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Saudi Journal of Kidney Diseases and Transplantation
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Table of Contents   
RENAL DATA FROM THE ARAB WORLD  
Year : 2020  |  Volume : 31  |  Issue : 6  |  Page : 1388-1394
Attitude and levels of awareness toward organ donation and transplantation among healthcare providers: A cross-sectional study


1 Plastic Surgery Division, Department of Surgery, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
2 Medical student, King Faisal University, Alhasa, Saudi Arabia
3 General Surgery Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
4 Medical student, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia
5 Pathology Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
6 Pediatric Department, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia

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Date of Web Publication29-Jan-2021
 

   Abstract 


End-stage organ damage is the major cause of death worldwide. The number of donors is low, and one of the challenging phases in organ donation is the availability of organ donors. There are many studies that suggest a strong correlation between knowledge and beliefs toward organ donation. A study conducted among Health-Care Providers in the Intensive Care Units at a Tertiary Center at Riyadh reported that only 57% of the health-care providers in the Intensive Care Unit were willing to donate their organs. The objective of our study was to evaluate the knowledge, attitude, and awareness of organ donation and transplantation among health-care providers at different hospitals around the Kingdom of Saudi Arabia. The data of this cross-sectional descriptive study were collected between February and July 2018 in different hospitals all around the Kingdom of Saudi Arabia. The investigators formulated a questionnaire based on several published studies. Ethical approval was obtained from the Unit of Biomedical Ethics, Research Committee at King Abdul Aziz University. Of the 241 participants, 130 (53.9%) were female. In addition, 110 (45.6%) of them were medical residents. Moreover, 224 (92.9%) participants were aware of the concept of organ donation. The overall level of knowledge is good (55.2%).The study showed 62.2% have participated in the organ donation program for their close relatives only. In conclusion, the level of perception and knowledge about organ donation among health-care providers was inadequate, although they showed positive attitudes toward this issue.

How to cite this article:
Mortada H, Alharbi NM, Alsuhaibani MA, Buhlagah RA, Mohamed YN, Alharbi A, Safdar OY. Attitude and levels of awareness toward organ donation and transplantation among healthcare providers: A cross-sectional study. Saudi J Kidney Dis Transpl 2020;31:1388-94

How to cite this URL:
Mortada H, Alharbi NM, Alsuhaibani MA, Buhlagah RA, Mohamed YN, Alharbi A, Safdar OY. Attitude and levels of awareness toward organ donation and transplantation among healthcare providers: A cross-sectional study. Saudi J Kidney Dis Transpl [serial online] 2020 [cited 2021 Mar 7];31:1388-94. Available from: https://www.sjkdt.org/text.asp?2020/31/6/1388/308351



   Introduction Top


End-stage organ damage (ESOD) is the major cause of death worldwide, and is characterized by the failure of the organ/s to work properly. Moreover, organ transplantation is the most preferred treatment of choice for ESOD worldwide. It improves long-term survival and quality of life. However, thousands of people die due to a steady decrease in donations, as well as prolonged waiting lists. The number of donors is low, and one of the challenging phases in organ donation is the availability of organ donors. Given the importance of organ donation and transplantation, the government of Saudi Arabia established the Saudi Center for Organ Transplantation in 1984 to supervise all the activities related to the process of organ donation and transplantation.[1] Later, deceased and live donations were officially approved by the Islamic Jurisprudence Assembly Council in Saudi Arabia.[2]

Although there is an increasing number of reported cases of brain deaths in Saudi Arabia, there is a reluctance toward deceased organ donation.[3],[4] Hence, the reported number of Saudi donors is much lower than the number of non-Saudi donors, which increases the human leukocyte antigen mismatch between donor and recipient.[5] A recent study done at Riyadh reported that 68.1% of Saudi Arabian survey takers stated that they would like to donate their organs in the case of brain death.

There are many studies that suggest a strong correlation between the knowledge and beliefs toward organ donation and the willingness to donate and register in the organ registry, as was demonstrated by Figuero et al, in a study among Dutch medical students.[4],[6] Another study done at the University of Dammam among nursing and medical students reported a positive correlation between knowledge and commitment to organ donation among nursing and medical students.[7] Although 89% of physicians reported that they were registered as donors and 94% reported that they support organ donation in an Australian study, 73% found it difficult and stressful to request organ donation from patients’ families.[8] Numbers of obstacles in the donation process were reported, including lack of experience in communication with the donor family, unfamiliarity with donor identification, and brain death diagnosis procedures. Moreover, on a questionnaire that tests the knowledge of brain death and organ donation, only 68% of physicians and 71% of nurses answered correctly, which indicates knowledge deficiencies regarding this topic.[8] In another study on nursing students, females may have more positive attitudes toward supporting a family member in donating a loved one’s organs, as well as toward participating in the donation process during their careers, and toward supporting the concept of donation and transplantation.[9] A study con-ducted among Health-Care Providers in the Intensive Care Units at a Tertiary Center at Riyadh reported that only 34% of the health-care providers in the Intensive Care Unit were to participate in a training program for organ donation and only 57% were willing to donate their organs.[10] Another study done in Germany reported evidence suggesting that health-care professionals’ attitudes have a great influence on the success of the organ donation campaign and the rates of organ donation.[11] The objective of our study was to evaluate the knowledge, attitude, and awareness of organ donation and transplantation among health-care providers at different hospitals around the Kingdom of Saudi Arabia.


   Materials and Methods Top


Study design and data collection

This cross-sectional descriptive study was designed to assess the attitude and level of awareness toward organ donation and transplantation among male and female health-care providers. The data were collected between February and July 2017, in different hospitals all around the Kingdom of Saudi Arabia.

Measures

After reviewing the literature, the investigators formulated a questionnaire based on several published studies.[8],[9],[10],[11] Furthermore, a group of experts, used personal judgments to check the content and face validity of the questionnaire by ensuring that no major dimensions were ignored. The questionnaire was self-administered, and included 22 questions, either yes-or-no inventories or multiple-choice, in addition to demographic items on the health-care providers. The first sector was gender, age, and qualification. Fifteen items evaluated the level of awareness of the participants on organ donation and transplantation. The inclusion criteria included male and female health-care providers. Participants who refused to participate or failed to complete their questionnaires were excluded. All participants were informed about the study beforehand, and only those who agreed to participate were enrolled in the study. Ethical approval was obtained before data collection began from the Unit of Biomedical Ethics, Research Committee at King Abdul Aziz University.


   Statistical Analysis Top


The data were entered and analyzed using IBM SPSS Statistics version 21.0 (IBM Corporation, Armonk. NY, USA). Data were presented as a mean for central tendency and as a standard deviation for variance. The Chi-square test was used to compare different variables. Statistically significant differences were defined as those with a P-value <0.05.


   Results Top


Demographic variables

Of the 241 participants, 130 (53.9%) were females, and 111 (46.1%) were males. The overall mean age was 21.36 ± 1.63 years. In addition, 110 (45.6%) of them were medical residents, 80 (33.2%) were specialists, and finally 51 (21.2%) were consultants. Out of all the participants, 94 (39%) were from the Makkah region [Table 1].
Table 1: Demographic descriptive.

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Levels of awareness

Moreover, 224 (92.9%) participants were aware of the concept of organ donation, while 142 (58.9%) were aware of the rules and legislation about organ donation. Furthermore, 97 (40.2%) answered partially effective for how effective the present efforts are toward obtaining donors, and only 32 (13.3%) answered very effective [Table 2].
Table 2: Awareness factor descriptive.

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In addition, [Table 3] shows the responses of awareness factors among health providers who agreed to participate in the questionnaire. 39.0% of them had a poor awareness level about donation, donation rules and legislation, and efforts spent toward obtaining donors. On the other hand, 123 (51%) had a good level of knowledge.
Table 3: Awareness factor level.

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Levels of knowledge

Regarding the level of knowledge toward organ donation, the study showed 58.9% of participants know what an organ donation card is. 72.2% were aware of whom qualifies as brain dead and legally dead according to the law. For the knowledge about the average waiting time on the organ transplant list: 47.7% of participants thought it took more than three years, 41.5% thought it took one to three years, and 10.8% thought it took less than one year. The knowledge about the organs that can be donated are as follows: kidney 92.1%, liver 76.3%, blood 68%, cornea 62%, bone marrow 59.8%, lung 50.6%, skin 39.4%, pancreas 23.2%, bone 19.1%, brain 13.3%, and leg 10%. The overall level of knowledge is good (55.2%).

Attitude toward organ donation

The study showed 62.2% have participated in the organ donation program for their close relatives only. When asked whether willing to educate the community about the significance of organ donation, 52.7% answered yes, 41.9% answered maybe, and 14.5% answered no. When we asked if they would like to register as organ donors, the majority, at 52.3%, said maybe, 33.2% said definitely yes, and 14.5% said no. 71.8% of participants would encourage their family and friends to participate in the organ donation program. Regarding whom they would donate to: 57.3% said they would donate to anyone, 36.1% said to only family, relatives and friends, and 6.6% said they would donate to someone they did not know but with the same nationality and religion. People are willing to participate in the organ donation program for the following reasons: 97.7% were willing due to the idea that after death, they could save someone’s life, 53.5% were willing due to potentially having a close friend/family member who needs organ transplantation, 38.6% were willing because people no longer need organs after death, and finally 2.9% claimed other reasons. There are several factors that prevent people from participation in the organ donation program, as follows: religious reasons 16.6%, medical reasons 14.9%, don’t want disfigured body 14.1%, afraid of organ being taken before death 9.1%, don’t trust the medical system (I feel I will not receive the best medical treatment if I am a donor) 8.7%, afraid that a brain dead person will recover 7.9%, have other reasons 3.3%, and the majority at 55.6% have no particular reason. Respondents were asked if they would donate one or part of their organ to their relatives or friends in their lifetime, whereby 95 (39.4%) of the respondents said yes, 109 (45.2%) said maybe, and 37 (15.4%) said no. The next question was about if they think they had received enough education about organ donation and transplantation; while 25 (10.4%) respondents believed that they had the best education, 45 (18.7%) thought that they had minimal education. Furthermore, 67 (27.8%) said that they participated in an organ donation and transplantation awareness campaign, whereas 174 (72.2%) said they did not participate.

Moreover, 127 (52.7%) of respondents willing to educate the community, 80 (33.2%) who think they could register as an organ donor, 173 (71.8%) who said they would encourage their family and friends to register in the donation program, 87 (36.1%) who said they would like to donate to their family and friends, 16 (6.6%) who would like to donate to someone of the same religion, and 138 (57.3%) who would like to donate to anyone.

In addition, respondents were asked about the reason they were willing to participate in the organ donation program: 40% of the respondents chose that after death, they no longer need their organs, while 80% chose finding the idea of saving someone’s life after death meaningful, and 53% were concerned that they might have a close friend or family member who needs organ transplantation. Finally, 3% of the respondents chose other reasons.

On the other hand, respondents were asked if there is a particular reason that made them not want to participate in the organ donor program, 28 (11.6%) who think it is against their religion, 36 (14.9%) who do not want to participate for medical reasons, 34 (14.1%) who do not want their body to be disfigured, 22 (9.1%) who are afraid that their organ will be taken before death, 21 (8.7%) who don’t trust the medical system (I feel that I will not receive the best medical treatment if I’m a donor), 19 (7.9%) who are afraid to donate because they are afraid that a brain dead person will recover, 134 (55.6%) who chose no particular reason, and 8 (3.3%) who chose other reasons.


   Discussion Top


The need for organ donation is increasing nowadays, with the opposing shortage of donors. The health-care provider’s knowledge toward organ donation is playing an important role in raising awareness in their community. This study shows that medical personnel with different levels of experience have overall good awareness regarding organ donation and its rules. This finding is expected because providers are exposed to this situation during their practice even if it is not in their field. This result is similar to a study conducted by Uzuntarla which shows that 59.6% of healthcare providers at Tertiary Hospital in Turkey have adequate information about organ donation.[12] Furthermore, in the current study, more than half of subjects are aware about the rules and legislation concerning organ donation, which is in agreement with a study published by Nadoushan et al that show 94% of physicians had enough knowledge about transplantation rules.[13]

Regarding the level of knowledge toward organ donation, the study showed 58.9% of participants know what an organ donation card is. A similar percent was found in a Turkish study disclosing that two-thirds of health personnel are aware about the cards.[12] The lack of high levels of knowledge about organ donation cards may be explained by different specialties involved in the study, as not all specialties deal with this issue. Brain death includes documentation that provides findings of clear brain dysfunction, which enables the person to qualify for an organ donation. Moreover, awareness of brain death is 72.2% in our study. This percent is comparable to an Indian study which showed that 91.95% of residents acknowledge the exact definition of brain death.[14]

The attitude of health-care providers was variable. Among respondents, the majority, at 62.2% (n = 150), had previously enrolled in the organ donation program. In addition, more than half of the respondents were willing to educate their community about the organ donation program. This came in agreement with Uzuntarla’s study, which showed that most healthcare providers have positive attitudes toward organ donation.[12] Although minimal respondents were looking to participate in the organ donation registry, most encouraged their families and friends to register in the organ donation program. This agreement regarding the organ donation concept was investigated well before among the Saudi community, including students and teachers involved in the study by Alfaqih in 2005, which concluded that 42.6% of young or middle-aged Saudis want to participate in the organ donation program.[15]

Thus, we explore the hidden agenda for this variety in the respondents’ opinions and motivation to participate in the organ donation program. Most were aiming to save lives, while more than half participated because of previous experiences of loved ones, and the minority preferred to donate because they believed that there was no value to their organs after death. On the other hand, some respondents rejected the concept of the organ donation program mainly because of religious thoughts.[15]

Moreover, some misbelieved that the organ donation program will impact their general health status, and some feared body disfigurements and losing a vital organ before they were cremated. A cross-sectional study published in 2012 by Alsaied et al investigating the Qataris Healthcare Professionals’ (HCP) reviews organ donations in their community. The study concluded that the HCP did not consider organ donations to be significantly against their religious beliefs. In addition, the HCP in Alsaied’s study feared body disfigurement and inadequate medical care post-transplant.[16]

Furthermore, there were a few obstacles and barriers preventing organ donation among those willing to donate, since every donor has a preferable candidate. While most (more than half) prefer donating to anyone, one third prefer donating to only family members, relatives or friends, while a small minority prefer to donate to those who have the same nationality and religion as they do. However, considering the variability in our respondents’ attitudes, a minority of them believed that they had had the best education about organ donation, while another portion thought they had minimal education. Promisingly, most respondents have participated in an organ donation and transplantation awareness campaign.


   Limitations Top


Although our sample size was much larger than that of other studies in the field, and despite the study having reached its aim, there were some limitations to the present study that need to be highlighted. First, our study was cross-sectional, and covered a short interval time, as well as a single institution; thus, there is a possibility that the responses and levels of awareness are not representative of the entire healthcare providers in Saudi Arabia. Secondly, response-bias may be possible because of the moderate overall response rate (62%) which was particularly affected by the refusal of some respondents to participate or failure to complete the questionnaire. This could be attributed to the lack of interest and time, which ultimately resulted in their exclusion from the study.


   Conclusion Top


The level of perception and knowledge about organ donation among healthcare providers was inadequate, although they showed positive attitudes toward this issue. This study ascertains the need for an effective educational program directed toward healthcare providers at the King Abdul Aziz University Hospital in order to improve their knowledge regarding organ donation.

Conflict of interest: None declared.



 
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Correspondence Address:
Hatan Mortada
Plastic Surgery Division, Department of Surgery, King Saud University Medical City (KSUMC), King Saud University, Riyadh
Saudi Arabia
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DOI: 10.4103/1319-2442.308351

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