Factors associated with organ donation.

Dear Editor,

Organ donation has evolved significantly from an experimental procedure to acceptable medical treatment for terminal illnesses. Despite these contemporary advances, there has been a relatively slow progress in the supply of organs for transplantation. This has resulted in global shortage of organs available for transplantation. There is a paucity of literature about the relationship between knowledge and attitudes toward organ donation. If barriers to the willingness for organ donation can be identified, these items can be targeted for change.[1] We conducted a literature search and identified numerous studies on factors associated with organ donation. We found many studies which assessed knowledge, attitudes, perceptions, and beliefs of health care professionals toward organ donation. We have attempted to summarize a few studies which we believe to have relevance regarding the same.

Matten et al. interviewed nurses regarding organ donation and found that they were knowledgeable about organ donation and their attitudes were moderately positive. Factors that were significant were knowledge, attitudes, and beliefs about donation.[2] Wakefield et al. assessed the role of religious and ethnic views regarding organ donation amongst university students. They administered the Organ Donation Attitude Scale with measures assessing knowledge and attitude. They found that females, younger students, and those with higher knowledge levels were more likely to have attitudes that favored organ donation. They also found that students who described themselves as having stronger religious beliefs and those with poor knowledge had less favorable attitudes toward organ donation. They suggested that further in-depth research examining the impact of religion and culture was essential to explore strategies for improving organ donation.[3] Jelinek et al. administered an online questionnaire regarding organ donation to Australasian healthcare professionals. They found that most members supported organ donation and around a quarter of their staff had received no education about it.[4]

Zampieron et al. conducted a survey on attitudes toward organ donation amongst undergraduate nursing students. They administered a self-rated quantitative questionnaire and the Organ Donation Attitude scale. They found no significant correlations between attitude toward organ-donation and the age and sex of the students. They concluded that awareness and attitude levels of nursing students toward organ donation was inadequate.[5] Siminoff et al. collected data regarding organ donation from health care professionals and family members of patients. Their study revealed that family and patient socio-demographics and prior knowledge of the patients’ wishes were significantly associated with willingness to donate. They suggested that public education is needed to modify attitudes about organ donation prior to a donation opportunity.[6]

Ballala et al. assessed the knowledge, attitude, and practices regarding organ donation among Indian medical professionals. They administered a semi-structured questionnaire and found that 8% were unaware of the term “body donation” and 85% believed that donated bodies were misused. They also found that 22% physicians were willing to donate their bodies and 68% expected the public to do the same.[7] Eide et al. investigated the need for learning and communication of intensive care doctors and neurosurgeons toward organ donation. They found that more than half had little experience of organ donation or how to relate to the patients’ relatives. They also found that many doctors reported a need to learn more about the medical issues and communication skills associated with organ donation. They concluded that training programs should focus on communication regarding organ donation with the caregivers of patients.[8] Tam et al. administered a questionnaire regarding knowledge, attitudes and commitment toward organ donation to nursing students. They found that attitude and educational year of the students were strongly correlated with commitment toward organ donation. They concluded that educational materials may be provided to students to facilitate their attitudes toward organ donation.[9] Jeon et al. assessed the knowledge and attitudes of health care professionals regarding organ donation. They found that the knowledge and attitudes of health care professionals regarding brain death and organ retrieval was poor. They found that gender, age, marital status, education level, and job position were significant in the attitude scores while marital status and education level emerged significant in the scores on knowledge.[10]

The reviewed literature suggests that health care professionals have poor knowledge and variable attitudes toward organ donation. We found differences in the methodology and measures in the studies that we reviewed. Certain studies used validated and reliable scales for assessment. However, few studies developed their own questionnaires for assessing knowledge and attitudes toward organ donation. Methods of data collection varied from telephone conversations, online surveys, face-to-face interviews to self-rated questionnaires.

Background literature suggests the need for improving existing knowledge and communication skills of health care professionals regarding organ donation. We believe that cultural factors may also contribute toward attitudinal differences regarding organ donation. There is a need to explore the complex interplay of culture, religion, and spirituality in this arena.