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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 101-105

A study of factors influencing decisions on organ donation among patient attendees in a Tertiary Care Hospital in North India


1 Department of Community Medicine, Gian Sagar Medical College and Hospital, Banur, Punjab, India
2 Department of Community Medicine, Sir Ganga Ram Hospital, New Delhi, India
3 Department of Community Medicine, IGMC, Shimla, Himachal Pradesh, India

Date of Web Publication29-Feb-2016

Correspondence Address:
Anjali Mahajan
Department of Community Medicine, IGMC, Shimla - 171 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-3334.177637

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  Abstract 

Introduction: Organ transplantation is the most preferred treatment modality for end-stage organ disease and organ failures as it improves the quality of life. Patients deemed fit for transplantation by the transplant team often wait expectantly for a donor organ. Each year thousands of individuals wait for organs to be donated for transplantation. There remains, therefore, a great need for increasing organ donation and harnessing of donor organs. Aims and Objectives: To determine knowledge, attitude, and practices of the general population for organ donation. To determine the factors which facilitate or inhibit general population from organ donation. Methodology: A cross-sectional survey was conducted among a total of 120 patient attendants attending outpatient department in the age group of 18–65 years at Sir Ganga Ram Hospital, New Delhi. Results: One hundred and twenty participants were enrolled in the study, but only 119 participated. The mean age of males was 37.7 ± 14.7 years while that of females was 32.7 ± 11.5. Maximum awareness was found to be for kidney donation, least awareness for ear drums, and intestine donation. About 49.1% males and 51.6% females were aware of the legislation related to organ transplantation. The majority of female respondents (73.3%) showed their willingness to donate their organs in contrast to males only 16.7% were ready to donate in any situation. Females (60.7%) outnumbered males (45.8%) in their readiness to sign an organ donor card. About 73.3% females and 64.4% males were ready to participate in any promotion campaign related to organ donation. Conclusion: The magnitude of organ retrieval for the execution of a successful donor program is heavily dependent upon the level of knowledge and attitudes of the general public, so the need of hour is to increase the awareness among masses.

Keywords: Awareness, knowledge, legislation, organ donation


How to cite this article:
Kaistha M, Kaistha S, Mahajan A. A study of factors influencing decisions on organ donation among patient attendees in a Tertiary Care Hospital in North India. CHRISMED J Health Res 2016;3:101-5

How to cite this URL:
Kaistha M, Kaistha S, Mahajan A. A study of factors influencing decisions on organ donation among patient attendees in a Tertiary Care Hospital in North India. CHRISMED J Health Res [serial online] 2016 [cited 2019 Oct 19];3:101-5. Available from: http://www.cjhr.org/text.asp?2016/3/2/101/177637


  Introduction Top


Each year thousands of individuals wait for organs to be donated for transplantation. According to United Network for Organ Sharing nearly 122,494 people are in waiting for a life-saving transplant in developed countries.[1] According to Indian Transplant Registry merely 20,952 kidney transplants have been done in India in the past 42 years.[2] India is in a situation where there is a chronic shortage of organs for transplantation.[3] There is an ever increasing gap between the number of patients on the waiting list for organ transplantation and the available number of donated organs. The prerequisites for the success of a transplantation program include awareness, positive attitude of the public toward organ donation and consent for organ donation.[4]


  Methodology Top


Study design and study setting

A cross-sectional survey was conducted at Sir Ganga Ram Hospital, New Delhi. It is a Multispeciality Hospital of Northern India known for its success of organ transplant. The present study was carried out to determine knowledge, attitude, and practices of the general population for organ donation.

Sample size and sampling method

Patient attendants attending outpatient department visiting the hospital between 9:30 am and 12 pm in the age group of 18–65 years were interviewed. Convenience sampling was used to draw the sample for this survey. A total of 120 participants were enrolled, but only 119 participated as one participant refused to complete the interview.

Method of data collection

Information was collected using face to face interviews based on a structured, pretested questionnaire. Informed consent was taken. The respondents were assured about the confidentiality and ethical principles that would be followed. The background and purpose of the study were explained before the questionnaires were distributed. Sociodemographic data including age, gender, and education, marital status, and occupation was also collected.

Knowledge, attitude, and practice variables

Knowledge of the respondents was assessed through questions regarding the meaning of the term “organ donation,” awareness of donation by living people as well as cadavers, risks involved in organ donation, and the sources of information for their knowledge. Attitudes of the respondents regarding organ donation was determined through questions regarding opinion on various issues such as the willingness to donate organs, and factors influencing the choice of recipient for future donation. Practices were assessed by inquiring about the actual donation of any organ and any untoward effects observed by individuals in the process that they attribute to organ donation.

Statistical analysis

The data collected were cleaned for any errors and entered into statistical software Microsoft IBM SPSS Version 20.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Mean and standard deviation was calculated for quantitative variables and categorical variables were analyzed using Chi-square or fisher exact test whichever was applicable value. P < 0.05 was considered statistically significant.


  Results Top


About 120 participants were enrolled in the study, but only 119 participated. The mean age of males was 37.7 ± 14.7 years while that of females was 32.7 ± 11.5 years. [Table 1] shows the demographic profile of the participants.
Table 1: Socio-demographic profile of Study Subjects

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Knowledge and educational status

Interestingly, none of the participants answered that kidney, cornea, liver, heart, lungs, ear drum, and intestine can all be donated. Only about 8.3% responded with maximum six options. Maximum awareness was found to be for kidney donation (96.6% males and 91.7% females), followed by cornea (84.7% males and 73.3% females), while only 44.1% males and 40% females were aware of heart transplant whereas awareness of ear drums and intestine was least among the study population [Table 2].
Table 2: Knowledge regarding organ donation

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Multiple sources of information about organ donation

Of the total 119 participants, information regarding organ donation was given to only 5.0% participants exclusively by doctors, 4.2% knew from friends and colleagues, (38.7%) of the participants heard about organ donation exclusively from print and electronic media and rest more than half (52%) knew from more than one source.

[Table 3] shows the awareness regarding legislation on organ donations, health facility where a person can get himself/herself registered for organ donation, and the concept of cadaver organ donation.
Table 3: Knowledge regarding law of organ donation

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Regarding belief and attitude related to organ donation

About 65% men found the process of organ donation risky whereas only 18.3% women considered it risky and this difference was found to be statistically significant (P < 0.005).

The attitudes of study population toward various aspects of organ donation are illustrated in [Table 4]. With regards to self-organ donation majority of respondents said that “they will think about it” and the results were found to be significant. The most important factor that one would consider before donating an organ to anyone, among males was a relation with the recipient 25 (43.1%) while in females was life giver 42 (71.1%). Twenty-five percent of men said “no to organ donation” for reasons such as: “they are the earning member,” and that they “found the process risky.”
Table 4: Belief and attitude towards organ donation

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None of the participants had donated an organ. When the respondents were asked to sign an organ donor card, about more than half (56.3%) agreed to sign it. Females (60.7%) outnumbered males (45.8%) in their readiness to sign an organ donor card, and these differences were found to be significant. One hundred and fourteen respondents (95.7%) were of the opinion that organ donation should be promoted and the results were found to be significant. About 82 (68.9%) of the participants showed their willingness to participate in organ donation promotion program [Table 4].


  Discussion Top


We aimed to determine the knowledge, attitude, and practices regarding organ donation in the patients attendees in a Multispeciality Hospital, New Delhi. It was observed that only 8.3% participants knew about the various organs such as kidney, eyes, blood, liver, lung, heart, and bone marrow all can be donated. These findings are lower than the findings of the study in Chennai and Karnataka where almost 16.1% and 11.2% considered that all organs can be donated, respectively.[5],[6] The plausible reason could be that these studies were conducted among college students and medical students who are expectedly well verse with the concept of organ donation.

The major source of information was mainly through printed, and electronic media (38.7%), and only 5.0% gained knowledge through health functionaries in the present study. In another study conducted in South India about 68.8% study subjects responded that major source of their information regarding organ donation was through the media including television, radio, and print media and doctors were the source of information only for 2.3% of the study population.[7] In Tamil Nadu, it was found that 53% of respondents heard about organ donation from print and electronic media. Moreover, 34.1% heard from health care workers.[5] Even in a study conducted on medical students, in 55.2% media as major source of information regarding organ donation and only 22.4% regarded health professionals as their source of information.[6] These findings present a dismal picture that health professionals are unable to give information regarding organ donation. The information circulated by the health professionals is always well taken, so efforts must be directed to sensitize the general masses through their focused and scrupulous involvement in propagating the same. A study done in California by Saub et al.[8] revealed that speaking to a physician about organ donation positively influenced the likelihood to donate an organ.

In our study, it was observed that almost 50% of study population did not have any clue regarding legislation, while the much higher number was obtained in a study conducted in New Delhi where it was between 76% and 93% among public school children, office goers, and villagers.[9]

The willingness to donate organs was higher among females than males (45% vs. 16%). Similar findings have been reported in a study in Mangalore by Mitra et al.[7]

About 65% men found the process of organ donation risky whereas only 18.3% women considered it risky while in a study in coastal South India only 40% participants believed that there are risks associated with organ donation.[7]

Positive attitude toward organ donation was seen in 37% participants (16.7% males, 45% females) who gave positive response toward self-organ donation. However, majority were indecisive, i.e., “they said that they will think about it.” This finding gives a positive hint that if awareness is more then there is a chance that most of these participants will agree to donate or sign a donor card. The primary hindrance to a successful deceased donor organ transplantation program is the extreme shortage of donor organs. The living and cadaver organ donation program in India is still in its infancy stage and is hindered not only by the lack of adequate knowledge and awareness in the general population but also about the criteria and guidelines for declaration of brain death, among health professional. Therefore, concerted efforts from all sectors are required to raise awareness among the masses regarding this burning issue.

Similar another study conducted in New Delhi where 61.59% people were ready to donate their organs after death [10] while study conducted in college students where 75.3% of the study population said positive response for their own organ to be donated. Similar finding has been reported in a study done by Odusanya et al.,[11] wherein 30% respondents expressed willingness for self-organ donation. In another study conducted in China by Zhang et al.[12] 49.8% respondents indicated they would be willing to be living organ donors, A still higher response was observed in a study in Ohio wherein 96% of respondents expressed favorable attitudes toward donation.[13] With regard to the willingness to donate the organs of their family members in the event of an unexpected death and, if they could decide about organ donation, more than half the subjects were willing to donate. Similar findings were found in other studies conducted by El-Shoubaki and Bener.[14]

About 68.9% study population was ready to participate in any promotion campaign related to organ donation. This finding is similar to other study in India,[7] but lower when compared to data from a study done in Brazil. This study reported that 87% of respondents were in favor of organ donation.[15]

In our study, 67 (56.3%) participants agreed to sign an organ donor card while in a study in Tertiary Care Hospital in India only 36% participants agreed to sign a donor card.[7]


  Conclusion Top


The magnitude of organ retrieval for the execution of a successful donor program is heavily dependent on the level of knowledge and attitudes of the general public. Therefore, the need of hour is to raise awareness among the masses so that they come out in large numbers in support of the same.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
UNOS. Waiting List Data: United Network for Organ Sharing; 2010. Available from: http://www.unos.org. [Last accessed on 2015 Sep 21].  Back to cited text no. 1
    
2.
Indian Transplant Registry. Available from: http://www.transplantindia.com. [Last accessed on 2015 Sep 21].  Back to cited text no. 2
    
3.
Reddy AV, Guleria S, Khazanchi RK, Bhardwaj M, Aggarwal S, Mandal S. Attitude of patients, the public, doctors, and nurses toward organ donation. Transplant Proc 2003;35:18.  Back to cited text no. 3
    
4.
Shroff S, Navin S, Abraham G, Rajan PS, Suresh S, Rao S, et al. Cadaver organ donation and transplantation-an Indian perspective. Transplant Proc 2003;35:15-7.  Back to cited text no. 4
    
5.
Annadurai K, Mani K, Ramasamy J. A study on knowledge, attitude and practices about organ donation among college students in Chennai, Tamil Nadu-2012. Prog Health Sci 2013;3:59-65.  Back to cited text no. 5
    
6.
Shreya A. Are medical students having enough knowledge about organ donation. IOSR J Dent Med Sci 2015;14:29-34.  Back to cited text no. 6
    
7.
Mithra P, Ravindra P, Unnikrishnan B, Rekha T, Kanchan T, Kumar N, et al. Perceptions and attitudes towards organ donation among people seeking healthcare in tertiary care centers of coastal South India. Indian J Palliat Care 2013;19:83-7.  Back to cited text no. 7
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8.
Saub EJ, Shapiro J, Radecki S. Do patients want to talk to their physicians about organ donation? Attitudes and knowledge about organ donation: A study of Orange County, California residents. J Community Health 1998;23:407-17.  Back to cited text no. 8
    
9.
Wig N, Gupta P, Kailash S. Awareness of brain death and organ transplantation among select Indian population. J Assoc Physicians India 2003;51:455-8.  Back to cited text no. 9
    
10.
Mishra PH, Aarti V, Sarma RK. A knowledge, attitude and practice study of organ donation and its problems in the metropolitan city of Delhi. J Acad Hosp Adm (Serial online) 2004;16:11. Available from: http://www.indmedica.com/journals.php. [Last accessed on 2015 Apr 24].  Back to cited text no. 10
    
11.
Odusanya OO, Ladipo CO. Organ donation: Knowledge, attitudes, and practice in Lagos, Nigeria. Artif Organs 2006;30:626-9.  Back to cited text no. 11
    
12.
Zhang L, Li Y, Zhou J, Miao X, Wang G, Li D, et al. Knowledge and willingness toward living organ donation: A survey of three universities in Changsha, Hunan Province, China. Transplant Proc 2007;39:1303-9.  Back to cited text no. 12
    
13.
Sander SL, Miller BK. Public knowledge and attitudes regarding organ and tissue donation: An analysis of the northwest Ohio community. Patient Educ Couns 2005;58:154-63.  Back to cited text no. 13
    
14.
El-Shoubaki H, Bener A. Public knowledge and attitudes toward organ donation and transplantation: A cross-cultural study. Transplant Proc 2005;37:1993-7.  Back to cited text no. 14
    
15.
Coelho JC, Cilião C, Parolin MB, de Freitas AC, Gama Filho OP, Saad DT, et al. Opinion and knowledge of the population of a Brazilian city about organ donation and transplantation. Rev Assoc Med Bras 2007;53:421-5.  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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