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Gonen LD, Bokek-Cohen Y, Tarabeih M. The general public's attitude towards accepting payment for kidney donation. Front Med (Lausanne) 2023; 10:1282065. [PMID: 38162890 PMCID: PMC10756681 DOI: 10.3389/fmed.2023.1282065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Kidney transplantation has become the most cost-effective treatment for patients with end-stage kidney disease (ESKD) and offers them the highest quality of life. Yet, kidney donation is often inaccessible due to cultural and traditional beliefs about organ donation. The goal of our study is to assess the value of kidney donation using the Willingness to Accept (WTA) technique. We also aim to understand the factors influencing an individual's willingness to donate an organ. Methods A self-administered survey was completed by 985 participants from the general public. The quantitative method and survey design that were chosen used descriptive, correlational, nonparametric, and multivariate statistical tests. Results Most of the respondents, 895 (90.9%) are not willing to donate a kidney while alive. Four hundred and five (41.1%) of the respondents are not willing to donate a kidney after their death, while the rest are willing to donate their kidney after their death without financial compensation. The same attitude applies to the donation of a kidney from their relatives. Significant predictors from the results of the logistic regression model in predicting the lowest (minimal) amount that will encourage donation of one kidney after death were: Marital status; Nationality; Adi card holder; Knowing people who need a kidney donation; confidence in the medical staff; and consideration of the family's opinions regarding organ donation. Discussion Using cost benefit analysis (CBA), with the aim of evaluating the willingness of individuals to accept payment for innovative medical procedures, such as kidney donation, allows an assessment of the perceived value of the medical procedure and enables policymakers to decide whether to allocate funds or offer subsidies for kidney donation, given the limited healthcare resources available. During our research, we found that most participants did not support the commercialization of organs. Our recommendation for policymakers and health professionals is to continue providing adequate funding for kidney donations and to implement educational programs aimed at improving attitudes towards organ donation.
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Affiliation(s)
| | | | - Mahdi Tarabeih
- School of Nursing, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
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2
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Umair S, Ho JA, Ng SSI, Basha NK. Moderating Role of Religiosity and the Determinants to Attitude, Willingness to Donate and Willingness to Communicate Posthumous Organ Donation Decisions among University Students in Pakistan. Omega (Westport) 2023; 88:216-244. [PMID: 34505539 DOI: 10.1177/00302228211045170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Organ transplantation is considered an alternative treatment to save lives or to improve the quality of life and is a successful method for the treatment of patients with end-stage organ diseases. The main objective of the current study was to explore the determinants of the attitudes and willingness to communicate the posthumous organ donation decisions to the families. Questionnaires were used to test the hypothesized relationships. The results confirmed altruism, knowledge, empathy, and self-identity as the antecedents to attitude. We also found perceived behavioral control, moral norms, and attitude as significant antecedents to the willingness to donate organs after death. The results of the study also indicated that those who were willing to sign the donor card were also willing to communicate their decision to their families. Religiosity moderated the relationship between willingness to donate and signing the donor card, and it strengthened the relationship. The findings of this study would provide insight into the factors which can influence posthumous organ donation among university students in Pakistan.
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Affiliation(s)
- Sonia Umair
- School of Business & Economics, Universiti Putra Malaysia, Selangor, Malaysia
| | - Jo-Ann Ho
- School of Business & Economics, Universiti Putra Malaysia, Selangor, Malaysia
| | - Serene Siew Imm Ng
- School of Business & Economics, Universiti Putra Malaysia, Selangor, Malaysia
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3
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He Y, Liu Q, Wen H, Yuan L, Luo C, Yuan R, Xiao Z, Li L. The relationship between body donation and attitudes toward death and altruism in Changsha City in China. Anat Sci Educ 2023; 16:1200-1208. [PMID: 37328430 DOI: 10.1002/ase.2309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/22/2023] [Accepted: 06/02/2023] [Indexed: 06/18/2023]
Abstract
In recent years, China has been facing a shortage of cadavers for teaching medical students. A better comprehension of the attitudes and factors influencing the general public's opinion toward body donation would be invaluable for planning and implementing body donation programs. Although altruistic attitude and attitudes toward death have received considerable attention in recent years globally, they have been largely understudied in China. Herein, the potential relationship between attitudes toward altruism and death, and willingness toward whole-body donation in a sample of university students in Changsha City in China were analyzed. A multi-stage sampling method was adopted to recruit 478 Chinese college students from two universities: the Medical College of Hunan Normal University (n = 272) and the College of Civil engineering of Hunan University (n = 206). The study participants were assessed by a sociodemographic questionnaire, the Death Attitude Profile-Revised (DAP-R-C) questionnaire, and the altruism scale. Moreover, Chinese University students demonstrated moderate willingness to donate their bodies. The mean score of the willingness of study participants to donate their bodies was 3.138 ± 0.933 (5-point Likert scale). Acceptance toward death, gender, and type of university were positive factors, whereas fear of death negatively affected willingness toward body donation. Regression analysis showed that factors, including gender (β = 0.237), type of university (β = 0.193), natural acceptance (β = 0.177), and fear of death (β = -0.160) influenced willingness toward body donation. Overall, the present study provides hitherto undocumented evidence on factors influencing willingness toward body donation among Chinese university students, which can assist in designing public awareness programs for encouraging body donation.
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Affiliation(s)
- Ying He
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Qian Liu
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Hong Wen
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Liming Yuan
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Chuhong Luo
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Rong Yuan
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - ZhiYong Xiao
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Lun Li
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, People's Republic of China
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Humar SS, Jung J, Krause S, Selzner N, Abbey S. Gift Discourse in Transplant and Its Implications in Anonymous Living Liver Donation. Transplant Proc 2023; 55:274-278. [PMID: 36822887 DOI: 10.1016/j.transproceed.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/24/2023] [Indexed: 02/25/2023]
Abstract
The Gift of Life metaphor is prevalent in pro-donation dialogue, aiming to promote transplant programs and conceptualize the act of organ donation. To obtain a better understanding of living donor perceptions on the term Gift of Life, we analyzed thematic views presented by anonymous living donors (ALLDs). Twenty-six ALLDs completed a semi-structured qualitative interview consisting of questions regarding their motivations, experiences, and perceptions on donation. The following 5 major themes relating to the Gift of Life terminology were elucidated: (1) Complete agreement with the term and its relevance to donation. (2) Their donation did not represent a Gift of Life. (3) The term was too grandiose. (4)A belief that the term has more meaning for the recipient rather than donor. (5 )That the "gift" goes both ways, with the donor also benefiting from the experience.
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Affiliation(s)
- Sapna S Humar
- Ajmera Transplant Center, University Health Network, Toronto, Ontario, Canada; Center for Mental Health, University Health Network, Toronto, Ontario, Canada.
| | - Judy Jung
- Multi-Organ Transplant & Medical Specialties, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sandra Krause
- Center for Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Nazia Selzner
- Ajmera Transplant Center, University Health Network, Toronto, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan Abbey
- Center for Mental Health, University Health Network, Toronto, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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5
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Haw J, Holloway K, Goldman M. How do we forecast tomorrow's transfusion? Applying social science approaches to meet tomorrow's transfusion needs: Blood donors and donation. Transfus Clin Biol 2023; 30:47-51. [PMID: 36372196 DOI: 10.1016/j.tracli.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Jennie Haw
- Medical Affairs & Innovation, Canadian Blood Services, Canada, 1800 Alta Vista Drive, Ottawa, ON K1G 4J5, Canada; Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
| | - Kelly Holloway
- Medical Affairs & Innovation, Canadian Blood Services, 67 College Street, Toronto, ON M5G 2M1, Canada; Institute of Health Policy Management and Evaluation, University of Toronto, 155 College Street, Suite 475, Toronto, ON M5T 3M6, Canada.
| | - Mindy Goldman
- Medical Affairs & Innovation, Canadian Blood Services, Canada, 1800 Alta Vista Drive, Ottawa, ON K1G 4J5, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, 451 Smyth Road, Suite 2044, Ottawa, ON K1H 8M5, Canada.
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Egerod I, Bargfeldt EH, Kaldan G. Ponderings, Pleas and Prayer: A Qualitative Content Analysis of Danish Hospital Chapel Guest Books. J Relig Health 2023; 62:172-193. [PMID: 35904692 DOI: 10.1007/s10943-022-01612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
In Denmark, religious behavior is usually very private. Little is known of religious and spiritual needs of patients and family during critical illness and hospitalization. We aimed to explore contemporary thoughts and prayers related to critical illness and hospitalization expressed in hospital chapel Guest Books. Qualitative content analysis of written texts was performed on Guest Books completed from 2005-2019. We identified the main themes of health and illness, life and death, and science and religion. Visitors welcomed the Guest Books as a place to express religious and spiritual thought, even in a nominally nonreligious society.
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Affiliation(s)
- Ingrid Egerod
- Department of Intensive Care, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen O, Denmark.
| | - Egil Hansen Bargfeldt
- Church at Rigshospitalet/Ethnic Resource Team Blegdamsvej 9, 2100, Copenhagen O, Denmark
| | - Gudrun Kaldan
- Department of Neurology, Copenhagen University Hospital Rigshospitalet Glostrup, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark
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7
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Rochelle TL, Ng JS. Examining behavioural intention towards organ donation in Hong Kong. J Health Psychol 2023; 28:17-29. [PMID: 35443819 DOI: 10.1177/13591053221092857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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8
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Siraj MS. How a compensated kidney donation program facilitates the sale of human organs in a regulated market: the implications of Islam on organ donation and sale. Philos Ethics Humanit Med 2022; 17:10. [PMID: 35897010 PMCID: PMC9331153 DOI: 10.1186/s13010-022-00122-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/05/2022] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales. METHODS This study reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation. RESULTS AND DISCUSSION According to Islamic law, organ donation is an act of sadaqatul jariyah, and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maxim eethaar, undermining donors of 'selfless' or 'altruistic' motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran's unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran's unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of 'buyer and seller', ensuring the philosophy of 'donor and recipient' is maintained. CONCLUSIONS Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors' health and reducing human suffering without legalizing the human organ trade.
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Affiliation(s)
- Md Sanwar Siraj
- Department of Government and Politics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
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9
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Siraj MS. Ethical Analysis of Appropriate Incentive Measures Promoting Organ Donation in Bangladesh. Asian Bioeth Rev. [DOI: 10.1007/s41649-022-00208-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 01/10/2023] Open
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10
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Gonen LD, Bokek-Cohen Y, Azuri P, Tarabeih M. Differential Willingness to Pay for Kidney Transplantation From Living and Deceased Donors: Empirical Study Among End-Stage Kidney Disease (ESKD) Patients. Inquiry 2022; 59:469580221139368. [PMID: 36484339 DOI: 10.1177/00469580221139368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Kidney transplantation has developed to the stage where it is currently the most cost-effective treatment for patients suffering from end-stage kidney disease (ESKD) and, when available, offers them the highest quality of life. Yet, kidney transplantation is challenged by cultural and traditional beliefs; thus, this study sought to evaluate the willingness to pay for a kidney transplant in a culturally sensitive population. A self-administered survey was completed by 734 end-stage kidney disease (ESKD) patients. A quantitative method and survey design were chosen and employed descriptive, correlational, nonparametric, and multivariate statistical tests. Participants were willing to pay a mean amount of $40 751.36 for a living donor kidney transplant, whereas the mean is considerably lower, $18 350.51, for a deceased donor kidney. Significant predictors of the willingness to pay (WTP) for a kidney transplant from a living donor and a deceased donor were found, among them: religiosity and ethnicity. The participants' willingness to pay for a kidney transplant could attest to significant benefits in enhancing patient well-being. The willingness to pay differentially for a donation from a deceased or a living donor stems from the higher chances of success with a living-donor organ as well as from moral and religious motives. In Israel kidney transplantation is not tradable in the free market and is fully funded by the state. The average cost of kidney transplantation in Israel is $61 714.50. Since the cost exceeds the utility and since the economic literature suggests that the funding of healthcare interventions should be provided up to the point where the costs of that funding equal the benefits that society derives from it, crucial revisions in public health policy should be made. Education may have a significant impact on the approach to kidney donation and organ donation in general.
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Affiliation(s)
- Limor Dina Gonen
- Department of Economics and Business Administration, Ariel University, Ariel, Israel
| | - Ya'arit Bokek-Cohen
- Department of behavioral sciences, Academic College of Israel, Ramat-Gan, Israel
| | - Pazit Azuri
- Tel Aviv-Yafo Academic College, Tel Aviv, Israel
| | - Mahdi Tarabeih
- School of Nursing Science, Tel Aviv-Yafo Academic College, Tel Aviv, Israel
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11
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Thomas R, Consolo H, Oniscu GC. Have we reached the limits in altruistic kidney donation? Transpl Int 2021; 34:1187-1197. [PMID: 34008872 DOI: 10.1111/tri.13921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/05/2023]
Abstract
Altruistic donation (unspecified donation) is an important aspect of living donor kidney transplantation. Although donation to a stranger is lawful and supported in many countries, it remains uncommon and not actively promoted. Herein, we ask the question if we have reached the limit in altruistic donation. In doing so, we examine important ethical questions that define the limits of unspecified donation, such as the appropriate balance between autonomous decision-making and paternalistic protection of the donor, the extent of outcome uncertainty and risk-benefit analyses that donors should be allowed to accept. We also consider the scrutiny and acceptance of donor motives, the potential for commercialization, donation to particular categories of recipients (including those encountered through social media) and the ethical boundaries of active promotion of unspecified kidney donation. We conclude that there is scope to increase the number of living donation kidney transplants further by optimizing existing practices to support and promote unspecified donation. A number of strategies including optimization of the assessment process, innovative approaches to reach potential donors together with reimbursement of expenses and a more specific recognition of unspecified donation are likely to lead to a meaningful increase in this type of donation.
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Affiliation(s)
- Rachel Thomas
- Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK
| | | | - Gabriel C Oniscu
- Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK.,Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
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Li P, Xu L, Tang T, Wu X, Huang C. Users' Willingness to Share Health Information in a Social Question-and-Answer Community: Cross-sectional Survey in China. JMIR Med Inform 2021; 9:e26265. [PMID: 33783364 PMCID: PMC8075348 DOI: 10.2196/26265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/10/2021] [Accepted: 03/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social question-and-answer communities play an increasingly important role in the dissemination of health information. It is important to identify influencing factors of user willingness to share health information to improve public health literacy. OBJECTIVE This study explored influencing factors of social question-and-answer community users who share health information to provide reference for the construction of a high-quality health information sharing community. METHODS A cross-sectional study was conducted through snowball sampling of 185 participants who are Zhihu users in China. A structural equation analysis was used to verify the interaction and influence of the strength between variables in the model. Hierarchical regression was also used to test the mediating effect in the model. RESULTS Altruism (β=.264, P<.001), intrinsic reward (β=.260, P=.03), self-efficacy (β=.468, P<.001), and community influence (β=.277, P=.003) had a positive effect on users' willingness to share health information (WSHI). By contrast, extrinsic reward (β=-0.351, P<.001) had a negative effect. Self-efficacy also had a mediating effect (β=.147, 29.15%, 0.147/0.505) between community influence and WSHI. CONCLUSIONS The findings suggest that users' WSHI is influenced by many factors including altruism, self-efficacy, community influence, and intrinsic reward. Improving the social atmosphere of the platform is an effective method of encouraging users to share health information.
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Affiliation(s)
- PengFei Li
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - TingTing Tang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.,The Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqian Wu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China.,Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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Fernández-Alonso V, Palacios-Ceña D, Silva-Martín C, García-Pozo A. Deceased donor care provided by the nurse transplant coordinator: A qualitative research study among Spanish nurses. Int J Nurs Pract 2020; 27:e12905. [PMID: 33305481 DOI: 10.1111/ijn.12905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/19/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this study is to describe the experience of nursing care provided to the deceased organ donor by the nurse transplant coordinator. METHODS A qualitative exploratory study was conducted within the National Transplant Organization and the Regional Office for Transplant Coordination. A purposive sampling method was used. Data collection methods included semistructured interviews. Sampling and data collection were pursued until the researchers achieved information redundancy. A systematic text condensation analysis was performed. The Guba and Lincoln criteria for guaranteeing trustworthiness were followed. RESULTS A total of 16 participants were recruited, and three themes were identified regarding care of organ donors by the nurse transplant coordinator during the organ donation process: (a) fulfilling the desire and will of the donor patient; (b) the family as an extension of the donor; (c) coordinating the organ donation process. CONCLUSIONS The donation process is both complex and delicate, and nursing care is an essential component. The care provided by the nurse transplant coordinator has the donor at the centre of the process, driven by respect for their decision. The family is seen as an extension of the donor. Nursing care should focus on continuous, honest communication, coordinating care with the intensive care unit, ensuring privacy and intimacy.
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Affiliation(s)
- Víctor Fernández-Alonso
- Gregorio Marañón Sanitary Research Institute (IiSGM), International Doctoral School, Rey Juan Carlos University, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Rey Juan Carlos University, Madrid, Spain
| | - Celia Silva-Martín
- Department of Nursing, Gregorio Marañón Sanitary Research Institute (IsSGM), Madrid, Spain
| | - Ana García-Pozo
- General University Hospital Gregorio Marañón, Gregorio Marañón Sanitary Research Institute (IiSGM), Madrid, Spain
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14
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Fernández-Alonso V, Palacios-Ceña D, Silva-Martín C, García-Pozo A. Facilitators and Barriers in the Organ Donation Process: A Qualitative Study among Nurse Transplant Coordinators. Int J Environ Res Public Health 2020; 17:E7996. [PMID: 33143168 DOI: 10.3390/ijerph17217996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/19/2023]
Abstract
Background: Spain is the world leader in organ donation, with a rate of 49.0 donations per million population. Nurse transplant coordinators fulfill key roles for the success of the complex donation process. Our aims were: (a) to describe the experience of nurse transplant coordinators and (b) to identify barriers and facilitators during the process of organ donation. Methods: A qualitative phenomenological study was conducted within the National Transplant Organization. A purposive sampling method was used, and data collection methods included semistructured interviews, researcher field notes, and participants’ personal letters. A systematic text condensation analysis was performed. The study was approved by the Clinical Research Ethics Committee. Results: A total of 16 participants were recruited and four themes were identified: (a) a different job for nurses, (b) facilitators and barriers of the coordinator’s job, (c) not a job for a novice nurse, and (d) coordinators facing a paradigm shift. Coordinators described their job as being characterized with uncertainty and having to face emotional and institutional barriers. The facilitators identified were high educational level and training, and feelings of pride for being part of the National Transplant Organization. Conclusions: The organ donation process requires specialized training to avoid organizational barriers.
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Abstract
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.
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Monday OI. Is altruism always sufficient for organ donation? vroom's expectancy theory, for expanding the organ donor pool. Saudi J Kidney Dis Transpl 2020; 31:503-507. [PMID: 32394924 DOI: 10.4103/1319-2442.284026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Organ transplantation is perhaps one area in which scientists have accomplished stunning outcomes in the 21st century. Nonetheless, the shortage of organs remains a major challenge of medical science, and worldwide, thousands of human organs are buried every day, especially from cerebrum-dead-injury victims. Using a method of philosophical analysis, this viewpoint study contends that the root cause of organ shortage is the dependence solely on altruistic organ donations. The unselfish organ donation is good, yet it is not enough. To close the gap between the demand and supply of organs, steps need to be taken to improve the organ donation pool. The Victor Vroom's expectancy theory, if applied, could expand the organ donor pool for transplantation.
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Ralph AF, Chadban SJ, Butow P, Craig JC, Kanellis J, Wong G, Logeman C, Tong A. The experiences and impact of being deemed ineligible for living kidney donation: Semi-structured interview study. Nephrology (Carlton) 2019; 25:339-350. [PMID: 31257667 DOI: 10.1111/nep.13628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2019] [Indexed: 11/29/2022]
Abstract
AIM We aimed to describe the impact and experience of being deemed ineligible as a living kidney donor. METHODS Semi-structured interviews were conducted with 27 ineligible donor candidates. Transcripts were analysed thematically. RESULTS Seven themes were identified: deriving health and relationship benefits in the process (strengthening emotional connection, identifying problematic health conditions); devastating loss and disappointment (harbouring guilt over personal failings, shattering confidence and hope, undermining relationships with extended family and friends, disrupting home dynamics); constrained within a rigid system (denied autonomy, resorting to other avenues); acknowledging as matter of fact (accepting the clinical decision, reassured by preventing a poor outcome); reluctant to relinquish the donor identity (unable to fulfil family duty, having the donor role stolen, holding onto other opportunities to donate); uncertainty in unpredictability, inconsistency and ambiguities (frustrated by inefficiencies, questioning clinician motivation, suspended donor status, unfairness in changeable eligibility criteria, unresolved concerns and questions of own health); and abandoned in despair (lacking practical support to meet eligibility criteria, ill prepared for rejection, dismissed and discarded by the system). CONCLUSION Being deemed unsuitable for donation took an emotional toll on ineligible donor candidates who felt immense guilt for 'failing' the potential recipient. Ineligible donor candidates were frustrated and angry with the perceived lack of support from clinicians and rigidity of the evaluation process. Informing potential donors of available services, including psychological support, communicating the decision sensitively and with sufficient time, and full disclosure of their health status, may contribute to improved adjustment following the ineligibility decision.
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Affiliation(s)
- Angelique F Ralph
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Steve J Chadban
- Kidney Node, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.,Renal Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Phyllis Butow
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.,Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Medical Psychology & Evidence-based Decision-making, The University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - John Kanellis
- Department of Nephrology, Monash Health and Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Charlotte Logeman
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Affiliation(s)
- Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Catherine Murray
- Division of Psychology, University of Stirling, Stirling, Scotland
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Ferguson E, Dorner L, France CR, France JL, Masser B, Lam M, Marta E, Alfieri S, Merz EM, Adams B, Huis in ’t Veld E, Scerri J. Blood donor behaviour, motivations and the need for a systematic cross-cultural perspective: the example of moral outrage and health- and non-health-based philanthropy across seven countries. ACTA ACUST UNITED AC 2018. [DOI: 10.1111/voxs.12471] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - Barbara Masser
- School of Psychology; The University of Queensland; Brisbane QLD Australia
- Clinical Services and Research; Australian Red Cross Blood Service; Brisbane QLD Australia
| | - Michael Lam
- School of Psychology; The University of Queensland; Brisbane QLD Australia
| | - Elena Marta
- Università Cattolica del Sacro Cuore; Milan Italy
| | - Sara Alfieri
- Università Cattolica del Sacro Cuore; Milan Italy
| | - Eva-Maria Merz
- Sanquin; Amsterdam The Netherlands
- Vrije Universiteit; Amsterdam The Netherlands
| | | | | | - Josianne Scerri
- University of Malta; Msida Malta
- University of London; London UK
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Dicks SG, Northam H, van Haren FMP, Boer DP. An exploration of the relationship between families of deceased organ donors and transplant recipients: A systematic review and qualitative synthesis. Health Psychol Open 2018; 5:2055102918782172. [PMID: 30083368 PMCID: PMC6069040 DOI: 10.1177/2055102918782172] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Following deceased organ donation and transplantation, the narratives of families of donors and organ recipients become connected. This is acknowledged when parties receive anonymous information from donation agencies and transplant centres, when they exchange correspondence or when they meet in person. This article reviews literature describing the experience from the points of view of donor families, recipients, and other stakeholders to explore the dynamic system that evolves around this relationship. Findings highlight a link between identity development and ongoing adjustment and will assist those supporting donor families and recipients to make decisions that fit meaningfully.
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Affiliation(s)
| | | | - Frank MP van Haren
- University of Canberra, Australia
- Australian National University,
Australia
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21
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Shaw RM, Bell LJ. 'Because you can't live on love': living kidney donors' perspectives on compensation and payment for organ donation. Health Expect 2015; 18:3201-12. [PMID: 25418552 PMCID: PMC5810734 DOI: 10.1111/hex.12310] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 11/30/2022] Open
Abstract
CONTEXT AND OBJECTIVE Living kidney donation accounts for approximately half of all kidney transplantation in many countries and is central to health policy focused on increasing organ supply. However, little examination of the economic consequences of living kidney donation has been undertaken from the perspective of donors themselves. This article documents living kidney donors' views regarding recompense and payment for organ donation, based on their experience. PARTICIPANTS Twenty-five living kidney donors from New Zealand participated in this study. METHODS This qualitative study, based on thematic analysis, uses semi-structured in-depth interviews to examine the experiences of living kidney donors. Themes were organized around altruism and the 'gift', perceptions of shared corporeality and identity, and donor support. RESULTS Most participants agreed the donation process was costly in terms of time and money. Many incurred personal costs, and some experienced financial hardship. All the participants viewed financial hardship as a barrier to organ donation and favoured recompense for direct and indirect costs. Most did not support payment for organs, and none supported commercialization. DISCUSSION AND CONCLUSIONS The findings show that framing organ donation as a 'gift' can stymie discussion about reciprocity, remuneration and exchange, making talk about financial recompense difficult. Financial well-being, nonetheless, has implications for the ability to care for self and others post-operatively. We conclude that the economic consequences for living kidney donors in jurisdictions where recompense for direct and indirect costs is insufficient are unfair. Review of financial assistance for live organ donors is therefore recommended.
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Affiliation(s)
- Rhonda M. Shaw
- School of Social & Cultural StudiesVictoria University of WellingtonWellingtonNew Zealand
| | - Lara J.M. Bell
- School of Social & Cultural StudiesVictoria University of WellingtonWellingtonNew Zealand
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Abstract
In jurisdictions where the sale of body tissue and organs is illegal, organ transplantation is often spoken of as a gift of life. In the social sciences and bioethics this concept has been subject to critique over the course of the last two decades for failing to reflect the complexities of organ and tissue exchange. I suggest that a new ethical model of organ donation and transplantation is needed to capture the range of experiences in this domain. The proposed model is both analytical and empirically oriented, and draws on research findings linking a series of qualitative sociological studies undertaken in New Zealand between 2007 and 2013. The studies were based on document analysis, field notes and 127 semi-structured in-depth interviews with people from different cultural and constituent groups directly involved in organ transfer processes. The aim of the article is to contribute to sociological knowledge about organ exchange and to expand the conceptual toolkit of organ donation to include the unconditional gift, the gift relation, gift exchange, body project, and body work. The rationale for the proposed model is to provide an explanatory framework for organ donors and transplant recipients and to assist the development of ethical guidelines and health policy discourse.
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Affiliation(s)
- Rhonda M Shaw
- School of Social and Cultural Studies, Victoria University of Wellington, New Zealand
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