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Saleh EEN, Tan JW, Lim HB, Annamalai O, Sim Chii M, Elhariri S. Knowledge, Attitudes and Intention to Donate Organs among the Public, Health Sciences Students and Health Personnel: A Scoping Review with a Systematic Review of Malaysian Studies. Malays J Med Sci 2024; 31:181-199. [PMID: 38456104 PMCID: PMC10917594 DOI: 10.21315/mjms2024.31.1.16] [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: 01/25/2023] [Accepted: 05/11/2023] [Indexed: 03/09/2024] Open
Abstract
Background Various barriers lead to a shortage of organs for transplantation in Malaysia. One drive to improve the organ donation rate operates through future healthcare practitioners and practitioner advocacy. This scoping review was carried out to establish and summarise findings about organ donation-related articles among the public, health sciences students and health personnel. A further aim was to synthesise the latest data on knowledge and attitudes towards organ donation in the Malaysian population. Methods PubMed, Scopus, Google Scholar and the Malaysian Medical Repository (MyMedR) were used for a search conducted up to May 2022. Relevant search terms included 'Organ donation' and 'Malaysia'. Journal articles related to knowledge, attitudes and intention were grouped under the general public and health science. Students and health personnel were included. Eligible studies were reviewed by two independent reviewers. Any disagreements were resolved by consensus with a third reviewer. Results The 31 included articles revealed an increased level of awareness among the public regarding organ donation. The analysis identified that nonrecognition of brainstem death (38.5%), no knowledge of how to contact the Organ Transplant Coordinator (82.3%) and never approaching the families of a potential donor (63.9%) led to a lack of confidence among healthcare practitioners to promote organ donation. Conclusion The shortage of organ donors is the result of the failure to identify the expected donor, obtain consent and procure the organs due to the passivity of Malaysian health professionals in promoting the organ donation process.
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Affiliation(s)
- Emad Eldin Naguib Saleh
- Department of Obstetrics and Gynaecology, International Medical University, Clinical Campus, Johor, Malaysia
| | - Jin Wei Tan
- International Medical University, Negeri Sembilan, Malaysia
| | - Hui Bing Lim
- International Medical University, Negeri Sembilan, Malaysia
| | | | - Ming Sim Chii
- International Medical University, Negeri Sembilan, Malaysia
| | - Sherreen Elhariri
- Department of Surgery, International Medical University, Negeri Sembilan, Malaysia
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Gan Kim Soon P, Lim SK, Rampal S, Su TT. A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants' perspective. PLoS One 2019; 14:e0220411. [PMID: 31404075 PMCID: PMC6690507 DOI: 10.1371/journal.pone.0220411] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/15/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION End-stage renal disease (ESRD) is increasing globally, and renal transplantation (RT) is the preferred renal replacement therapy to treat ESRD. Internationally, there are only a few countries with RT rates above 50 per million population (pmp), while most of the countries have RT rates between 30-40 pmp. The low- and middle-income countries (LMIC) makes up the majority for the RT rates below 20 pmp in which Malaysia belongs to despite its increasing ESRD rates. There is a need to explore the barriers to access RT with targeted solutions to improve the RT rates and service in LMIC. Thus, a qualitative study was undertaken in Malaysia to address this issue. METHOD A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly. RESULTS Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public's attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration. CONCLUSION The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.
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Affiliation(s)
- Peter Gan Kim Soon
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo Kun Lim
- Nephrology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sanjay Rampal
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- South East Asia Community Observatory (SEACO), Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Ríos Zambudio A, López-Navas AI, Garrido G, Ayala-García MA, Sebastián MJ, Hernández AM, Ramírez P, Parrilla P. Attitudes of Latin American Immigrants Resident in Florida (United States) Toward Related Living Kidney Donation. Prog Transplant 2018; 29:11-17. [PMID: 30595099 DOI: 10.1177/1526924818817073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Latin American immigrants comprise an important population group in the United States. The purpose of this study was to analyze the attitude toward living kidney donation found among Latin American citizens who are residents in Florida and to identify the psychosocial variables affecting their attitude. MATERIAL AND METHODS A sample of Latin American residents in the state of Florida was randomly obtained and stratified by nationality, age, and sex (n = 1524). Attitude was assessed through a validated questionnaire that was self-administered and completed anonymously. Descriptive, Student t test and the χ2 test were used to analyze findings. RESULTS The questionnaire completion rate was 94% (N = 1433), with 59% (n = 845) in favor of related living donation, 40% (n = 571) were opposed to donation, with the remaining 1% (n = 17) undecided. The following variables were related to attitude toward living donation: country of origin (P < .001), marital status (P < .001), having descendants (P = .004), educational background (P < 0.001), having had previous experience of donation and transplantation (P < .001), attitude toward deceased donation (P < .001), considering the possibility of needing a transplant (P < .001), the respondent's partner's opinion (P < .001), having considered the subject with one's family (P < .001), having carried out prosocial type activities (P < .001), the respondent's religion (P < .001), knowing that one's religion is in favor of this therapy (P < .001), concern about mutilation after donation (P < .001), and considerations of the risks of living donation (P < .001). CONCLUSIONS The attitude toward related living kidney donation of Latin American residents in Florida is not very favorable (only 59%).
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Affiliation(s)
- Antonio Ríos Zambudio
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain.,Department of Surgery, Pediatrics, Obstetrics and Gynecology, University of Murcia, Murcia, Spain.,Transplant Unit, Surgery Service, IMIB-Virgen de la Arrixaca University Hospital, Murcia, Spain.,Regional Transplant Center, Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain
| | - Ana Isabel López-Navas
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain.,Department of Surgery, Pediatrics, Obstetrics and Gynecology, University of Murcia, Murcia, Spain.,Department of Psychology, Universidad Católica San Antonio, UCAM, Murcia, Spain
| | | | - Marco Antonio Ayala-García
- Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, Mexico.,HGSZ No. 10 del Instituto Mexicano del Seguro Social Delegación, Guanajuato, Mexico
| | - María José Sebastián
- Transplant Coordination Center, UMAE Hospital de Especialidades Nº 25 IMSS, Monterrey, Mexico
| | - Antonio Miguel Hernández
- Endocrinology and Nutrition Service, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Servicio Murciano de Salud, Murcia, Spain
| | - Pablo Ramírez
- Department of Surgery, Pediatrics, Obstetrics and Gynecology, University of Murcia, Murcia, Spain.,Transplant Unit, Surgery Service, IMIB-Virgen de la Arrixaca University Hospital, Murcia, Spain.,Regional Transplant Center, Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain
| | - Pascual Parrilla
- Transplant Unit, Surgery Service, IMIB-Virgen de la Arrixaca University Hospital, Murcia, Spain.,Regional Transplant Center, Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain
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Lentine KL, Kasiske BL, Levey AS, Adams PL, Alberú J, Bakr MA, Gallon L, Garvey CA, Guleria S, Li PKT, Segev DL, Taler SJ, Tanabe K, Wright L, Zeier MG, Cheung M, Garg AX. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation 2017; 101:S1-S109. [PMID: 28742762 PMCID: PMC5540357 DOI: 10.1097/tp.0000000000001769] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022]
Abstract
The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a "proof-in-concept" risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided.In citing this document, the following format should be used: Kidney Disease: Improving Global Outcomes (KDIGO) Living Kidney Donor Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(Suppl 8S):S1-S109.
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Affiliation(s)
| | | | | | | | - Josefina Alberú
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | | | | | - Dorry L. Segev
- Johns Hopkins University, School of Medicine, Baltimore, MD
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Abstract
There is a trend of recruiting faith leaders at mosques to overcome religious barriers to organ donation, and to increase donor registration among Muslims. Commentators have suggested that Muslims are not given enough information about organ donation in religious sermons or lectures delivered at mosques. Corrective actions have been recommended, such as funding campaigns to promote organ donation, and increasing the availability of organ donation information at mosques. These actions are recommended despite published literature expressing safety concerns (i.e., do no harm) in living and end-of-life organ donation. Living donors require life-long medical follow-up and treatment for complications that can appear years later. Scientific and medical controversies persist regarding the international guidelines for death determination in end-of-life donation. The medical criteria of death lack validation and can harm donors if surgical procurement is performed without general anesthesia and before biological death. In the moral code of Islam, the prevention of harm holds precedence over beneficence. Moral precepts described in the Quran encourage Muslims to be beneficent, but also to seek knowledge prior to making practical decisions. However, the Quran also contains passages that demand honesty and truthfulness when providing information to those who are seeking knowledge. Currently, information is limited to that which encourages donor registration. Campaigning for organ donation to congregations in mosques should adhere to the moral code of complete, rather than selective, disclosure of information. We recommend as a minimal standard the disclosure of risks, uncertainties, and controversies associated with the organ donation process.
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Affiliation(s)
- Mohamed Y. Rady
- Department of Critical Care Medicine, Mayo Clinic Hospital, 5777 East Mayo Blvd, Phoenix, AZ 85054 USA
| | - Joseph L. Verheijde
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259 USA
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