRODUCTION

Without dissection of cadavers teaching and learning of anatomy is nearly difficult; there remains a gap between the practical knowledge and the gathered theoretical knowledge. But there is a scarcity in the availability of the donated bodies for the sake of medical education. On the other hand a large number of people in our country are in waiting list for organ transplantation which could be overcome by deceased organ donation.

AIM

Aim of the study was to evaluate the awareness regarding body donation after death.

MATERIALS AND METHODS

A cross-sectional study was conducted among medical students, engineering students and doctors in Indian population. Total 300 participants were answered the questionnaire providing information about the knowledge and attitude towards body and organ donation.

RESULT

46.33% of entire study group had strongly positive attitude about cadaveric organ donation and 17% had no idea about this. 18% of total participants were unwilling for body donation after death.

CONCLUSION

The present study has been done elaborately to find out the different barriers for body or organ donation. It is clear from the study that though there is high level of awareness, nobody has filled up the pledge form till now. It indicates that there is a gap between the knowledge and motivation for organ and body donation after death which has to be overcome by proper guidance and education. Media and other voluntary organisations could take an important role for this purpose.

Knowledge levels of and attitudes to organ donation and transplantation among university students. North Clin Istanb. 2015;2:19-25. [PMID: 28058335 PMCID: PMC5175046 DOI: 10.14744/nci.2015.58070]

OBJECTIVE:

The aim of the present study was to determine knowledge levels and attitudes about organ donation and transplantation among university students.

METHODS:

This descriptive study was performed with third-grade students of medicine, pharmacy, and law at a university. Samples weren’t selected in the study and it was executed with 145 students who had agreed to participate in the study. The data was collected using a questionnaire of 19 questions. Descriptive statistics were used to analyze the data.

RESULTS:

71.7% of students had positive views about transplantation of their own organs to a suitable recipient, with half of them giving being useful to others as a reason. Among students who had negative views about organ donation, the most important reason given was that it would mean a loss of bodily integrity. 44.1% of participants had positive views about transplantation of their relatives’ organs to another person after death. 51.7% of participants had positive views about transplantation of the organs of a homeless person to another person after death.

CONCLUSION:

Students had generally positive views about organ donation. However; organ transplantation and donation should be included in the students’ educational programs in order to increase positive attitudes and organ donations, and transform attitudes into behaviors.

Effects of targeted education for first-year university students on knowledge and attitudes about stem cell transplantation and donation

OBJECTIVES

Hematopoietic stem cell transplantation is a life-saving treatment, but donor numbers are lacking in Turkey and elsewhere. Increased awareness of hematopoietic stem cell transplantation among university students might help expand donation. We evaluated the effect of a brief targeted educational intervention on knowledge and attitudes about hematopoietic stem cell transplantation and donation among first-year university students in Turkey.

MATERIALS AND METHODS

There were 301 first-year university students (median age, 18 y) who volunteered: 163 medical students (54%) and 138 law students (46%). Before and after a brief lecture about hematopoietic stem cell transplantation, students answered a 5-item yes-or-no questionnaire regarding (1) knowledge about health benefits of hematopoietic stem cell transplantation; (2) knowledge about stem cell banking and donation in Turkey; (3) knowledge about the transplantation procedure; (4) prior experience and/or willingness to donate blood; and (5) willingness to donate stem cells. Reasons for motivation to donate blood and/or stem cells were categorized. Results before and after the lecture were evaluated with univariate and multivariate analyses.

RESULTS

The response rate was 100%. Significantly greater proportions of students had knowledge about hematopoietic stem cell transplantation and willingness to donate blood and stem cells after the lecture. There were no differences between medical and law students before the lecture. After the lecture, a significantly greater proportion of medical students indicated knowledge about health benefits of hematopoietic stem cell transplantation, stem cell banking and donation in Turkey, and the transplantation procedure.

CONCLUSIONS

Brief education about hematopoietic stem cell transplantation for university students can increase knowledge and awareness about hematopoietic stem cell transplantation and cause more positive attitudes about stem cell donation.

Relationships between Islamic religiosity and attitude toward deceased organ donation among American Muslims: a pilot study

BACKGROUND

Religion-rooted beliefs and values are often cited as barriers to organ donation among Muslims. Yet how Islamic religiosity relates to organ donation attitude among Muslims is less studied.

METHODS

Using a community based participatory research approach, we recruited adults from mosque communities to self-administer a questionnaire assessing levels of Islamic religiosity, attitude toward deceased organ donation, and sociodemographic descriptors.

RESULTS

Of the 97 respondents, there were nearly equal numbers of men and women. Over a third were Arab American (n=36), and nearly a quarter were either South Asian (n=23) or African American (n=25). Respondents viewing difficulties in life as punishment from God had a decreased odds of believing deceased organ donation to be justified (OR 0.85, P<0.05). Other measures of Islamic religiosity, such as intrinsic religiosity, positive religious coping and one related to following Islamic ethical guidelines, were not associated with organ donation attitude. Arab Muslims were more likely to believe deceased organ donation to be justified than South Asian or African Americans (OR 7.06, P<0.05). Sociodemographic descriptors including age, sex, and country of origin, as well as self-reported health and trust of the American health-care system, were not significantly associated with attitude toward deceased organ donation.

CONCLUSION

Higher levels of intrinsic religiosity or adherence to Islamic ethics do not appear to associate with negative attitudes toward deceased organ donation. Negative religious coping appears, however, to be related to lower rates of believing deceased organ donation to be justified. Future studies with larger samples that incorporate additional measures of religiosity can further clarify relationships between religiosity and organ donation attitude among Muslim communities.

Factors of the willingness to consent to the donation of a deceased family member's organs among the Romanian urban population

OBJECTIVES

Romania ranks near the bottom of the European hierarchy of posthumous organ donation rates. Objectives of this study were as follows: (1) to assess the willingness to donate (WTD) a family member's organs in the inhabitants of a large Romanian city (Iasi) and to analyze its factors; and (2) to determine the most important behaviors of the medical staff for our respondents in a hypothetical donation decision scenario.

METHODS

The study included a representative sample of the Iasi population. The instrument addressed WTD a family member's organs, both in general and in the particular situation of knowing that the deceased had a positive attitude toward organ donation, knowledge of transplantation-related issues, endorsement of beliefs concerning organ donation, and the importance of a set of medical staff's behaviors.

RESULTS

The questionnaire was completed by 1,034 participants, 48% (n = 496) of whom would most likely consent to donate a family member's organs, 18% (n = 191) would most likely refuse and 34% (n = 347) were unsure. The following factors were found to influence this variable: believing in the possible reversibility of brain death (P = .004); believing that body integrity should be preserved after death (P < .001); believing that part of the deceased continues to live through the organ recipients (P = .001); and being concerned about mutilation after donation (P < .001).

CONCLUSIONS

The WTD the organs of a deceased next of kin in the Iasi population, even when the deceased had positive attitudes on the matter, is lower than that reported by other studies in other European countries. It is mainly influenced by knowledge and concerns regarding the posthumous manipulation of the body. Consent in a potential donation situation also depends on the way in which the medical staff interacts with the bereaved family.

Knowledge and ethical perception regarding organ donation among medical students

BACKGROUND

To determine the knowledge and ethical perception regarding organ donation amongst medical students in Karachi- Pakistan.

METHODS

Data of this cross sectional study was collected by self administered questionnaire from MBBS students of Ziauddin University from 2010 to 2011. Sample size of 158 (83 First years and 75 Fourth years) were selected by convenient sampling and those students who were present and gave consent were included in the study. The data was analyzed by SPSS version 20.

RESULTS

A total of 158 participants from Ziauddin Medical University filled out the questionnaire out of which 83(52.5%) were first years and 75(47.5%) were fourth year medical students. Mean age of sample was 20 ± 1.7. Majority of students were aware about organ donation with print and electronic media as the main source of information. 81.6% agreed that it was ethically correct to donate an organ. In the students' opinion, most commonly donated organs and tissues were kidney, cornea, blood and platelet. Ideal candidates for donating organ were parents (81%). Regarding list of options for preference to receive an organ, most of the students agreed on young age group patients and persons with family. Willingness to donate was significantly associated with knowledge of allowance of organ donation in religion (P = 0.000).

CONCLUSION

Both 1st year and 4th year students are aware of Organ Donation, but there is a significant lack of knowledge regarding the topic.

The difference in the attitude of Chinese and Japanese college students regarding deceased organ donation

BACKGROUND

Under the influence of traditional oriental culture, the lack of organ donation is especially serious in China and Japan. The aim of this study was to compare Chinese and Japanese college students' attitudes and analyze contributing factors toward deceased donation.

METHODS

An anonymous, self-administered questionnaire comprising 15 questions was distributed to approximately 400 college students at Liaoning University, China, and Kyushu University, Japan. Statistical analysis used SPSS software.

RESULTS

Japanese students' attitude towards deceased organ donation was more favorable than that of Chinese students (43.6% versus 35.9%, P = .001). Several factors contributed to positive responses by students from both countries: family perspective on organ donation and transplantation; decision to donate to family members; prior blood donation; living liver or kidney donation; possibility of needing a transplant; and willingness to receive a deceased or a living donor organ.

CONCLUSIONS

More efforts must emphasize awareness and up-to-date knowledge regarding organ donation among citizens and should be undertaken by the Chinese and Japanese governments.

Religious and ethnic influences on willingness to donate organs and donor behavior: an Australian perspective

CONTEXT

Globally, the demand for donated organs outstrips supply, meaning that there are both practical and theoretical reasons for examining factors that are predictive of individuals' willingness to donate their organs upon their death.

OBJECTIVES

To determine whether individuals of different religious denominations living in Australia have different views on organ donation, whether donation attitudes differ significantly across ethnic groups, and whether factors identified in international research are predictors of willingness to donate and actual donor behavior in this population.

PARTICIPANTS

Data for this study were collected from students at an Australian university from a range of religious and ethnic backgrounds, and their friends and relatives (N = 509). Intervention-Participants were administered the Organ Donation Attitude Scale, as well as additional attitudes and knowledge measures.

MAIN OUTCOME MEASURES

Self-reported "willingness to donate" and "donor behavior".

RESULTS

Our findings complemented those reported in comparable countries, with females, younger Australians, and those with high knowledge levels being more willing to donate than males, older persons, and those with low knowledge. Persons who described themselves as having stronger religious beliefs (particularly Buddhist and Islamic) held less favorable attitudes toward donation, had lower knowledge levels, and were more likely to oppose donation.

CONCLUSIONS

Although this study established that attitudes toward, knowledge about, and predictors of organ donation in Australia are similar to those reported elsewhere, donation rates remain low. Further in-depth research examining the impact of religion and culture on attitudes, beliefs, and behavior is essential when exploring strategies to improve organ donation rates in highly multicultural societies such as Australia.

Religious and Ethnic Influences on Willingness to Donate Organs and Donor Behavior: An Australian Perspective

Context

Globally, the demand for donated organs outstrips supply, meaning that there are both practical and theoretical reasons for examining factors that are predictive of individuals' willingness to donate their organs upon their death.

Objectives

To determine whether individuals of different religious denominations living in Australia have different views on organ donation, whether donation attitudes differ significantly across ethnic groups, and whether factors identified in international research are predictors of willingness to donate and actual donor behavior in this population.

Participants

Data for this study were collected from students at an Australian university from a range of religious and ethnic backgrounds, and their friends and relatives (N = 509).

Intervention

Participants were administered the Organ Donation Attitude Scale, as well as additional attitudes and knowledge measures.

Main Outcome Measures

Self-reported “willingness to donate” and “donor behavior.”

Results

Our findings complemented those reported in comparable countries, with females, younger Australians, and those with high knowledge levels being more willing to donate than males, older persons, and those with low knowledge. Persons who described themselves as having stronger religious beliefs (particularly Buddhist and Islamic) held less favorable attitudes toward donation, had lower knowledge levels, and were more likely to oppose donation.

Conclusions

Although this study established that attitudes toward, knowledge about, and predictors of organ donation in Australia are similar to those reported elsewhere, donation rates remain low. Further in-depth research examining the impact of religion and culture on attitudes, beliefs, and behavior is essential when exploring strategies to improve organ donation rates in highly multicultural societies such as Australia.

Knowledge, attitudes, and behaviors of officials of religion about organ donation in Kahramanmaras, an eastern Mediterranean city of Turkey

OBJECTIVE

To establish the knowledge, attitudes, and behaviors of the officials of religion, a group with potentially powerful influence on the society, in particular regarding organ donation.

METHODS

This study, performed in Kahramanmaras Province, Turkey, included 416 of 641 officials of religion (64.9%): 295 of 492 imams (59.9%) and 121 of 149 Koran course educators (81.2%).

RESULTS

The mean (SD) age of the study group was 37.2 (8.2) years. Only 1.4% had stated that carried organ donation cards. Of participants who had not donated organs asked whether they thought of donation, 14.1% answered yes, 17.1% answered no, and 68.8% were undecided. Of the study group, 88.2% considered organ donation appropriate according to their religion. The imams compared with Koran course educators, and men compared with women demonstrated higher rates of considering organ donation appropriate according to their religion (P < .05). Among participants who stated they had knowledge about organ donation, the 3 leading information sources were television, newspapers or journals, and in-service training by the Directorate of Religious Affairs. The 3 primary organs the study group stated they were aware of being transplanted were kidneys, liver, and heart.

CONCLUSION

Although 88.2% of religious officials in the present study stated that organ donation was appropriate according to their religion, only 1.4% agreed to donate organs. Officials of religion hold an important place in society, and should be well informed and educated about organ donation via in-service training courses, and encourage organ donation by members of society.

Attitudes toward organ donation and donor behavior: a review of the international literature

OBJECTIVE

To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior.

DATA SOURCES

MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009.

STUDY SELECTION

Eligible studies included members of the general public (i.e., not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors. Data Extraction-The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis.

DATA SYNTHESIS

Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs.

CONCLUSIONS

The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs. (Progress in Transplantation.

Attitudes toward Organ Donation and Donor Behavior: A Review of the International Literature

Objective

To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior.

Data Sources

MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009.

Study Selection

Eligible studies included members of the general public (ie, not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors.

Data Extraction

The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis.

Data Synthesis

Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs.

Conclusions

The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs.

Attitude and behavior related to organ donation and affecting factors: a study of last-term students at a university

AIM

The aim of this study was to detect the behavior and attitude of our last-term students.

METHODS

The study group for this cross-sectional research consisted of 1690 last-term students. We applied a questionnaire about sociodemographic features, behaviors, and attitudes about organ donation. Data were evaluated with SPSS 11.0.

RESULTS

We accessed 1287 students among whom 1.3% stated that they would donate their organs. Among students who did not agree, 58.7% were considering donation. The main reasons for not agreeing to donation were fear of commercial use (45.7%) and the belief of inappropriateness related to religion (25.7%). In contrast, 62.3% stated that they would donate their organ when needed for their relatives. Also, 50.6% indicated that if one of their relatives died, they would donate their relative's organs; there was no significant difference based on gender. In addition, favorable thoughts about donation were significantly more prevalent for female subjects (P = .001). Organ donation behavior and thoughts were significantly higher among the group with better economic position (P = .001, .018); and for students whose mother had an education higher than high school (P = .003, .004). Higher donation ratios were observed for students who had a relative working in the medical field (P = .04) and the group who stated they were well informed about organ donation (P < .001).

CONCLUSION

When we take into account that our study group consisted of university students, organ donation rates were low. To overcome the difficulties, we have to inform the community and collaborate with religious organizations. To prevent fear that organs will be used commercially we must prove confidence in the system.

Survey of medical students of Shahed University in Iran about attitude and willingness toward organ transplantation

BACKGROUND

Transplantation is a successful procedure that prolongs the lives of people suffering from debilitating diseases. The purpose of this study was to assess medical students' attitude toward organ donation.

METHODS

The study population consisted of 262 medical students with a mean age of 22.1 +/- 2.5 years who were surveyed using a reliable questionnaire that examined their attitudes and willingness. All data analyses were performed using Chi-square and analysis of variance tests with SPSS.

RESULTS

The medical students had highly positive attitude toward organ donation (mean score 4.34 +/- 0.46) and a great willingness. Participants were more willing to donate their own organs than those of a deceased relative (85% vs 49.2%) to help others more than to develop science (91.2% vs 8.8%). The greatest willingness among students was kidney (84%) donation. There was no correlation between age, gender, education levels, and attitude toward organ donation.

CONCLUSION

These findings necessitate an organized education program of medical students in all aspects of organ and tissue donation.