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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE  
Year : 2020  |  Volume : 31  |  Issue : 6  |  Page : 1344-1350
Knowledge and attitude toward organ donation among medical staff and outpatients at King Abdulaziz Medical City, Riyadh, Saudi Arabia


1 Hepatology Division, Department of Liver Transplantation, National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2 Medical Student, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
3 Research Unit, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
4 Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Date of Web Publication29-Jan-2021
 

   Abstract 


Organ transplantation is still the treatment of choice for end-stage organ failure. Despite the establishment of the Saudi Center for Organ Transplantation (SCOT), the organ supply still does not meet the increasing demand. This study aims to assess the knowledge of Saudis about organ donation both among the public and the medical staff and to assess the trend in the change from 1996 until now. A cross-sectional study was conducted among Saudis above the age of 18 years. A self-administered, 25-item, questionnaire was completed by participants including both outpatients and medical staff at King Abdulaziz Medical City using a convenient sampling technique. A total of 376 individuals answered the questionnaire; 238 (63.1%) heard about SCOT, of whom 124 (70.5%) were males. Health-care professionals had better attitude and knowledge on organ donation (P <0.05). Compared to the results from 1996to 2017, there was (51.22%) to (30.4%) decrease in people who allowed their families to donate their organs; on the other hand, there was an increase in the percentage of people who had the correct knowledge that Islam supports organ donation. Unsatisfactory levels of awareness impacted negatively on the knowledge and attitude of the population that is showed by the minor improvements over the years, and the slight proportion of participants who owned a donor card. Although 97.6% of the participants knew about the concept of organ donation, only 66.5% were familiar with the positive Islamic opinion. Based on the results of the comparison with the study in 1996, we conclude that more efforts from both the governmental and religious authorities are needed to increase awareness.

How to cite this article:
Altraif I, Altuwaijri N, Aldhbiban L, Alhoshan F, Alomari R, Moukaddem A, Alashgar H, Alqahtani F. Knowledge and attitude toward organ donation among medical staff and outpatients at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Saudi J Kidney Dis Transpl 2020;31:1344-50

How to cite this URL:
Altraif I, Altuwaijri N, Aldhbiban L, Alhoshan F, Alomari R, Moukaddem A, Alashgar H, Alqahtani F. Knowledge and attitude toward organ donation among medical staff and outpatients at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Saudi J Kidney Dis Transpl [serial online] 2020 [cited 2021 Apr 21];31:1344-50. Available from: https://www.sjkdt.org/text.asp?2020/31/6/1344/308343



   Introduction Top


Organ transplantation is still the treatment of choice for end-stage organ failure.[1] It was found that one donor can save approximately eight patients’ lives.[1],[2] In 1985, the National Kidney Foundation (NKF) in Saudi Arabia was established.[3] In 1982, the Senior Ulama Commission authorized organ donation and transplantation.[4] Then, NKF was developed into the Saudi Center for Organ Transplantation (SCOT) in 1994.[5],[6]

Many studies measured the knowledge and attitude toward organ donation. Regarding the Islamic point of view, a study that surveyed 223 males in 1996 reported that 67% were willing to donate, and only 56% were familiar with the Islamic point of view.[7] Furthermore, one study conducted in 1992 found that 88% believed Islam permits organ donation.[8] Moreover, one study conducted in 2005 showed an increase in people’s knowledge about the fatwa in association with higher educational level.[9] Another local study was done in 2016 showed 86% of participants believed that organ donation is accepted in Islam.[10] However, a study conducted in a college in Qassim in 2013 concluded that students had limited knowledge about the matter.[11]

Based on these studies, few obstacles were found to be facing the development of the Saudi program for organ donation.[4] One of the most important barriers is the misunderstood religious beliefs toward organ donation which greatly affect the public opinions and attitude toward rejection of donation. Another issue is the inadequate number of donors in Saudi Arabia. Among other factors, very few local studies had targeted the subject of knowledge and attitude toward organ donation and transplantation in Saudi Arabia.

This research aims to assess the knowledge and attitude of Saudis about organ donation both in the public and medical personnel. Another objective of the study is to compare our results with the results of the study published in 1996 to see if any significant change was noticed.[7]


   Subjects and Methods Top


A cross-sectional study was conducted among Saudis who are above the age of 18 years. The sample was equally divided between the health-care providers and the outpatient visitors at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. Sample size calculation was based on a population size of 20,000 with a response distribution of 50%, a 95% confidence level, and a margin of error of 5% and estimated to be 377. Data were collected using a questionnaire to assess the knowledge and attitude toward organ donation among outpatient clinic visitors and medical staff at KAMC. For validation purposes, the survey included 25 items, and it was pilot tested on 38 individuals and reviewed by three experts in the field to detect any ambiguity in the questions prior to the study.

The main variables collected were demographics such as age, gender, and levels of knowledge and attitude toward organ donation in two different ways. Questions were either Yes/No questions such as “Have you heard about SCOT?” or scale questions, e.g., “Choose from strongly agree to strongly disagree, are you willing to donate your organs?” The outcome variables were the levels of knowledge and attitude toward organ donation. Co-investigators designed the written questionnaire to be self-administered and it was handed over to Saudi males and females who agreed to participate from the period of December 2017 to mid-February 2018. For the medical staff, the surveys were dropped off and collected later. For the outpatient participants, they were given and collected while being in the waiting areas.

The study subjects were selected using a nonprobability convenient sampling technique as the sample was taken randomly from visitors and health-care professionals who were present at outpatients’ clinics and KAMC and agreed to do the survey.


   Statistical Analysis Top


Data were entered and analyzed using IBM SPSS Statistics version 21.0 (IBM Corp., Armonk. NY, USA). Descriptive statistics were presented as frequencies and percentages for the categorical variables and mean and standard deviation for the numerical variables. The categorical responses were compared using Chi-square test, e.g., gender and know ledge about SCOT. t-test and analysis of variance test were used to compare between categorical and numerical data depending on the nature of the question, e.g., age and knowledge about SCOT. All statistical tests considered significant for P < 0.05.


   Results Top


A total of 376 participants were included in the study. The distribution of participants by sociodemographic factors is shown in [Table 1]. There were 192 (50.9%) females. The average age of participants was 31.8 years. Two-hundred and ten (56.1%) were married and 151 (40.4%) were single. Two hundred and thirty-three (61.8%) of the participants had a bachelor’s degree and 78 (20.7%) had a higher education. Health-care professionals constituted 193 (51.5%) of the total number. The other 182 (48.6%) were nonhealth-care providers.
Table 1: Demographic characteristics of study sample (n=376).

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[Table 2] illustrates the association between the following factors: gender, education level, and occupation on knowledge questions with P <0.05. There was a correlation between higher educational level and the knowledge of brain-dead donation 236 (76.6%), P = 0.003; also, they had better knowledge regarding the Islamic point of view 216 (70.4%), P = 0.02. Regarding SCOT, 238 (63.1%) of the respondents heard about the organization (P = 0.03). Other factors such as higher education 208 (68.2%), P = 0.003, and health-related occupation 134 (70.9%), P = 0.01, were linked to more knowledge about SCOT. Moreover, health-related occupations showed more awareness which is reflected by their willingness to donate their families’ organs 72 (37.5%), P = 0.001. The organs that are believed to be transplanted by most respondents were the kidney 260 (69%), liver 235 (63%), and the heart 181 (49%). When asked about their opinions regarding donating their organs, 40 (10.8%) of them never thought of donating their organs. The most reported barrier for organ donation reported was not having enough information 149 (41.5%). In addition, 57 (15.1%) and 234 (62.1%) respondents believed that organ donation disfigures the body and that donated organs can be misused or abused, respectively. Regarding the answers to the question about the recipient of the donated organs, the following were the most preferred recipients as 160 (59.7%) chose the answer “anyone” followed by 118 (44%) those who chose “family member.” Age was also an important factor where most of the respondents preferred donating to young people 215 (80.5%) versus 82 (30.6%) for the elderly. Meanwhile, the most important factor for organ donation was health status 144 (46.5%).
Table 2: Bivariate associations of gender, educational level, and occupation on knowledge questions.

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[Figure 1] shows the trend in the change of knowledge among Saudi males from 1996 until 2017. A total of 105 (51.22%) males agreed on donating their families’ organs back in 1996; however, it decreased to 55 (30.4%) males in 2017. In addition, 115 (56.10%) believed Islam supports organ donation in 1996, and it increased to 119 (65%) in 2017. Furthermore, 41 (20%) believed that organ donation disfigures the body, and in 2017, it decreased to 27 (14.70%).[8] Lastly, [Figure 2] showed the association of gender with knowledge about organ donation
Figure 1: The trend in the change of knowledge among Saudi males between 1996 and 2017.

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Figure 2: Associations of gender on knowledge questions.

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   Discussion Top


[Table 3] showed the variable results from the two studies conducted in 1992 and 2016[8],[10] with our study regarding the acceptance to donate and its association with higher educational level. Regarding organs that are believed to be transplanted by most participants were the kidney (69%), liver (63%), and the heart (49%). We believe that these numbers are relatively low due to the late establishment of transplantation programs which were started in the early 1980s.[4] A majority of our population (89.2%) have thought about donating their organs which we think is a positively high number. We think this could be attributed to awareness campaigns done by competent authorities. However, more efforts are needed to improve the knowledge and thus the attitude regarding organ donation is Saudi Arabia, since there are still misconceptions in some areas. For example, not having enough information about the process of organ donation was the main reason why people are hesitant to donate 149 (41.5%), and this result is similar to the result of a study that was done in 2016 where they found that 85.1% believed that there is low public awareness regarding the subject.[12] Moreover, more than half of the participants had speculations about how donated organs are dealt with were 234 (62.1%) of the respondents believed that donated organs can be misused or abused. Other barriers reported in another study done in 2018 were religious misconceptions and accessibility of donor cards.[11] Therefore, proper education for both the public and the medical staff is essential. In respect to preferences of donation, two factors were important regarding the recipient; one was recipient’s age where 215 (80.5%) preferred donating to young people. The other was health status where 144 (46.5%) wanted to donate to healthier patients. Finally, 160 (59.7%) chose donating to “anyone” over the option of “donating to a family member” which is encouraging for promotion of living related and unrelated organ transplantation.
Table 3: Comparison between accepting to donate, and its association with educational level.

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   Conclusion Top


To conclude, in spite of the fact that 97.6% knew about the concept of organ donation, only 66.5% were familiar with the positive Islamic opinion. Upon comparing the results with the study back from 1996, we recommend that more efforts from both the religious authorities and the government sectors are needed to increase organ donation awareness. Moreover, we suggest continuing spreading knowledge about organ donation through social media platforms and to finally conduct a larger study with a study sample that covers all regions of the kingdom.

Conflict of interest: None declared.



 
   References Top

1.
World Health Organization. Human Organ Transplantation. World Health Organization; 2018. Available from: http://www.who.int/transplantation/organ/en/. [Last accessed on 2016 Dec 07].  Back to cited text no. 1
    
2.
US Department of Health & Human Services. Organ Procurement and Transplantation Network. US Department of Health & Human Services; 2018. Available from: https://optn.transplant.hrsa.gov/learn/about-transplantation/ history/. [Last accessed on 2016 Dec 26].  Back to cited text no. 2
    
3.
Al-Attar B, Shaheen F, Salam MA, Al-Sayyari A, Babiker A, Zakaria H, et al. Implications of ICU stay after brain death: The Saudi experience. Exp Clin Transplant 2006;4:498-502.  Back to cited text no. 3
    
4.
Shaheen FA, Souqiyyeh MZ. Increasing organ donation rates from Muslim donors: Lessons from a successful model. Transplant Proc 2004;36:1878-80.  Back to cited text no. 4
    
5.
Saudi Center for Organ Transplantation. Directory of the Regulations of Organ Transplantation in the Kingdom of Saudi Arabia. 2nd ed. Saudi Arabia: Saudi Health Council; 2014 Available from: http://www.scot.gov.sa/webb/Str/42?lang=En. [Last accessed on 2016 Dec 09].  Back to cited text no. 5
    
6.
Al-Dossary S, Al-Dulaijan N, Al-Mansour S, Al-ZahraniS, Al-Fridan M, Househ M. Handbook of Research on ICTs for Human-Centered Healthcare and Social Care Services. Organ Donation and Transplantation: Processes, Registries, Consent, and Restrictions in Saudi Arabia. United State: IGI Global; 2013. p. 511-28. Available from: http://www.irma-international.org/viewtitle/77160/. [Last accessed on 2016 Dec 10].  Back to cited text no. 6
    
7.
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.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Aswad S, Souqiyyeh MZ, Huraib S, el-Shihabi R. Public attitudes toward organ donation in Saudi Arabia. Transplant Proc 1992;24:2056-8.  Back to cited text no. 8
    
9.
Al Shehri S, Shaheen FA, Al-Khader AA. Organ donations from deceased persons in the Saudi Arabian population. Exp Clin Transplant 2005;3:301-5.  Back to cited text no. 9
    
10.
Alhussain B, Alasmari B, Omair A, Altraif I, Altamimi A. Attitudes and perceptions towards organ donation in Riyadh. J Health Specialities 2018;6:68-71.  Back to cited text no. 10
    
11.
Almohsen SS, Alobaishy SM, Alghammas NI, et al. Attitudes and beliefs on organ donation among students in a university in Central Saudi Arabia. Saudi Med J 2016;37:591.  Back to cited text no. 11
    
12.
AlHabeeb W, AlAyoubi F, Tash A, AlAhmari L, AlHabib KF. Attitude of the Saudi community towards heart donation, transplantation, and artificial hearts. Saudi Med J 2017;38:742-7.  Back to cited text no. 12
    

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Correspondence Address:
Ibrahim Altraif
Hepatology Division, Department of Liver Transplantation, National Guard Hospital, King Abdulaziz Medical City, Riyadh
Saudi Arabia
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DOI: 10.4103/1319-2442.308343

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