| Abstract|| |
Organ transplant programs are increasing in Saudi Arabia with the major barrier to transplantation being a shortage of organs. The majority of Saudi Nationals are reluctant and unwilling to donate or consent for donation. This study was undertaken to determine the knowledge and attitude towards organ donation among males in Riyadh, Saudi Arabia. A questionnaire was distributed to 223 men attending the out-patient department of the National Guard Hospital, Riyadh. A total of 205 (92%) individuals answered the questionnaire. Of them, 187 (91%) were Saudis and 18 (9%) were non-Saudis. A total of 187 (88%) had heard about organ donation of whom 80 (43%) each, had acquired this knowledge through television or radio, 16 (8%) through newspaper and magazines, seven (4%) through friends and relatives, and four (2%) through health-care workers. Of the 205 study subjects, 88 (43%) claimed they understood the concept of brain-death, 96 (47%) did not, and 19 (10%) did not respond to this question. One hundred and thirty-eight (67%) were willing to donate, and 156 (76%) were willing to receive an organ. One hundred and fifteen (56%) believed that Islam permits people to donate organs, five (2%) thought Islam does not permit organ donation, 64 (31%) gave a "don't know" answer and 21 (11%) did not attempt to answer the question. In addition, 41 (20%) thought organ donation disfigures the body. In conclusion although 67% of the respondents in this survey were willing to donate, there was a significant lack of knowledge and misconception with regard to Islamic support to, and the mutilating effects of, organ donation. Public educational programs and other measures addressing these issues may help in increasing the rate of organ donation among Saudis.
Keywords: Organ donation, Attitude and knowledge, Saudi Center for Organ Transplantation (SCOT), Brain-death.
|How to cite this article:|
Altraif IH, Al Sebayel MI, Nondo H. Knowledge and Attitude towards Organ Donation among Males in Riyadh, Saudi Arabia. Saudi J Kidney Dis Transpl 1996;7:135-8
|How to cite this URL:|
Altraif IH, Al Sebayel MI, Nondo H. Knowledge and Attitude towards Organ Donation among Males in Riyadh, Saudi Arabia. Saudi J Kidney Dis Transpl [serial online] 1996 [cited 2020 Apr 2];7:135-8. Available from: http://www.sjkdt.org/text.asp?1996/7/2/135/39514
| Introduction|| |
Organ transplantation has received considerable recognition in recent years as the treatment of choice for patients with end-stage organ disease. The major problem facing transplantation programs world-wide is a shortage of suitable donor organs. The same is noticeable in Saudi Arabia according to figures published by the Saudi Center for Organ Transplantation (SCOT)  .The number of cadaveric organ donors in Saudi Arabia in 1995 was 82. On the other hand, the number of patients on dialysis in Saudi Arabia in 1996 is about 5000 of whom 4050% are suitable for transplantation (personal communication with SCOT). Also, the estimated number of liver transplantations required in Saudi Arabia is 300-500 per year. Hence, the number of patients who need transplantation (kidney, liver, lung, heart and cornea) far exceeds the number of available donors. We have observed that many Saudi families are unwilling to donate organs when approached. Earlier studies in Saudi Arabia have shown that 66-88% of the general public are willing to donate organs for transplantation , . The purpose of this survey was to collect data and assess the knowledge and attitude of Saudi males towards organ donation so that decisive strategies could be adopted to promote organ donation within the National Guard population as well as the general public.
| Materials and Methods|| |
Between May 2 to 9, 1994, a convenient survey questionnaire was distributed to male individuals attending the out-patient department at the King Fahad National Guard Hospital, Riyadh. The survey questionnaire included 15 items. Prior to distribution, this questionnaire was pre-tested on 10 individuals to detect any ambiguity in the questions and obtain comments from the responders. The questionnaire was designed to be self-administered using paper and pencil and was distributed to 223 individuals. The questions were open-ended and in Arabic language.
Two sets of questions were developed:
a) Questions on demographic variables including age, nationality and martial status.
b) Questions on attitude towards organ donation variables which included the following:
c) whether a person had heard about organ donation and if so, through what source
d) whether the person understood "brain death" and was willing to donate organ(s),
e) whether the person would allow his wife (wives) and son(s)/daughter(s) to donate their organ(s),
f) whether the person would be willing to receive transplantation treatment,
g) whether people should donate their organ(s),
h) whether Islam supports organ donation,
i) whether organ(s) donation disfigures the body,
j) which country would the respondent prefer to have transplantation treatment if required, and
k) the individual opinion about organ donation.
The study subjects were selected using a simple random method, where every fifth male person seated in the waiting area of the hospital appointment desk was selected. The first person was chosen at random to ensure that every individual in the waiting area had an equal chance of being selected. A research assistant explained the objectives of the survey and answered any questions that might arise while completing the questionnaire. Persons who refused to answer the questionnaire were considered refusals.
| Data Analysis|| |
The data was analyzed using an Excel Computer Program. Univariate analysis was performed.
| Results|| |
The questionnaire was distributed to 223 individuals of whom 205 (92%) agreed to answer. Of these 205 individuals, 187 (91%) were Saudis and 18 (9%) non-Saudis. There were 122 (60%) in the age-group 15-35 years, 53 (26%) in the age-group 36-50 years and 13 (6%) were 51 years or above. Seventeen (8%) individuals did not report their age. One hundred and forty-one persons (69%) were married, 53 (26%) single, one (0.5%) divorced, one (0.5%) a widower and nine (4%) did not respond. Sixty-two (31%) of the responders had high school education, 60 (29%) had secondary, 53 (26%) primary, two (1%) Quran only, five (2%) had adult education while eight (4%) had no formal education. Fifteen others (7%) did not respond to this question.
Organ Donation Variables
Equal number of individuals had heard about organ donation through television and radio, 80 (43%) each. Other individuals had heard about organ donation through newspaper and magazines (n=16; 8%), friends and relatives (n=7; 3%) and health-care workers (n = 4; 2%). There were 18 (9%) non-responders to this question. Eighty-eight (43%) persons answered that they knew what the term "brain- death" meant, and 96 (47%) did not know. There were 21 (10%) non-responders to this question. The results of other variables are presented in [Table - 1].
| Discussion|| |
In this survey, females were intentionally excluded because we believe that the decision for donation is often made primarily by male members of the family. Therefore, we believe women exclusion in this survey was justified. However, future studies should include both sexes to determine whether women are different from men in their knowledge and attitude toward organ donation. Although this is a convenient hospital-based survey, possibly likely to include more knowledgeable subjects than a group from the general public, it provided similar findings as far as willingness to donate organs is concerned (67%) compared to the 66-88% willingness reported in earlier studies , .
This survey shows that the majority of responders had heard about organ donation. Television and radio were the main sources of information. Surprisingly, health-care workers played little role to disseminate information about organ donation. The majority of the responders were willing to donate (67%) and receive (76%) organs. However, these findings are in contradiction with practical experience drawn from SCOT (personal communication) and from our own experience in this hospital. This is similar to the experience from North America where positive attitudes toward organ donation and transplantation is prevalent, yet many people still refuse to donate organs when approached  . In this survey, the willingness to donate organs (own, wife or sibling) is high and not representative of the real picture. This could be attributed to the fact that this is a hospital-based survey which may result in a higher response than one would anticipate in real life. Furthermore, individual opinion was sought in a relaxed, non-grieving and non-emotional situation and not at a time of bereavement when agreement of the whole extended family is required.
Although 43% of the responders thought they understood the concept of "braindeath", we are not certain this is the case because religion and organ donation are sensitive issues, therefore, many people feel uncomfortable to publicly discuss their views. Furthermore, we have often been questioned, how an individual could be dead; yet the heart is still beating. We assume a much smaller percentage truly understand the "brain- death" concept. Hence, its not surprising that 10% did not respond to the question on "brain-death" despite a clear and succinct question and the availability of the research assistant to answer any questions the respondent may have. In Japan, a lack of understanding of brain-death among the general public has been reported, among other reasons, to inhibit organ donation  .
There is misconception and lack of knowledge regarding the Islamic support of organ donation and the mutilating effect of donation. This is evident from the fact that 31% of responders were not certain whether Islam supports organ donation, and 2% thought donation to be against Islamic teaching. Twenty percent thought that organ donation disfigures the body. Clearly, more efforts are needed to educate the public regarding the positive Islamic teaching about organ donation and that organ donation does not mutilate the body.
Based on this study we recommend the following:
(a) To continue disseminating information about organ donation and transplantation through television, radio, newspaper/magazine and friends/relatives.
(b) Encourage health-care workers to educate people about organ donation.
(c) Educate the public about "brain-death", Islamic support for organ donation and correct the myths of the mutilating effects of organ donation on the body.
(d) A prospective study of families who refuse to donate when approached is required, to elucidate and deal with the reasons that inhibit donation.
| Acknowledgment|| |
We thank Adel Alhassoon for his help in translating the questionnaire into Arabic, Emad Kashmiri for his assistance in the distribution of the questionnaire, Mohammed Al Imram for his assistance in the data analysis and Zoraida D Miranda and Jill Taylor for their expertise in typing the manuscript.
| References|| |
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|3.||Al faqih SR. The influence of Islamic views on public attitudes toward kidney transplant donation in a Saudi Arabian community. Public Health 1991;105:161-65. |
|4.||Buckley PE. The delicate question of the donor family. Transplant Proc 1989;21:1411-12. |
|5.||Evers S, Farewell VT, Halloran PF. Public awareness of organ donation. Can Med Assoc J 1988;138:237-39. |
Ibrahim H Altraif
Department of Hepatobiliary Sciences, King Fahad National Guard Hospital, PO Box 22490, Riyadh 11426
[Table - 1]