UNDERSTANDING THE ATTITUDES AND FACTORS INFLUENCING ORGAN DONATION DECISIONS AMONG UNIVERSITY STUDENTS IN PAKISTAN: A QUALITATIVE STUDY

Main Article Content

Sonia Umair
Jo Ann Ho
Norazlyn Kamal Basha
Serene Siew-Imm Ng
Umair Waqas

Keywords

Organ Donation, Pakistan, Attitudes, Willingness to Donate, Willingness to Sign Donor Card, Qualitative Study

Abstract

Purpose: The main purpose of this study was to identify factors that were important in posthumous organ donation decisions in a developing country such as Pakistan.


Methodology: A qualitative study was conducted with 50 semi-structured interviews among students of one public and one private university in Lahore (Pakistan) to understand their attitudes and factors influencing their decisions on posthumous organ donations. Purposive sampling technique was used in this study. The interview questions focused on the level of knowledge, motivation and overall attitude towards the posthumous organ donation decision of the respondents.


Main Findings: There was a lack of general knowledge among university students in Pakistan. Most of the students had a positive attitude for posthumous organ donation yet moral norms are very influential in the decision-making process for organ donation after death. Those who were willing were reluctant because of the influence of family and friends. Religion was also another significant norm factor for prohibiting them to be an organ donor after death.


Implications/Applications: The present study provided a way in the advancement of knowledge towards an understanding of the attitude, moral norms along with social and family influence for not only intention to donate but also signing the donor card. The findings of the study are useful for the government, policymakers and the organizations in Pakistan in their efforts to increase awareness and organ donation rates in the country.


Novelty/Originality: The present research was exploratory and the intention for this research was to explore the underlying behavioral and normative beliefs which may inhibit or encourage organ donation among university students. Such qualitative studies are relatively uncommon in transplant literature.

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References

1. Ali, N.F., Qureshi, A., Jilani, B.N., & Zehra, N. (2013). Knowledge and ethical perception regarding organ donation among medical students. BMC Medical Ethics, 14(1), 38. https://doi.org/10.1186/1472-6939-14-38
2. Ashraf, O., Ali, S., Ali, S.A., Ali, H., Alam, M., Ali, A., & Ali, T.M. (2005). Attitude Toward Organ Donation : A Survey in Pakistan, Artificial Organs,29(11), 899–905. https://doi.org/10.1111/j.1525-1594.2005.00153.x
3. Anderson, C. (2010). Presenting and evaluating qualitative research. American journal of pharmaceutical education, 74(8), 141. https://doi.org/10.5688/aj7408141
4. Bile, K. M., Qureshi, J. A. R. H., Rizvi, S. A. H., Naqvi, S. A. A., Usmani, A. Q., & Lashari, K. A. (2010). Human organ and tissue transplantation in Pakistan: When a regulation makes a difference. Eastern Mediterranean Health Journal, 16, 159–166. https://doi.org/10.26719/2010.16.Supp.159
5. Choy, L. T. (2014). The strengths and weaknesses of research methodology: Comparison and complimentary between qualitative and quantitative approaches. Journal Of Humanities And Social Science, 19(4), 99–104. https://doi.org/10.9790/0837-194399104
6. Da Silva, I. R. F., & Frontera, J. A. (2015). Worldwide barriers to organ donation. JAMA neurology, 72(1), 112-118. https://doi.org/10.1001/jamaneurol.2014.3083
7. Dart Dr., R. grounded qualitative study of the meanings of effectiveness in C. ’Results-F. environmental organizationsd. (2010). A grounded qualitative study of the meanings of effectiveness in Canadian “Results-Focused” environmental organizations. Voluntas, 21(2), 202–219. https://doi.org/10.1007/s11266-009-9101-4
8. Demir, B., &Kumkale, G. T. (2013). Individual differences in willingness to become an organ donor: A decision tree approach to reasoned action. Personality and Individual Differences, 55(1), 63-69.
9. Faltynek, P. (2013). Religiosity and its relationship to organ donation acceptability. Western Undergraduate Psychology Journal, 1(1). https://doi.org/10.1111/j.0021-9029.2007.00159.x
10. Feeley, T. (2007). College students’ knowledge, attitudes, and behaviors regarding organ donation: an integrated review of the literature. Journal of Applied Social Psychology, 37(2), 243–271.
11. Horton, R. L., & Horton, P. J. (1991). A model of willingness to become a potential organ donor. Social Science & Medicine, 33(9), 1037-1051. https://doi.org/10.1016/0277-9536(91)90009-2
12. Hübner, G., Mohs, A., & Petersen, L.E. (2014). The role of attitude strength in predicting organ donation behaviour by implicit and explicit attitude measures. Open Journal of Medical Psychology, 3(5), 355 – 363. https://doi.org/10.4236/ojmp.2014.35037
13. Hyde, M. K. & White, K. M. (2009). To be a donor or not to be? Applying an extended theory of planned behavior to predict posthumous organ donation intentions. Journal of Applied Social Psychology, 39(4), 880–900. https://doi.org/10.1111/j.1559-1816.2009.00464.x
14. Irving, M. J., Tong, A., Jan, S., Cass, A., Rose, J., Chadban, S., Howard, K. (2012). Factors that influence the decision to be an organ donor: A systematic review of the qualitative literature. Nephrology Dialysis Transplantation, 27(6), 2526–2533. https://doi.org/10.1093/ndt/gfr683
15. Jafarey, A., & Nagral, S. (2014). Towards deceased organ donation in Asia: negotiating the challenges. Indian Journal of Medical Ethics,11(3), 137–8. https://doi.org/10.20529/IJME.2014.037
16. Kocaay, A. F., Celik, S. U., Eker, T., Oksuz, N. E., Akyol, C., & Tuzuner, A. (2015). Brain death and organ donation: Knowledge, awareness, and attitudes of medical, law, divinity, nursing, and communication students. Transplantation Proceedings, 47(5), 1244–1248. https://doi.org/10.1016/j.transproceed.2015.04.071
17. Khan, N., Masood, Z., Tufail, N., Shoukat, H., Ashraf, K., Ehsan, S., Khalid, S. (2011). Knowledge and Attitude of People Towards Organ Donation. Jumdc, 2(2), 15–21.
18. Krespi, M. R., Tankurt, A., Acarli, K., Kanmaz, T., Yankol, Y., & Kalayoglu, M. (2017). Beliefs of Living Donors About Recipients’ End-Stage Liver Failure and Surgery for Organ Donation. Transplantation Proceedings, 49(6), 1369–1375. https://doi.org/10.1016/j.transproceed.2017.02.050
19. Manzari, Z. S., , E. Mohammadi, A. H., Shearbaff, H. R. A., Azizi, M. J. M., & Khaleghi, E. (2012). Exploring the Needs and Perceptions of Iranian Families Faced with Brain Death News and Request to Donate Organ: A Qualitative Study. International Journal of Organ Transplantation Medicine, 3, 92–100.
20. Manzano, A. & Pawson, R. (2014). Evaluating deceased organ donation: A programme theory approach. Journal of Health Organization and Management, 28(3), 366–385. https://doi.org/10.1108/JHOM-07-2012-0131
21. McGlade, D. & Pierscionek, B. (2013). Can education alter attitudes, behaviour and knowledge about organ donation? A pretest-post-test study. BMJ Open, 3(12), e003961. https://doi.org/10.1136/bmjopen-2013-003961
22. Melku, M., Terefe, B., Asrie, F., Enawgaw, B., Melak, T., Tsegay, Y. G.,& Shiferaw, E. (2016). Knowledge, attitude, and practice of adult population towards blood donation in Gondar Town, Northwest Ethiopia: a community based cross-sectional study. Journal of blood transfusion, 1-10. https://doi.org/10.1155/2016/7949862
23. Morgan, S. E. & Miller, J. K. (2001). Beyond the organ donor card: The effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family. Health Communication, 14(1), 99–119. https://doi.org/10.1207/S15327027HC1401_6
24. Morgan, S. & Miller, J. (2002). Communicating about gifts of life: The effect of knowledge, attitudes, and altruism on behavior and behavioral intentions regarding organ donation. Journal of Applied Communication Research, 30(2), 163-178. https://doi.org/10.1080/00909880216580
25. Murray, L., Miller, A., Dayoub, C., Wakefield, C., & Homewood, J. (2013). Communication and consent: Discussion and organ donation decisions for self and family. Transplantation Proceedings,45(1), 10-12. https://doi.org/10.1016/j.transproceed.2012.10.021
26. Pakistan Bureau of Statistics. (2017). Population Census 2017. Retrieved from Pakistan Bureau of Statistics: http://www.pbscensus.gov.pk/
27. Pakistan Tourism Development Corporation. (2017). About Pakistan. Retrieved from Pakistan Tourism Development Corporation: http://www.tourism.gov.pk/peoples_of_pakistan.html
28. Park, H. S., Smith, S. W., & Yun, D. (2009). Ethnic differences in intention to enroll in a state organ donor registry and intention to talk with family about organ donation. Health Communication, 24(7), 647-659. https://doi.org/10.1080/10410230903242259
29. Potter, J. E., Herkes, R. G., Perry, L., Elliott, R. M., Aneman, A., Brieva, J. L., & Gebski, V. (2017). Communication with families regarding organ and tissue donation after death in intensive care (COMFORT): Protocol for an intervention study. BMC Health Services Research, 17(1), 42. https://doi.org/10.1186/s12913-016-1964-7
30. Ralph, A. F., Alyami, A., Allen, R. D., Howard, K., Craig, J. C., Chadban, S. J., & Tong, A. (2016). Attitudes and beliefs about deceased organ donation in the Arabic-speaking community in Australia: a focus group study. BMJ open, 6(1), e010138. https://doi.org/10.1136/bmjopen-2015-010138
31. Randhawa, G., & Neuberger, J. (2016). Role of Religion in Organ Donation-Development of the United Kingdom Faith and Organ Donation Action Plan. Transplantation Proceedings, 48(3),689–694. https://doi.org/10.1016/j.transproceed.2015.10.074
32. Rivis, A., Sheeran, P., & Armitage, C. J. (2009). Expanding the affective and normative components of the theory of planned behavior: A meta-analysis of anticipated affect and moral norms. Journal of Applied Social Psychology, 39(12), 2985–3019. https://doi.org/10.1111/j.1559-1816.2009.00558.x
33. Robinson, D. H., Klammer, S. M. G., Perryman, J. P., Thompson, N. J., & Arriola, K. R. J. (2014). Understanding African American’s religious beliefs and organ donation intentions. Journal of Religion and Health,53(6), 1857-1872. https://doi.org/10.1007/s10943-014-9841-3
34. Russell, E., Robinson, D. H. Z., Thompson, N. J., Perryman, J. P., & Arriola, K. R. J. (2012). Distrust in the healthcare system and organ donation intentions among African Americans. Journal of Community Health, 37(1), 40–47. https://doi.org/10.1007/s10900-011-9413-3
35. Saigol, M. A. (2014). Organ donation, the two fold problem. Retrieved from The Express Tribune: https://tribune.com.pk/story/748281/organ-donation-the-two-fold-problem/
36. Saleem, T., Ishaque, S., Habib, N., Hussain, S. S., Jawed, A., Khan, A. A., ... & Jehan, I. (2009). Knowledge, attitudes and practices survey on organ donation among a selected adult population of Pakistan. BMC Medical Ethics, 10(1), 5. https://doi.org/10.1186/1472-6939-10-5
37. Sanner, M. A. (2006). People's attitudes and reactions to organ donation. Mortality, 11(2), 133-150. https://doi.org/10.1080/13576270600615351
38. Siminoff, L. A., Gordon, N., Hewlett, J., & Arnold, R. M. (2001). Factors influencing families' consent for donation of solid organs for transplantation. Jama,286(1), 71-77. https://doi.org/10.1001/jama.286.1.71
39. Skumanich, S. A. & Kintsfather, D. P. (1996). Promoting the organ donor card: A causal model of persuasion effects. Social Science and Medicine, 43(3), 401–408. https://doi.org/10.1016/0277-9536(95)00404-1
40. Skwirczyńska-Szalbierz, E., Matoszka, N., Sepioło, A., & Ostrowski, M. (2014). Communication with family after loss, in the context of transplantology. Transplantation Proceedings, 46(6), 2036–2039. https://doi.org/10.1016/j.transproceed.2014.06.016
41. Stephenson, M. T., Morgan, S. E., Roberts-Perez, S. D., Harrison, T., Afifi, W., & Long, S. D. (2008). The role of religiosity, religious norms, subjective norms, and bodily integrity in signing an organ donor card. Health Communication,23(5), 436-447. https://doi.org/10.1080/10410230802342119
42. Umair, S. (2017). Factors associated with posthumous organ donation for Transplantation. The International Journal Of Humanities & Social Studies, 5(10), 287–289.