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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2012  |  Volume : 23  |  Issue : 5  |  Page : 929-933
Attitude and willingness of high school students toward organ donation

1 Department of Nephrology and Cardiology, Faculty of Medicine, Shahed University, Mustafa Khomeini Hospital, Tehran, Iran
2 Clinical Department, University of Social Welfare and Rehabilitation Sciences, Akhavan Center, Tehran, Iran

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Date of Web Publication13-Sep-2012


Public awareness of organ donation fundamentally affects the organ transplantation programs. This study was performed to assess the attitude and willingness of high school adolescents regarding organ donation. The study population consisted of 416 high school girls who were studying in four grades of three educational courses. Data were collected by a questionnaire and included demographic variables and attitude and willingness, which were assessed based on the Likert scale. The SPSS v.16 was used for data analysis. The mean age of the study subjects was 16.26 ± 1.06 years, 31% studied in grade-1, 27% in grade-2 (25% natural sciences, 27% mathematics and 48% humanities), 26% in grade-3 (30% natural sciences, 34% mathematics and 36% humanities) and 16% in pre-university stage (32% natural sciences, 42% mathematics and 26% humanities). The students had a highly positive attitude toward organ donation (mean score 4.2 ± 0.54). The greatest willingness for organ donation was concerning the kidney (88%) and heart (84%), followed by the liver (83.4%), pancreas (79.6%), cornea (67.8%) and skin (51%). Willingness for deceased as well as living organ donation was indicated by 92% and 47%, respectively, of the participants. Organ donation was considered acceptable only to relatives by 5% of the participants when the donors were deceased donors and by 16% of the participants when the donors were living donors; donation to all needy persons from deceased donors was accepted by 87% of the participants and from living donors by 31%. The purpose of donation was stated as lending help to others by 89% and progression of science by 40.2% of the participants. Willingness for organ donation from a deceased relative was declared by 63% of the students. There was significant positive correlation between willingness for organ donation and attitude (P <0.001). In addition, attitude and willingness had positive correlation with educational levels, age and educational courses. Our study suggests that Iranian adolescents have a great attitude and willingness toward organ donation, which reflects favorable knowledge of transplantation. Further research on public awareness in both genders and various age ranges is needed.

How to cite this article:
Afshar R, Sanavi S, Rajabi MR. Attitude and willingness of high school students toward organ donation. Saudi J Kidney Dis Transpl 2012;23:929-33

How to cite this URL:
Afshar R, Sanavi S, Rajabi MR. Attitude and willingness of high school students toward organ donation. Saudi J Kidney Dis Transpl [serial online] 2012 [cited 2021 Dec 2];23:929-33. Available from: https://www.sjkdt.org/text.asp?2012/23/5/929/100863

   Introduction Top

Organ transplantation is increasingly complex and at the same time increasingly effective in prolongation of lives. Transplantation programs are completely dependent on donor organ pools, and public attitude toward organ donation is the most significant determinant of donation activity. [1] However, the attitudes of medical professionals also have a profound impact because they are usually the first individuals to contact the donor's family. Lack of participation among medical professionals may be attributed to a tight workload that causes them to view organ donation as a low priority, lack of adequate information about transplantation procedures and their complications compared with the general population and to a lack of extensive education programs. Organ procurement organizations (OPOs) are entities that play an integral role in the organ transplantation process through the co-ordination of all activities related to organ donation. In order to impact organ donation rates positively, OPOs must attempt to modify the attitudes and behaviors of the general public and medical professionals regarding organ donation. [2] Although most of the public claim to support organ donation, only one-third have eventually become an actual donor. [3] The purpose of this study was to assess the public opinion toward transplantation process and organ donation among high school students who are capable of suggesting new ideas.

   Materials and Methods Top

This cross-sectional study was conducted on 416 high school girls, who were aged between 15 and 18 years, in Tehran, Iran, in the year 2009. Based on the five-point Likert scale, [4] an anonymous questionnaire including the following items: demographic variables (age, education and socioeconomic levels) as well as attitude and willingness to donate was prepared. All students filled the questionnaire without prior education. Attitudes about donation were assessed by the five-point Likert scale, from five (strongly agree) to one (strongly disagree), consisting of 14 items (seven positive and seven negative toward organ donation), and the total score was calculated as the average of all items (with the results of negative items inverted). Willingness to donate was evaluated by nine items, six about donation of one's own organs, two in relation to organ donation for scientific purposes or helping others and one about donation of deceased relative organs. Each item was rated on the five-point Likert scale (from 1 no willingness to 5 absolute willingness). Statistical analyses were performed by using the Statistical Package for the Social Sciences software, SPSS v.16. The Spearman's, Pearson's and one-way ANOVA tests were applied for analyses and P-value < 0.05 was considered statistically significant.

   Results Top

The study population consisted of 416 girls with a mean age of 16.26 ± 1.06 years and moderate socioeconomic levels. The participants studied in four grades of three scientific courses, including 31% (n = 129) in grade-1 or general; 27% (n = 112) in grade-2 (25% natural sciences, 27% mathematics and 48% humanities); 26% (n = 108) in grade-3 (30% natural sciences, 34% mathematics and 36% humanities) and 16% (n = 67) in grade-4 or pre-university stage (32% natural sciences, 42% mathematics and 26% humanities). Among the study students, 92% (n = 283) expressed willingness toward deceased organ donation and 47% (n = 196) expressed willingness toward living organ donation. In addition, based on the Likert scale, the overall attitude of the students was highly positive, with a mean score of 4.2 ± 0.54. Among students who expressed willingness for deceased organ donation, 5% expressed inclination to donate organs only to their relatives and 87% agreed to donate to any needy patient. Similarly, for living organ donation, 16% expressed inclination to donate organs only to their relatives while 31% agreed to donate to any needy patient. The greatest willingness to organ donation (88%, n = 367) was related to the kidney and heart 84% (n = 349), followed by the liver 83.4% (n = 347), pancreas 79.6% (n = 331), cornea 67.8% (n = 282) and skin 51% (n = 213). The aim of organ donation expressed by the students was as follows: 51% (n = 210) wanted to help the needy, 2.2% (n = 9) declared scientific purposes as the cause for donation and 38% (n = 156) stated both scientific and altruistic purposes. The willingness to donate the organs of a deceased relative was less than ones own organs (63%, n = 261). About 10% of the students wished to carry a donor card; however, they had not reached the required legal age. The one-way ANOVA test showed a significant positive correlation between willingness toward organ donation and attitude (P <0.001). The attitude and willingness had a positive correlation with educational grades (P = 0.019 and P = 0.026, respectively), age (P = 0.027 and P = 0.031, respectively) and educational courses (P <0.05). The students of mathematics had the greatest positive attitude score (4.4 ± 0.39) and willingness toward living organ donation; however, students of humanities highly agreed with deceased organ donation.

   Discussion Top

Organ supply has been known to be the corner stone of any successful organ transplantation program. [5] The increasing number of patients on transplantation waiting lists worldwide has resulted in shortage of organ donation. [6] Family consent is the major obstacle for organ procurement, [7],[8],[9],[10] and educational programs have tried to address the medical and psychological problems regarding this issue. [6],[11],[12],[13],[14],[15] Although many individuals have a positive attitude toward organ donation, [9],[16],[17],[18] very few of them finally make a decision and inform their next of kin. [3],[9] Besides, if people are asked to decide for close relatives, the percentage of indecisiveness increases still further. [8],[9],[16] In this study, we addressed the problem of public awareness toward organ donation, particularly among adolescents, who have the capability of accepting as well as suggesting new ideas. Our study has the inherent disadvantage of not including males, but public surveys to date have not shown any major gender differences in attitude toward organ donation. [9],[16],[19] However, some studies that have been conducted on medical professionals have yielded conflicting results. [20],[21] In comparison with public surveys, our study population had a greater or nearly equal willingness to donate their own and deceased relative's organs (92% vs. 47- 61% and 63% vs. 50-64%, respectively). [22],[23],[24],[25] This may be attributed to widespread educational programs that have been presented through the mass media within Iran in recent years, particularly for vital organs such as the kidney and heart. The greatest willingness for organ donation pertained to the kidney and the least was to the skin, and the aim expressed was to help the needy, which is compatible with other reports. [4],[26],[27] While living donor transplantation [2],[28],[29] has been recently increasing throughout the world, this transplantation has been more customary among Iranian populations because of erroneous religious and cultural beliefs concerning the integrity of body and soul and, as such, deceased organ donation is less popular. Our survey showed that extensive propaganda regarding the real viewpoint and official position of Islam about deceased organ donation through the mass media has been shown to be beneficial. [27] Consequently, adolescents in this study had a positive attitude toward deceased organ donation. However, despite widespread educational programs, the ultimate behavior of the Iranian population regarding organ donation does not seem to show great improvement, which is compatible with the findings in other populations. [4],[30],[31],[32],[33],[34] It seems that the lack of an integral organ procurement organization in Iran, which supervises all aspects of organ transplantation, plays an important role in the discrepancy between the number of potential donors and the number of organs actually harvested. We found that students of mathematics and humanities had a higher positive attitude and willingness compared with students of natural sciences. Also, in comparison with our previous study on medical students, [27] high school adolescents had greater willingness for organ donation (92% vs. 85%); these features could be due to heightened awareness among natural science students about the fields of medicine and transplantation surgery. Because of the socioeconomic similarity among the participants of the present study, we did not consider this factor as important. Unfortunately, despite the critical role played by public perceptions on organ donation toward improving the supply of organs for trans­plantation, relatively little has been published about public attitudes toward organ donation. This survey revealed that the knowledge, attitude and willingness of Iranian high school students regarding organ donation has been dramatically favorable compared with few public surveys that have been published up to now, and is even comparable with the findings of medical professional studies. [20],[27] We recommend more extensive educational and motivetional programs, particularly regarding deceased organ donation. Additionally, further studies should be conducted on public awareness toward organ donation in both genders and among the different age groups.

   Acknowledgments Top

The authors would like to thank Mrs. Sayeh Sanavi and the personnel at the Hejrat High School and the students for their kind cooperation.

   References Top

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Correspondence Address:
Suzan Sanavi
Clinical Department, University of Social Welfare and Rehabilitation Sciences, Akhavan Center, Tehran
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DOI: 10.4103/1319-2442.100863

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