|Year : 2019 | Volume
| Issue : 1 | Page : 15-19
Knowledge, attitude, and practice regarding organ donation among adult Population of an Urban field practice area of a medical college in Durgapur, West Bengal, India
Sourabh Paul1, Tapas K Som2, Indranil Saha2, Gautam Ghose2, Arpan Bera2, Akansha Singh2
1 Department of Community Medicine, Adesh Institute of Medical Science and Research, Bathinda, Punjab, India
2 Department of Community Medicine, IQ City Medical College and Narayana Hrudayalaya Hospital, Durgapur, West Bengal, India
|Date of Web Publication||29-Mar-2019|
Dr. Sourabh Paul
Department of Community Medicine, Adesh Institute of Medical Science and Research, Barnala Road, Bathinda - 151 001, Punjab
Source of Support: None, Conflict of Interest: None
Background: Organ donation is either when a person allows healthy transplantable organs/tissues to be removed, after death, or when the donor is alive and transplanted into other persons. Common transplantations include eyes, kidneys, liver, heart, skin, and bone marrow. The present study was conducted to understand the knowledge, attitude, and practice pattern of organ donation among the participants and to find out the association between the knowledge of organ donation with selected variables of interest. Methods: The present study was a cross-sectional study conducted among adult participants of an urban area of Durgapur from October 18, 2016, to November 5, 2016. A predesigned and pretested pro forma was used for data collection. Results: About 73.3% of the participants had heard about organ donation. Majority of the participants were female, aged 31–40 years, illiterate, and with a monthly income less than Rs. 5000/month. Eye was the most common donatable organ identified by the participants. Majority of the participants were unaware about the existing law in India about organ donation. Not a single participant had donated any organ, but 6% of them had signed form for cadaveric donation. Participants those who have educational status above high school had better knowledge compared to those who have lesser educational qualification (P = 0.001). Similarly, participants with monthly family income ≥10,000 also had better knowledge compared to other groups (P = 0.029), and this relation was statistically significant. Conclusion: Awareness about organ donation is not satisfactory, but the community had a positive attitude toward organ donation.
Keywords: Attitude, knowledge, organ donation, willingness to organ donation
|How to cite this article:|
Paul S, Som TK, Saha I, Ghose G, Bera A, Singh A. Knowledge, attitude, and practice regarding organ donation among adult Population of an Urban field practice area of a medical college in Durgapur, West Bengal, India. Indian J Transplant 2019;13:15-9
|How to cite this URL:|
Paul S, Som TK, Saha I, Ghose G, Bera A, Singh A. Knowledge, attitude, and practice regarding organ donation among adult Population of an Urban field practice area of a medical college in Durgapur, West Bengal, India. Indian J Transplant [serial online] 2019 [cited 2019 Sep 17];13:15-9. Available from: http://www.ijtonline.in/text.asp?2019/13/1/15/255175
| Introduction|| |
Organ donating is the noblest work people can do in their life. As we all know, helping others, who are in need, is the best possible work a human can do. Organ donation is either when a person allows healthy transplantable organs/tissues to be removed, after death, or when the donor is alive and transplanted into another person. Common transplantations include eyes, kidneys, liver, heart, skin, and bone marrow. Thousands of lives can be saved globally by organ transplantation, but multiple factors (such as medical, legal, social, cultural, and emotional) make the scenario of transplantation complex and critical.,,, Experts say that organs from one donor can save or help the lives of fifty people.
Globally, 100 World Health Organization member countries have done at least one organ transplantation till December 2011. In 2011, 112,939 solid organs have been transplanted globally, but majority are from economically developed countries. A huge demand and supply gap exists between organ donation and transplantation globally as well as in Asia. Current cadaveric organ donation list toper is Spain with 35/million, whereas India is with 0.08/million.
Human organ donation was legalized in India since 1994 through “The transplantation of Human Organs Act, 1994.≵ Ever after 22 years of passing a law related with organ donation, voluntary organ donation has not picked up in India., According to the National Organ and Tissue Transplant Organization (NOTTO) and Regional Organ and Tissue Transplant Organization, the current demand in the country for kidney transplant is 250,000; liver transplant is 80,000 and heart transplant is 50,000. According to the Horton and Horton's model of factors related to organ donation, the strongest predictors of organ donation willingness are knowledge and attitudes, with personal values playing a much weaker role. Lack of awareness along with rumors, myths, and misconceptions adds to the low percentage of organ donation.
The success of organ donation largely depends on community participation, and there are very few studies highlighting the knowledge, attitude, and practice of semi-urban community toward organ donation. In this background, the present study was conducted with the objective to determine the knowledge, attitude, and practice pattern of a semi-urban community toward organ donation and to assess the association between knowledge of organ donation with selected variables of interest, if any.
| Methods|| |
The present study was a community-based observational cross-sectional study conducted between October 18, 2016, and November 5, 2016, in an urban community of Durgapur, West Bengal, India. This was the urban field practice area of the Department of Community Medicine, IQ City Medical College and Narayana Hrudayalaya Hospital, Durgapur. Individuals aged >18 years residing permanently in the study area for the last 2 years and who gave written informed consent were included in the study. About 84.5% were found to be aware about organ donation from a previous study conducted in a slum area of West Bengal. Considering the prevalence rate (P) of 84.5%, relative error (d) of 5%, and nonresponse rate of 10%, the sample size came out to be 229. Convenience sampling technique was used for selecting the participants. A predesigned, pretested structured interview schedule was used for data collection. The schedule had both open- and close-ended questions. Questions were translated from English into regional language (Bengali) for easy understanding of the participants. Topic was introduced to illiterate persons by showing pictures and photographs of different organs. The schedule was developed after rigorous review of literature and consultations with the experts of the institute. The schedule had four parts: the 1st part contained demographic details of the participants, the 2nd part included knowledge of organ donation, the 3rd part included attitude toward organ donation, and the 4th part included practices related to organ donation. Each knowledge question was given a weighted score and the total knowledge score was calculated. Higher score indicates better knowledge about organ donation. The maximum possible score was 24, and it was divided into three categories as follows: 0–8, poor; 9–16, moderate; and 17–24, good knowledge. All the data were entered into a Microsoft Excel Worksheet (Microsoft, Redwoods, WA, USA) and were analyzed using the Statistical Package for the Social Sciences software (SPSS Inc., Chicago, IL, USA), version 21.0. Descriptive statistics including mean, standard deviation, and proportion were used for analyzing the data. The significance of association between the two attributes was analyzed using Chi-square test. P ≤ 0.05 was considered statistically significant. During the whole period of research, we followed the ethical guidelines mentioned by the Indian Council of Medical Research. Informed written consent was taken from the participants. Confidentiality and anonymity was maintained during the entire study period.
| Results|| |
[Figure 1] shows that among 229 eligible individuals, 206 (89.9%) had given consent for participation and among them 151 (73.3%) had heard about organ donation. Mean age of the participants was 33.7 ± 23 years with a median age of 32 years (range: 18–72 years).
[Table 1] shows that majority of the participants who had heard about organ donation were aged 18–30 years (57%), female (60.3%), Hindu by religion (100.0%), illiterate (35.1%), homemaker (39.7%), had monthly family income < Rs. 5000 (67.5%), and married (88.0%). There was not much difference between respondents and nonrespondents on demographic characteristics.
|Table 1: Demographic characteristics of the participants who have heard about organ donation (n=151)|
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[Table 2] shows that eye (78.1%) was the most common donatable organ according to the participants. About 33.8% of the participants had the knowledge that both live and cadaveric donation is possible. However, 68 (45%) participants were unaware about living organ donation, whereas 54 (35.8%) were unaware about cadaveric donation. Majority (58.9%) of the participants had the knowledge that consent for live organ donation is given by the donor himself/herself, whereas 123 (81.5%) thinks that it is given by spouse or family after death. About 67 (44.4%) participants were unaware about the existing law related with organ donation in India. The most common source for information about organ donation was television (77 [51.0%]) followed by neighbors (65 [43.0%]) and friends (47 [31.1%]). Participants cited that the most common reason for organ donation was to save some one's life (130 [86.1%]) followed by sympathy (36 [23.8%]).
[Table 3] shows that 87 (57.6%) participants who had heard about organ donation want to donate organ in the future and 59 (39.1%) of them want to donate only to their relatives. The highest preference for organ donation among willing participants is kidney 48 (31.8%) followed by eye (29.1%) and liver (12.6%). A total of 130 (86.1%) participants think that organ donation is ethical and 81.0% desire that it should be promoted. A total of 103 (68.2%) participants are not in favor of taking money in exchange of organs. Nearly 50% of them disagreed that mostly poor people donate organ.
Practice of organ donation
None of the participants had ever donated any organ, but nine (6%) participants who had heard about organ donation had signed form for cadaveric donation in the future. Nearly 11.9% of them had seen people donated organ from their locality.
Ninety-eight (64.9%) participants who have heard about organ donation had poor knowledge, 53 (35.1%) of them had moderate knowledge, but nobody had good knowledge about organ donation. Mean knowledge score of the participants was 7.00 ± 3.10 years with range of 0–13. [Table 4] shows that participants who have educational status above high school had better knowledge compared to those who have lesser educational qualification (P = 0.001). Similarly, participants with monthly family income ≥10,000 also had better knowledge compared to other groups (P = 0.029), and this relation was statistically significant. Age, gender, occupation, marital status, and type of family had no significant relation with knowledge score. There was also no signification association between knowledge score and wiliness of organ donation (P = 0.609).
|Table 4: Association between age, sex, educational status, occupation, income, marital status and type of family with knowledge of organ donation (n=151)|
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| Discussion|| |
Organ and tissue donation and transplantation provide a second chance of life for thousands of people and nowadays, it has become an integral part of the advanced health-care system in every nation. Not only are the transplant receivers benefited from the donation, the donor families and relatives also get a satisfaction that it has saved or improved the quality of life of a person. Finally, the society also gets a reward from this humanitarian act.
Response rate of our present study was 90%, which is very encouraging considering such an uncommon but important topic. Our present study found that 73.3% of the willing participants have heard about organ donation, which is similar to other studies conducted in Kolkata (84.5%) and Faisalabad (86%), but slightly lower than a study conducted in Kerala (97%). There was not much difference in demographic characteristics between respondents and nonrespondents. Television was the most common source of information followed by neighbors and that was similar with other studies.,, Nobody was mentioning doctor or health-care providers as a source of information. In our present study, majority of the participants had poor knowledge (64.9%) about organ donation. Similar studies conducted in Kolkata among slum dwellers and in Chennai among college students also had found that knowledge of organ donation was unsatisfactory among 60% and 71.1% of the participants, respectively. In our present study, education (P = 0.001) and monthly family income (P = 0.029) were significantly associated with better knowledge score. Age, gender, employment status, marital status, and type of family do not have significant association with the level of knowledge. Studies conducted by Dasgupta et al. in Kolkata, Khan et al. in Faisalabad, Saleem et al. in Pakistan, and Annadurai et al. in Chennai had also found similar findings. Few studies had also found a significant association between age, sex, and higher level of knowledge on organ donation., According to NOTTO, out of 12 donatable organs, participants were aware about only three and the most common organ mentioned by them was eye. Similar findings were reported by other studies also.,,, Few studies have reported about other organs also which can be donated., In the present study, 33.8% of the participants have replied that organ can be donatable during life as well as after death also, which is much better than some other studies. Our study has shown that in nearly 60% of cases, the donor himself/herself will give his/her consent for living organ donation, which is much higher than other reported studies., However, spouse or family members will give consent for organ donation after death was the response of more than 80% of the participants, which is similar to other studies. The most common reason for organ donation cited by the participants was “to save someone's life≵ followed by “sympathy.≵ Similar findings were reported by other studies conducted in Pakistan and Faisalabad. Nearly one-third of the participants were aware about the existing law on organ donation in India, which is very less compared to another study conducted in Kolkata in a similar population.
In spite of poor (64.9%) or moderate (35.1%) knowledge about organ donation, nearly 60% of the participants are willing to donate organ in the future, but nobody has donated any organ till date. It is comparable with other studies conducted in Ahmedabad and Chennai among college students. Interestingly, it was much higher than a study conducted among slum dwellers in Kolkata and Faisalabad. The present study could not find any significant association between knowledge and willingness for organ donation. Interestingly, 6% of the participants had already signed form or card for cadaveric donation in the future and 12% had seen people donated organ in their community. It shows that organ donation is not an unknown phenomenon of this locality. Majority of the participants consider that organ donation is ethical and it should be promoted. Findings are much better than a study conducted in Pakistan, but similar to a study conducted in Faisalabad. Nearly one-third of the participants had the view that mostly poor people donate organ and one-tenth of the participants had the opinion that money should be taken in exchange of organ donation. This finding is much lower than a similar study conducted in Kolkata.
| Conclusion|| |
Awareness about organ donation was not satisfactory, but the community had a positive attitude toward organ donation. Lack of knowledge probably has limited them from becoming a successful donor. Low level of education and socioeconomic status are major determining factors for low level of knowledge. Media is the most common source of information which is easily accessible, widely acceptable and followed. Mass awareness campaigns should be undertaken to promote organ donation at multisectoral level because organ donation can give a new lease of life and bring back smile to faces of many. Further multicentric studies are required for understanding the topic and motivating people for organ donation in the future.
Limitations and achievements
In the present study, we used convenience sampling and all the participants were Hindu by religion. However, the present study has improved the knowledge and understanding of many people about organ donation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Edwards TM, Essman C, Thornton JD. Assessing racial and ethnic differences in medical student knowledge, attitudes and behaviors regarding organ donation. J Natl Med Assoc 2007;99:131-7.
Ghods AJ. Ethical issues and living unrelated donor kidney transplantation. Iran J Kidney Dis 2009;3:183-91.
Edwards AG, Newman A, Morgan JD. Exposure to the field of renal transplantation during undergraduate medical education in the UK. BMC Med Educ 2005;5:32.
Edwards AG, Weale AR, Morgan JD. A survey of medical students to assess their exposure to and knowledge of renal transplantation. BMC Med Educ 2004;4:32.
White SL, Hirth R, Mahíllo B, Domínguez-Gil B, Delmonico FL, Noel L, et al.
The global diffusion of organ transplantation: Trends, drivers and policy implications. Bull World Health Organ 2014;92:826-35.
Shroff S. Legal and ethical aspects of organ donation and transplantation. Indian J Urol 2009;25:348-55.
] [Full text]
Horton RL, Horton PJ. A model of willingness to become a potential organ donor. Soc Sci Med 1991;33:1037-51.
Gortmaker SL, Beasley CL, Sheehy E, Lucas BA, Brigham LE, Grenvik A, et al.
Improving the request process to increase family consent for organ donation. J Transpl Coord 1998;8:210-7.
Dasgupta A, Shahbabu B, Sarkar K, Sarkar I, Das S, Das MK. Perception of organ donation among adults: A community based study in a urban community of West Bengal. Sch J Appl Med Sci 2014;2:2016-21.
Khan N, Mashood Z, Tufail N, Shoukat H, Asraf K, Ehsan S, et al
. Knowledge and attitude of people towards organ donation. JUMDC 2011;2:15-21.
Manojan KK, Raja RA, Nelson V, Beevi N, Jose R. Knowledge and attitude towards organ donation in rural Kerala. Acad Med J India 2014;2:25-7.
Saleem T, Ishaque S, Habib N, Hussain SS, Jawed A, Khan AA, et al.
Knowledge, attitudes and practices survey on organ donation among a selected adult population of Pakistan. BMC Med Ethics 2009;10:5.
Shah R, Patel A, Ramanuj V, Solanki N. Knowledge and attitudes about organ donation among commerce college students. Natl J Community Med 2015;6:533-5.
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.
[Table 1], [Table 2], [Table 3], [Table 4]