|Year : 2017 | Volume
| Issue : 1 | Page : 81-89
|Knowledge and attitude towards organ donation among adult population in Al-Kharj, Saudi Arabia
Sandeep Agrawal1, Saud Binsaleem2, Mohammed Al-Homrani2, Abdullaziz Al-Juhayim2, Abdullah Al-Harbi2
1 Department of Family and Community Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia
2 Faculty of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia
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|Date of Web Publication||12-Jan-2017|
| Abstract|| |
Organ transplantation is a lifesaving treatment for patients with end-stage organ failure. Despite the advanced medical science and technology, shortage of organs had led to a growing gap between the demand for organs and the number of donors. With a limited number of studies on the subject and based on those findings, the public knowledge and attitudes must be assessed to understand more clearly that why many people are opposing donating their organs in Saudi Arabia. The objective of our study was to assess the knowledge and attitude of the adult population toward organ donation in Saudi Arabia. This was a hospital-based cross-sectional study where the information was collected using a self-administered questionnaire in Al-Kharj, Saudi Arabia. The questionnaire was distributed in both King Khalid Hospital and Prince Sattam Bin Abdulaziz University Hospital, and data gathered analyzed by Statistical Package for Social Sciences (SPSS version 20.0). There were a total of 403 respondents. Nearly 35.6% did not have the knowledge that organ donation is legal in the KSA. Almost 97% did not know where to go if they want to become donors. All of who were willing to donate, the most common reason was to save someone's life (92.7%). Body distortion (39%) and fear of health complications (35%) were the most common causes people opposed donation. It was suggested that, in order to increase the awareness for organ donation, the important role of health workers and hospital displays should be immediately addressed and public lectures should be held on regular basis. Information regarding organ donation should be incorporated with clear messages in various mass media.
|How to cite this article:|
Agrawal S, Binsaleem S, Al-Homrani M, Al-Juhayim A, Al-Harbi A. Knowledge and attitude towards organ donation among adult population in Al-Kharj, Saudi Arabia. Saudi J Kidney Dis Transpl 2017;28:81-9
|How to cite this URL:|
Agrawal S, Binsaleem S, Al-Homrani M, Al-Juhayim A, Al-Harbi A. Knowledge and attitude towards organ donation among adult population in Al-Kharj, Saudi Arabia. Saudi J Kidney Dis Transpl [serial online] 2017 [cited 2017 Apr 30];28:81-9. Available from: http://www.sjkdt.org/text.asp?2017/28/1/81/198150
| Introduction|| |
Organ transplantation has been and still recognized as the standard treatment for patients with end-stage organ disease worldwide. The field of organ transplantation has witnessed many achievements in the past few decades which lead to saving and dramatically improving hundreds of thousands of lives. The need for organs is constantly growing, and the gap between patients in need and donors is a source of major concern. In many countries and regions, more and more patients are being added to the transplant list every year which correlates with the high expenses of caring for patients with end-stage organ disease on every health system. In the United States, the 2012 spending for end-stage renal disease patients increased 3.2%, to $28.6 billion, accounting for 5.6% of the medicare budget costs ($507 billion). There are 123,746 patients on the organ waiting list in the United States including more than 30,000 added in 2014. In Saudi Arabia, a growing Asian country with more than 31 million people, the cadaver and living organ donation between human beings was approved in 1982. Three years later, the National Kidney Foundation was established in 1985. The National Kidney Foundation was upgraded to the Saudi Center for Organ Transplantation (SCOT) in 1993 located in Riyadh and is responsible for coordination of medical faculties caring for end-stage organ disease and promoting public health education among other responsibilities. The organ need is met with low cases of transplantation each year in Saudi Arabia; 13,160 patients are receiving hemodialysis and 5154 patients are suitable for transplantation. In 2013, out of 243 brain death cases suitable for transplantation, 68% of the families rejected donation. There had been a continuous advancement in medical facilities throughout the kingdom which has made the transplantation facilities available in several centers, but the gap between donation and transplantation still remains high.
Religious reasons and lack of information are major causes of opposing organ donation. , While others think that living with one organ is not enough. Many people believe humanitarian reasons are most important causes for them to donate. With increasing prevalence of chronic diseases as in the cases of diabetes and hypertension among the Saudi population, the risk of patients reaching end-stage organ disease is increasing which will lead to more patients needing organ transplantation in the future but with an increasing shortage of donors. Saudi studies about organ donation are limited compared to other countries. This cross-sectional study, conducted in Al-Kharj, was intended to assess the public knowledge and beliefs about organ donation using data gathered by a self-administered questionnaire.
| Methodology|| |
Study design and sample
A hospital-based cross-sectional study was conducted where the information are collected using a self-administered questionnaire distributed to respondents attending the outpatient's departments in the two main hospitals of Al Kharj, i.e., Prince Sattam Bin Abdulaziz University Hospital (PSAUH) and King Khalid Hospital (KKH). These hospitals were selected to avoid time constraints and for the "convenience" for the collection of data since the students have their clinical postings and classes in the two hospitals as the part of their curriculum. To calculate the sample size, Raosoft website was used. The population of Al-Kharj as per the latest report/survey was found to be around 234,000. Taking a confidence level of 95% as convention and 5% of error margin, the sample size was found to be 384. Assuming a nonresponse rate of 5%, (5% of 384 = 19) the final sample size was calculated to be 384 +19 = 403 participants.
A semi-open-ended and self-prepared question- naire was used. The questionnaire was divided into three sections. Section I included questions on demographic characteristics. Section II consisted of questions on know-ledge and sources of information about organ donation while Section III had statements regarding respondents' attitude toward organ donation and transplantation. The responses for items on knowledge and attitude of organ donation were in "yes" and "no" form. Before distribution, this questionnaire was pretested on ten individuals to detect any ambiguity in the questions and obtain comments from the responders. Two academic staffs reviewed the questionnaire, and their suggestions were incorporated into the final questionnaire to strengthen the face validity of the questionnaire
Written permission was obtained from the directors of the respective hospitals before conducting the study. Verbal consent was taken from each respondent before giving the questionnaire. It was a descriptive study, and no intervention was to be done, and moreover, data was collected anonymously. Institutional Review Board's permission was not required.
| Statistical Analysis|| |
Data gathered through the questionnaires was entered into Microsoft Excel sheet and Statistical Package for Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used for analysis. Appropriate statistical tests were applied.
| Results|| |
A total of 403 respondents were surveyed with the mean age of 29.32 ± 9.32 years ([Figure 1]). The number of respondents from KKH were 229 (56.80%) while from PSAUH were 174 (43.20%). Three hundred and ninetysix out of the total 403 respondents have heard of the term "organ donation." There were 301 (74.7%) males and 102 (25.3%) females. Other sociodemographic variables are shown in [Table 1]. [Figure 2] shows the participants' response regarding their source of information about organ donation chosen from multiple-choice answers. As shown in [Table 2], half of the respondents, i.e., 199 (50.25%) knew that both the living and the dead are eligible to donate organs, whereas 141 (35.6%) did not have the knowledge that organ donation is legal in Saudi Arabia. Less than 3% correctly mentioned SCOT as a correct response for where to go if you wanted to become a donor. When asked about the knowledge of organs that can be donated, the majority answered kidney (95.20%), followed by liver (70.95%), heart (51.26%), eye (44.6%), and lung (43.6%) ([Figure 3]).
We assessed the knowledge part using a score of 5 questions, with each correct answer given "20 points" and "0 points" for incorrect answers; the data were analyzed using Chisquare test ([Table 3]). [Table 4] shows the attitude of the respondents toward organ donation. Although nearly 78% was in support of promotion of organ donation, less than 25% were actually willing for organ donation at any stage. All of who were willing to donate, the most common reason was to save someone's life (92.7%). Fear of body distortion (39%), fear of health complications (35%), lack of information (20 %), and religion (19%) were the common reasons for the unwillingness for organ donation. As demonstrated in [Table 5] and [Table 6], a cross-table correlation was done between the knowledge of the respondents compared with their attitude toward organ donation, among the total number of participants who are willing to donate 97 (24.5%). The majority of them, 73 (40.6%), have a good knowledge of organ donation, and most of the respondents with poor knowledge 192 (88.9%) have shown a negative attitude toward organ donation. We studied the socio-demographic data of the participants and found no significant relation between the level of education and other personal aspects with the attitude toward donation ([Table 6]). In the same context, the demographic data did not show a significant association with the knowledge of respondents ([Table 7]).
|Table 6. Sociodemographic status in relation to the willing of donation.|
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| Discussion|| |
The mean age of the study population was 29 years with ± 9.32. More than half of the respondents had the correct knowledge of eligibility of donation and legality of organ donation, but still, a knowledge gap was present and was substantial. Nearly half of the respondents believe that religion does not allow for organ donation. Less than 3% knew the correct place to go for organ donation. In a study conducted in Saudi Arabia and included 948 Saudi citizens from multiple regions, 41.5% never heard of SCOT whereas 27.5% are not willing to donate due to religious reasons and a similar result was also seen in another study with (26.2%) opposing donation for the same reasons. , The lack of knowledge was also seen among the medical staff in Saudi Arabia as less than one-third of intensivists in a study knew the role of SCOT in organ donation.
TV and internet were the major sources of information for the people in this study. The role of health workers and hospital displays as a source was found to be minimal, which correlates with the results of other Saudi studies. , This shows that the media plays a key role in raising awareness of organ donation. Our study has shown that people with more knowledge are more willing to donate their organs. A similar result was also seen in a cross-sectional study conducted at King Saud University, where students with more information on the subject are having a more positive attitude compared to others. We found <25% are willing for organ donation among those supporting the promotion of organ donation. The attitude toward organ donation in Saudi Arabia was seen negative in other studies, as 59.3% refused to donate their organs in one study and a different study showed only 30.8% are willing to donate their organs while alive and 59.8% stated they would donate after death. , Fear of body mutilation, health complications, lack of proper information, and religious reasons were the most common reasons for a significant proportion of unwillingness for organ donation. In different studies, health concerns were the main causes to oppose donation including fear of living with one kidney, fear of operation, and other medical reasons, in addition to inadequate information on organ donation. ,
A study comparing rural and urban areas level of knowledge and attitude in Saudi Arabia found the urban population to have a higher level of knowledge and more positive attitude compared with those of rural areas. Many international studies have been published on organ donation. Nearly 60% of participants had adequate knowledge on organ donation in a cross-sectional survey conducted in Pakistan, but only (23%) knew that organs can come from both living and cadaver bodies. In Malaysia, an overwhelming majority of the respondents (98.5%) are against donating their organs, despite receiving information on organ donation. In Turkey, 31.9% of the 163 who are unwilling to donate their organs refused due to religious reasons. Almost 75% of the 1000 participants in an Iranian study in Ahwaz city were pro-donation and 73% of them disagreed any type of compensation for it. In a public survey in the United States, 75% are more likely to donate their organs, and similarly, in the United Kingdom, a cross-sectional study included 119 respondents has shown two-thirds of them were in favor of donating their organs and participants who knew someone who had donated or received an organ are having a more positive attitude. , Health-care professional's opinions on organ donation were seen as negative in Qatar, 83.3% supported organ donation but more than half plan to be buried with all their organs intact. A study in Korea has shown there is a high level of knowledge among health-care professionals which is influenced significantly by the marriage status and educational level of the respondents. Australian emergency department clinicians were having a very positive attitude toward donation as (90%) would donate their organs after death and (79.6%) will agree to donate their children organs after death. Medical students' knowledge and attitude were evaluated by different studies. The level of knowledge of medical students was higher than nurses in Saudi Arabia, and as seen in our study, there was a positive correlation between the level of knowledge and the willing toward donation. They had a higher level of knowledge compared with other students in another study in central Saudi Arabia. , Medical students in other countries such as Ireland, India, and Nigeria have an adequate level of knowledge, and the majority are willing to donate. , , More awareness campaigns sponsored by SCOT are to be held throughout the kingdom and should be promoted by social media sites to improve the population knowledge. One can hope that this will definitely reflect positively on their attitude toward organ donation. ,
| Conclusion|| |
Public lectures should be held on a regular basis to increase the awareness for organ donation and the important role of health workers. Hospital displays should be immediately addressed. Information regarding organ donation should be incorporated with clear messages in various mass media as well.
| Acknowledgments|| |
The authors would like to thank both directors and medical staff of both KKH and PSAUH, for their cooperation. We are also thankful to the study participants.
Conflict of interest: None declared.
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College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]
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