| Abstract|| |
The gap between demand and supply of organs continues. No country has found a concrete solution for tackling this problem. We attempted to evaluate the general information and attitude of university students in their primary basic science stage, when they did not receive special education regarding brain death and organ donation in Saudi Arabia. Since they were from different cities with different cultures and values, we believe that we could assess the educational needs of future doctors and paramedical staff, to help them gain enough competence for solving the concerns of the population at large. The present study is a secondary analysis of a survey conducted at the King Khalid University, Abha, Saudi Arabia, from March to May 2014, about the knowledge of and attitudes toward brain death, organ donation, and transplantation in a sample of university students. A total of 873 university students participated in the survey and 93% from the cohort had heard about brain death. Eighty-five percent got their information about brain death from the media. Seventy-three percent of the cohort had the impression that there is no difference between brain death and natural death. An organized educational program about all aspects of organ donation, particularly from deceased donors, seems necessary in the curriculum, which can be started at an early level and built up gradually to impart a gradual comprehensive knowledge on beliefs and practices about brain death, organ donation, and transplantation. The Saudi Center for Organ Transplantation in collaboration with other regional societies and regional professional organizations has to work together to achieve this long-term goal to save the precious lives of people, awaiting transplantation.
|How to cite this article:|
Al Bshabshe AA, Wani JI, Rangreze I, Asiry MM, Mansour H, Ahmed AG, Assiri JM. Orientation of university students about brain-death and organ donation: A cross-sectional study. Saudi J Kidney Dis Transpl 2016;27:966-70
|How to cite this URL:|
Al Bshabshe AA, Wani JI, Rangreze I, Asiry MM, Mansour H, Ahmed AG, Assiri JM. Orientation of university students about brain-death and organ donation: A cross-sectional study. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2019 Nov 13];27:966-70. Available from: http://www.sjkdt.org/text.asp?2016/27/5/966/190865
| Introduction|| |
Organ transplantation is the most preferred modality of treatment for patients with endstage organ disease.  Patients deemed fit for transplantation often wait expectantly for a donor organ. There is an increasing discrepancy between the number of patients on the waiting list for organ transplantation and the number of available deceased donor organs. The primary hindrance to a successful deceased donor organ transplantation program is the extreme shortage of donor organs. Although the public is accustomed to the idea of donating blood, donation of organs after death continues to be a problem.  There is a great need for increasing awareness about organ transplantation and organ donation among the general public, beginning with the health-care professionals who in turn, can motivate the public. One factor that might contribute to this limited availability of donor organs is the lack of knowledge about the legal and procedural details of organ donation.
In this study, we tried to study the general information and attitude of university students in their primary basic science stage when they did not receive any special education regarding the concept of brain death and organ donation in Saudi Arabia. As they were from different cities with different cultures and values, we believe that this survey will be able to assess the educational needs of future doctors and paramedical staff to help them gain enough competence for solving the concerns of the population at large. Furthermore, we felt that we may understand how they can be strong advocates of the program.
| Materials and Methods|| |
The present study is a secondary analysis of a survey conducted at the King Khalid University, Abha, Saudi Arabia, from March to May 2014, about the knowledge and attitudes toward brain death, organ donation, and transplantation in a sample of university students. The University Ethics Committee approved the study, and verbal consent was obtained from all participants. A nonrandom sampling method was used.
A total of 873 university students participated in the survey, which was conducted and completed via a written questionnaire interview. The survey included 20 items, selected after a review of the literature that measured knowledge and attitudes toward brain death, organ donation, and organ transplantation.
The participants were evaluated about personal aspects of deceased organ donation and the factors, which may affect their willingness to donate their own or their families', their confidence in the diagnosis of brain death, and knowledge about the process of brain-dead organ donation in the country. We report only findings from the questionnaire interviews with university students from medical and allied health science colleagues. No attempt was made to compare the results with the general population or graduate health-care personnel.
| Results|| |
A total of 873 university students participated in the survey from the college of medicine, dentistry, pharmacy, and applied medical sciences.
The mean age was 21.2 ± 3.45 years; 93% from the cohort had heard about brain death and 85% of them got information about brain death from the media sources (35.7% from television, 8.3% from radio, 41.2% from the internet, and 14.6% from friends [Figure 1]. Out of them, 22.5% knew somebody who had brain death, whereas 22% equated brain death with real death. On the other hand, 20% felt that brain death is not death at all, whereas the majority had no conclusive idea. Of the respondents, 22.5% thought that a brain-dead person might recover and 34.8% felt that there was no chance of recovery. Furthermore, 73.4% of the cohort had the impression that there is no difference between brain death and natural death.
About 34.3% of the respondents had no idea about the cause(s) of brain death in Saudi Arabia. Road traffic accidents, heart attacks, and strokes were considered to be the cause of brain death in 26.8%, 11%, and 27.8% of the respondents, respectively.
Surprisingly, 92.4% of the respondents did not know the religious point of view of brain death and had not heard of any existing decree or Fatwah regarding brain death in Saudi Arabia. However, 20% of the respondents thought that brain death is approved by Islamic law.
Almost half of the group (49.1%) said that they would accept the concept of brain death if one of their relatives had it, and this percentage increased to 74% once the relative was transferred to higher center and confirmed brain dead. Twenty percent did not ask for transfer to higher center for confirmation of brain death. About 73% preferred to get the information about brain death as a group of family members rather than individually, and two-thirds of them preferred getting that information from senior staff, i.e., by consultant or a specialist. About 52% thought that it might take them days to accept the fact of brain death.
Regarding the concept of organ donation, 40% heard about it from television, 12% from radio, 41% from the internet, and a small minority got this information from friends (6.27%). Majority of the cohort (76.2%) expressed a desire to donate organs of relatives in case of brain death. Seventy percent have heard about the Saudi Center for Organ transplantation (SCOT; [Figure 2], and 52% liked to have an organ donation card.
|Figure 2: Knowledge regarding the existence of the Saudi center for organ transplantation.|
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| Discussion|| |
Organ donation continues to be a challenging issue worldwide, and approximately, 20% of patients die annually awaiting transplantation, due to lack of donor organs.  The situation in the Middle-Eastern countries including Saudi Arabia is not different. The sources of organ donation so far have been from living donors. However, in recent years, there have been efforts to streamline and organize this healthcare facility and emphasis is being laid on deceased donor organ donation. To make this a reality, lot of emphasis is being laid on improving awareness among general public, health-care professionals and medical students.  In our study, 93% of students who participated in the study were aware about the concept of brain death and had obtained this information from various media resources. However, in 70% of them, the level of knowledge about brain death was very much inadequate which is almost similar to various other studies reported in literature among medical students, ,,, wherein there are variable results of level of knowledge of the concepts of organ donation and brain death. Most of these studies have shown a relative lack of knowledge regarding the subject among medical students. ,
In one study, there was a positive correlation of level of knowledge about brain death and transplantation with the level of seniority of students, indicating that they gained their knowledge during progress of their curriculum. This observation gives us essential information regarding the learning outcomes of students and can be used as a tool to modify the curriculum of students and to include a short course regarding the subject early in the curriculum.
Health-care professionals, including medical students, play an important role in improving the awareness of organ donation because they are usually the first individuals in contact with donor families, particularly in local communities, and our students being at primary basic science level, their knowledge indirectly reflects the level of awareness among the community, which necessitates strengthening the community awareness programs.
Expectedly, the knowledge regarding the common cause of brain death in Saudi Arabia was not appropriate among students. In 2014, deaths due to injuries constituted 16% among all causes of death in Saudi Arabia;  however, the number is much higher among the younger generation as reported in another report "World report on road traffic injury prevention 2004,"  wherein accidents were the second most common in the age-group of 15-29 years and third in the age-group of 30-45 years after infection with the human immunodeficiency virus and tuberculosis. These data are crucial for planning and organization of cadaver organ donation and transplantation.
Saudi Arabia is governed by Islamic Sharia law and there is a decree by the senior Ulemah commission, issued in 1982, which permitted organ donation and transplantation of living and cadaveric donors.  The SCOT was established in 1984, which supervises all activities of organ donation and transplantation including awareness programs among general public and health-care professionals. In our study, most of the participants (92%) did not know anything about the religious aspects of organ donation and any existing religious law in Saudi Arabia regarding organ donation and transplantation. However, almost 70% had heard about the existence of SCOT and many of them were aware of organ donation and would have liked to have an organ donation card. The lack of awareness about religious law and Fatwah did not seem to have a great influence on the willingness of organ donation. There is a positive attitude among students regarding organ donation but the level of knowledge was inadequate, which is the reason of low decision-making level regarding brain death.
| Conclusion|| |
An organized educational program about all aspects of organ donation, particularly from cadavers, is necessary in the curriculum and should be started at an early level and built up gradually to impart a gradual comprehensive knowledge, beliefs, and practices about the concepts of brain death, organ donation, and transplantation.
In addition, awareness among the community needs to be improved using various types of mass media resources involving professionals, members of the society, and religious scholars. The SCOT in collaboration with other regional societies and regional professional organizations has to work together to achieve this longterm goal to save the precious lives of people, awaiting transplantation.
Conflict of interest: None declared.
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Ali A Al Bshabshe
Department of Medicine, College of Medicine, King Khalid University, P. O. Box 641, Abha
[Figure 1], [Figure 2]