Organ donation is a complex topic that is influenced by various factors, including correct knowledge, attitudes, cultural beliefs, and individual motivations. These elements have been the subject of numerous studies to better understand organ donation.
An Indian study found that the general public, even terminally sick patients, lacks information and comprehension of organ donation.11 This lack of knowledge, combined with religious attitudes and superstitious beliefs, has led to fear and mistrust towards organ donation. Similar results were obtained in a study carried out in China, where it was discovered that many Chinese residents lack awareness about organ donation and hold unfavourable opinions about it.12
Students who are enrolled in professional programmes like medicine, engineering, nursing, and management make up the cream of society and have several advantages like being tech-savvy, having high emotional intelligence, proficient in English, participating in undergraduate research, and having efficient teachers.13 To make sure they are aware and ready to discuss this subject with their relatives and friends, as well as to help educate and inspire the general public to donate their organs, it is crucial to evaluate their knowledge of and attitudes about organ donation.
The general level of awareness about organ donation was found to be moderate generally, with potential for improvement, in research conducted in Peru among students of health sciences. 14 In order to increase knowledge and awareness among professional students, the study emphasised the necessity for educational initiatives. Another study examined the six-year evaluation of medical students' education in organ donation. The study emphasised the beneficial effects of educational interventions on influencing medical students' attitudes towards organ donation.15 Young age, women, high socioeconomic status, education, knowledge and awareness of organ donation, experiential knowledge about organ donation, and family positive attitudes were found to be the most influencing factors for organ donation, according to a recent review of the literature based on 33 studies.16
Empathy and the idea that organ donation has benefits are just two of the many elements that affect attitudes. According to a US study, people who felt more self-benefits and had higher levels of empathy were more likely to donate organs.17 Similar findings were made by a Japanese study, which indicated that people's opinions about organ donation are significantly influenced by their families.18 Individual attitudes and family perspectives both have an impact on decision-making. Aspects like ethnicity and culture also influence attitudes towards organ donation. According to a study done among Hispanic women in the US, attitudes about donation were influenced by perceptions of prejudice regarding the distribution of donated organs between Hispanic and Anglo Americans. 19
Beyond having access to correct knowledge, there may be a number of sociocultural factors affecting the willingness to donate organs. Tumin et al. observed that 55.6% of the participants were eager to give their organs after passing away.20 In their narrative review on undergraduate nursing students' attitudes towards organ donation, Tsubaki et al. (2019) noted that factors like being in the first year of nursing school, not knowing any organ donors, and being in favour of organ donation all had an impact on students' willingness to donate organs.18
Correlates of knowledge, attitude and willingness
Age:
Age is a key component of human development and is recognised to have an impact on a variety of personal traits, such as attitudes and beliefs.21 Despite the fact that all of the participants in the study were first-year students in a variety of professional courses, it was discovered that the older participants exhibited a more positive attitude than their younger counterparts. The meta-analysis by Iniesta-Seplveda M et al. showed a favourable correlation between age and the proportion of students who supported organ donation. 22
Gender
Organ donation is an altruistic act that benefits other people, making it more consistent with the nurturing and caring gender roles assigned to women. 23 However, conflicting data have been found about the part gender plays in organ donation. While some studies, including the one at hand, have shown that women are more optimistic and charitable than men, other research has shown the opposite. 24 In two research carried out in the southern Indian states, it was discovered that women had a less favourable attitude towards organ donation.25,26 The paradox may be explained by the fact that, despite being a positively regarded act of charity, organ donation can also cause people to feel anxious.
Religion
Individuals' willingness to give organs after death can be influenced by their various religious beliefs and practises. This idea is deeply ingrained in the Hindu psyche since Hindu scriptures have many vivid examples of organ donation and transplantation, like Guru Dadheech and Lord Ganesha. 27 When compared to people of other religious backgrounds, Muslims in the West have more negative attitudes on organ donation and transplantation, according to Ali et al.'s discussion of the Islamic stance on these topics. 28
In a Turkish survey, 26.2% of participants stated that they would not give organs because of their religious convictions. 29 Similar findings were observed in a study of non-medical university students from China, who were shown to have favourable opinions towards living organ donation but who would only do so if the beneficiaries were their blood relatives, illustrating the effect of traditional Chinese culture. 30 Similar to the results of the current study, a study conducted in South India discovered that Christians (63.3%) and Hindus (63.6%) were more eager to donate organs and had more favourable attitudes towards doing so than Muslims (38.2%). 11
Residence
In India, there is a significant disparity between the urban and rural areas in terms of health care access, economic position, and educational attainment. This disparity may affect the study participants' knowledge, attitudes, and behaviours. Students from metropolitan areas were shown to have superior knowledge but a less positive attitude towards organ donation in the current study. According to a survey conducted in China among people aged 18 to 30 years old, fewer rural residents were prepared to give their organs than urban ones. 31
According to a survey conducted in Greece, over three-quarters of respondents who received primary care in a rural area and were interested in becoming organ donors had never brought up the idea with anyone else or taken any further step. 32
Professional course
The desire to have a beneficial impact on society is shared by students in all of the professional courses, but there are differences in their driving forces, personality features, academic performance, difficulties they have faced, educational strategies, and professional development. All of these students need to comprehend the difficulties and complexity of organ donation and transplantation. Understanding these shifting attitudes and views might help students in engineering and management courses develop more effective techniques for raising awareness of organ donation.
A study conducted in the United Kingdom discovered that both nursing and medical students had generally good attitudes towards organ donation, and that there was a significant association between their attitude and their own willingness to donate organs. 33 Another study in Japan discovered that nursing students had good attitudes regarding organ donation despite having less knowledge on the subject than medical students.18
Interestingly, one study contrasted medical students' attitudes to those of the general community and discovered that medical students were less ready to donate their organs. Concerns about the procurement method and fear of organs being utilised for commercial purposes are two possible causes for this reluctance among medical students. 34 A study conducted in Karnataka found that medical students had much greater knowledge about organ donation than engineering students. Medical students, on the other hand, had a substantially less favourable opinion than engineering students. 35
According to one study, medical students had a generally positive attitude towards organ donation, with a high percentage indicating desire to donate their organs. This shows that there may be impediments to students taking real measures towards organ donation.36 According to a survey conducted among Ankara University students, nursing and medical students had better knowledge and attitudes regarding organ donation than other students studying law, religion, and communication.37
Willingness for organ donation in future
Positive attitudes and understanding about organ donation do not always convert into action. Individual motivations and advantages assessments also influence organ donation decisions. A study of young persons' intentions to become organ donors discovered that empathy and perceived advantages to others were connected to readiness to donate. Furthermore, sentiments of self-benefit, such as pride or satisfaction, were found to predict readiness to donate. These findings imply that organ donation decisions can be influenced by both altruistic considerations for others and self-interest. 38
Various problems and concerns can influence the decision-making process for organ donation. According to research, problems include mistrust in the organ donation process, fear of being held responsible for any error, and the influence on one's health. 39 Donor motivations are also influenced by cultural viewpoints and ideas of the body and death. In Bangladesh, for example, strong familial relationships and kinship relations may induce relatives to donate organs to a patient. 40
Strength and weakness of the study:
This was the first study of its kind to describe the various facets of organ donation among students from a variety of specialties, resulting in a wide demographic coverage. Furthermore, the 95% response rate demonstrates a high level of participation on the side of the participants in their readiness to provide information.
The study's limitations may include over-generalization of the results because they were based on self-reported data, which may be vulnerable to biases such as misunderstanding of the survey questions. The study's observational design, which may include methodological issues such as the Hawthorne effect and observer-expectancy bias, may also contribute to the study's limitations.