Journal of Health Specialties

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 6  |  Issue : 2  |  Page : 68--71

Attitudes and perceptions towards organ donation in Riyadh


Basil Mohammed Alhussain1, Bader Mohammed Alasmari1, Aamir Omair1, Ibrahim Altraif2, Abdulrahman R Altamimi2,  
1 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi Arabia
2 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, College of Medicine; Department of Surgery, Division of Transplant, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia

Correspondence Address:
Dr. Basil Mohammed Alhussain
King Saud bin Abdulaziz University for Health Sciences, Riyadh
Kingdom of Saudi Arabia

Abstract

Context: Organ donation is an optimal solution for patients with certain conditions who benefit from transplantation such as liver cirrhosis. The organs come from living and brain-dead donors, who opt to donate parts of their bodies to treat others. This serves to treat and improve the outcome to those in need; however, the awareness in this regard is unclear. Aims: This study aimed to assess the attitude and perceptions towards organ donation and the concept of brain death in the population of Riyadh, Saudi Arabia. Settings and Design: A cross-sectional quantitative design was used. The study was conducted at four large malls in different geographical areas. Data collection was done at random times during the day. Subjects and Methods: A self-administered questionnaire was designed to examine the sociodemographic data. A 4-item questionnaire was developed to assess the attitude and perception of organ donation and brain death. Statistical Analysis Used: Data were entered and analysed using SPSS v21. Descriptive statistics are presented as frequencies and percentages for the categorical variables and mean ± standard deviation for numerical variables. Results: The study included 409 participants from different sociodemographic backgrounds. Over 60% were able to identify the correct definition of brain death and 68.1% stated that they would like to donate their organs in case of brain death. Conclusions: Our findings suggest that the population has an acceptable understanding of the concept of brain death and that they are willing to donate in cases of brain death. It also shows an excellent understanding of the religious aspect, but with poor family and friends' communication regarding the subject.



How to cite this article:
Alhussain BM, Alasmari BM, Omair A, Altraif I, Altamimi AR. Attitudes and perceptions towards organ donation in Riyadh.J Health Spec 2018;6:68-71


How to cite this URL:
Alhussain BM, Alasmari BM, Omair A, Altraif I, Altamimi AR. Attitudes and perceptions towards organ donation in Riyadh. J Health Spec [serial online] 2018 [cited 2018 Dec 18 ];6:68-71
Available from: http://www.thejhs.org/text.asp?2018/6/2/68/229023


Full Text



 Introduction



Organ transplantation is considered the mean treatment for the failure of vital organs. It also greatly enhances the quality of life of patients with end-stage organ diseases.[1] The shortage of organ donation remains a major health problem worldwide.[2],[3],[4] The Uniform Determination of Death Act (UDDA) is a model legislation adopted nationwide that provides a more concrete definition of death for legal purposes. It defines brain death as 'the irreversible cessation of all functions of the entire brain, including the brain stem'. Even in countries with high transplantation success rates, many patients in the waiting lists will not receive a transplant because of the insufficient rates of donation.[5] Health systems rely on both living and brain–dead donors to obtain organs. Several studies performed in different countries have shown that the number of brain-injured patients who have progressed to brain death has been constant or even decreased over time.[6],[7],[8],[9],[10],[11],[12] These results have been attributed to the advances in injury prevention, resuscitation and supportive care.[13],[14],[15],[16],[17]

Research suggests that attitudes and beliefs of people towards organ donation contribute significantly to their willingness to donate and to register as an organ donor in the organ registry.[18] In 2012, The National Survey of Organ Donation Attitudes and Behaviors in the United States has shown that 94.9% of adults participated in the study supported organ donation.[19] A similar study done in Saudi Arabia showed that approximately 91% of respondents agreed with the concept of all organ transplantations regardless of organ type (with no specification) and that transplantation is a humane treatment that ultimately saves lives.[20] The need to raise awareness of organ donation and brain death in the Islamic perspective would ultimately result in more donation and less suffering for patients in need. This research aims to assess the attitude and perceptions regarding organ donation of the general population in Riyadh, Saudi Arabia.

 Subjects and Methods



Study design

A cross-sectional quantitative study design was used.

Study subjects

Saudi adults over the age of 18 years from shopping malls in different regions of Riyadh city participated in the survey and written consents were taken. Those non-willing to participate were excluded from the study.

Study population and sampling technique

The study was done in Riyadh, the capital city of Saudi Arabia. Four large malls in different geographical areas representing east, west, north and south regions were selected to ensure a better representation. Data collection was done at random times during the day to ascertain a good distribution of the sample. Four to six data collectors (males and females) spent an average of 3 h for a minimum of 1 day per mall in every mall.

Data collection methods

A self-administered questionnaire was designed to collect information about the sociodemographic data such as nationality, age, gender, educational level, marital status and income. The 4-item questionnaire was developed to assess the attitude and perception of organ donation and brain death.

Data analysis

Data were entered and analysed using SPSS v21 (IBM SPSS Statistics for Windows, IBM Corp: Armonk, NY).[21] The descriptive statistics are presented as frequencies and percentages for the categorical variables and mean ± standard deviation for numerical variables.

Ethical considerations

No name or identification was collected, filling of the questionnaire was taken as consent. More than 1200 booklets were provided to participants after the interview, and these booklets contained general information about organ donation.

 Results



The total number of participants was 454, among those, 409 responded, yielding a response rate of 90%. The study took place in four shopping malls with a minimum of 100 participants from each mall. There were 248 female and 161 male participants in the study; the mean age was 29.5 ± 9.1 years. The majority were high school graduates (49%) and had a bachelor's degree (34%) and most of the participants had a family income of <10,000 SAR [Table 1].{Table 1}

Over half of those questioned (60.1%), stated that they accepted the definition of brain death as the irreversible stopping of all brain functions, where as 22.4% said that it is when someone is in a long coma. A smaller portion (13.3%) chose the previous definition with the addition of the heart shutting down and 4.2% of the respondents said that they did not know. When asked about the Islamic religion's view on the subject of organ donation, 86.3% of the respondents said that it is accepted in the religion, whereas 8.8% said that it is not allowed and 4.4% said that they did not know.

When asked if they would donate their organ in case of brain death, 68.2% of the respondents said that they would donate, whereas 27.4% preferred not to donate and 4.4% said that they did not know. The next question was about conveying the wish of donation to family and friends, of which 73.8% said that they informed their families of their decision, whereas 26.2% said that they did not inform their families.

Organ donation is a vital method to treat, alleviate and improve a lot of diseases in terms of outcome.[1] This method of treatment, however, is donor dependent. We believe, as our results showed, that there is a good understanding of the nature of organ donation and brain death, but this can be greatly improved with proper multilevel education. The religious role is rather positive, but evidence-based readily available information is still difficult to find for the general population. This kind of education will not only enhance the awareness but will also help guide the public towards donating their organs in case of brain death.

 Discussion



The basic understanding of the nature of brain death remains somewhat of a mystery in our society, and this lack of understanding leads the population into believing that a brain-dead individual is not 'completely' dead, but rather is in a deep coma, or that as long as the person has a beating heart, then they remain alive. These kinds of beliefs could hinder the process of harvesting and utilising the organs that could save many lives. These beliefs are sometimes magnified when the person takes the wrong side of the Islamic religion, or when influential Islamic scholars fail to study and emphasise the basic concept behind brain death and fail to provide a clear, well-educated opinion on the matter. There is also the hurdle of family, as any one choosing to donate his/her organs in case of brain death has to go through convincing his/her family of their decision and explaining everything that led them to making this decision, which can be a tiring process.

After going through our results, we found that well over half (60.1%) were able to select the most proper definition to brain death of the presented options, and this can be attributed to a growing awareness in terms of health and bodily conditions. A portion of 22.4% of the respondents chose the definition as being a long state of coma, which is true in a way but lacks the important distinction of irreversible loss of brain functions, and this can be explained by not reading enough on the topic and relying merely on observations and hearsay. A small segment (13.3%) opted to add the heart shutting down, but this definition includes cardiac death as part of brain death, which can be due to a lack of understanding of the UDDA, which is a legal technical act that the general population is not expected to completely comprehend and abide by. This leaves a small fragment of 4.4% who stated that they did not know the definition.

When asked about religion's view in regard to organ donation, a high portion (86.2%) of the respondents stated that it was acceptable to donate, while the rest were between saying it was not acceptable (8.8%) and not knowing at all (4.4%). This reflects the positive role carried out by Islamic scholars in understanding and educating the public on the religious perspective. When asked if the participants would themselves donate their organs in case of brain death, we can see a general enthusiasm towards donating, with 68.2% agreeing to donate, while 27.4% stated that they would not donate, whereas 4.4% were not sure what to do. Many reasons can be behind the decision to not donate, but one can say that with proper education on the nature of brain death, one can understand and appreciate the irreversibility of it, and thus be more willing to donate.[5]

Finally, when asked about discussing the decision with family and friends, only 26.2% of the respondents stated that they did that, with the majority (73.8%) stating that they did not discuss their decision with their relatives. This is easily understandable when you consider that decisions relating to the end of one's life are not something that is usually discussed without stirring a feeling of stress and fear. Family and friends may view this as a non-favourable topic and wish to avoid discussing it, or simply because they do not view their decision to be final, thus they would not convey their wishes to their families and friends unless they deem them final.

 Conclusion



The perception of organ donation in cases of brain death is considered rather good. The religious scholars' role is also good as almost three quarters of the sample were educated enough religiously to choose the correct answer. More than half of those questioned agreed to donate their organs in case of brain death, which reflects a good mindset towards donation, but the population should be advised as to discuss their decisions with their family and friends to prepare when and if the day comes.

Financial support and sponsorship

This study was financially supported by KAIMRC.

Conflicts of interest

There are no conflicts of interest.

References

1Kim JR, Fisher MJ, Elliott D. Undergraduate nursing students' knowledge and attitudes towards organ donation in Korea: Implications for education. Nurse Educ Today 2006;26:465-74.
2Muralidharan A, White S. The need for kidney transplantation in low- and middle-income countries in 2012: An epidemiological perspective. Transplantation 2015;99:476-81.
3Wolfe RA, Roys EC, Merion RM. Trends in organ donation and transplantation in the United States, 1999–2008. Am J Transplant 2010;10:961-72.
4Wynn JJ, Alexander CE. Increasing organ donation and transplantation: The U.S. experience over the past decade. Transpl Int 2011;24:324-32.
5Wakefield CE, Watts KJ, Homewood J, Meiser B, Siminoff LA. Attitudes toward organ donation and donor behavior: A review of the international literature. Prog Transplant 2010;20:380-91.
6Kramer AH, Zygun DA, Doig CJ, Zuege DJ. Incidence of neurologic death among patients with brain injury: A cohort study in a Canadian health region. CMAJ 2013;185:E838-45.
7Callahan DS, Kim D, Bricker S, Neville A, Putnam B, Smith J, et al. Trends in organ donor management: 2002 to 2012. J Am Coll Surg 2014;219:752-6.
8Saidi RF, Markmann JF, Jabbour N, Li Y, Shah SA, Cosimi AB, et al. The faltering solid organ donor pool in the United States (2001-2010). World J Surg 2012;36:2909-13.
9Van Gelder F, Delbouille MH, Vandervennet M, Van Beeumen G, Van Deynse D, Angenon E, et al. An 11-year overview of the Belgian donor and transplant statistics based on a consecutive yearly data follow-up and comparing two periods: 1997 to 2005 versus 2006 to 2007. Transplant Proc 2009;41:569-71.
10Desschans B, Evrard P; Coordinator Transplant Section of the Belgian Transplant Society. Organ donation and transplantation statistics in Belgium for 2012 and 2013. Transplant Proc 2014;46:3124-6.
11Johnson RJ, Bradbury LL, Martin K, Neuberger J; UK Transplant Registry. Organ donation and transplantation in the UK-the last decade: A report from the UK national transplant registry. Transplantation 2014;97 Suppl 1:S1-27.
12Kompanje EJ, de Groot YJ, Bakker J. Is organ donation from brain dead donors reaching an inescapable and desirable nadir? Transplantation 2011;91:1177-80.
13Kramer AH, Deis N, Ruddell S, Couillard P, Zygun DA, Doig CJ, et al. Decompressive craniectomy in patients with traumatic brain injury: Are the usual indications congruent with those evaluated in clinical trials? Neurocrit Care 2016;25:10-9.
14Schirmer CM, Hoit DA, Malek AM. Decompressive hemicraniectomy for the treatment of intractable intracranial hypertension after aneurysmal sub- arachnoid hemorrhage. Stroke 2007;38:987-92.
15Fung C, Murek M, Z'Graggen WJ, Krähenbühl AK, Gautschi OP, Schucht P, et al. Decompressive hemicraniectomy in patients with supratentorial intracerebral hemorrhage. Stroke 2012;43:3207-11.
16Schwab S, Steiner T, Aschoff A, Schwarz S, Steiner HH, Jansen O, et al. Early hemicraniectomy in patients with complete middle cerebral artery infarction. Stroke 1998;29:1888-93.
17Head Injuries in Canada: a Decade of Change (1994–1995 to 2003–2004). Ottawa: Canadian Institute of Health Information; 2006. Available from: https://www.secure.cihi.ca/free_products/ntr_head_injuries_2006_e.pdf. [Last accessed on 2015 Nov 02].
18Evanisko MJ, Beasley CL, Brigham LE, Capossela C, Cosgrove GR, Light J, et al. Readiness of critical care physicians and nurses to handle requests for organ donation. Am J Crit Care 1998;7:4-12.
19U.S. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, 2012 National Survey of Organ Donation Attitudes and Behaviors. Rockville, Maryland: U.S. Department of Health and Human Services, 2013. Available from: https://organdonor.gov/dtcp/nationalsurveyorgandonation.pdf. [Last accessed 2017 Feb 10].
20AlHabeeb 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.
21IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.; 2012.