A total of 495 individuals were approached for participation in our survey, 55 (11.1%) declined to participate in the study. Table provides details of the socio-demographic characteristics of our non-respondent population.
Socio-demographic characteristics of Non-respondents
Of the 440 individuals who gave consent to participate in the survey, 408 completed the full interview. The sociodemographic characteristics of our study population (n = 408) are described in table . Most of the participants were Muslims (97%).
Socio Demographic characteristics of Study Population
Participants who hadn't heard of the term "Organ Donation" were not asked to answer other questions of the Organ Donation section. They were included among respondents who were not adequately knowledgeable about organ donation.
Two hundred and forty five people (60%) in this survey achieved an adequate knowledge score for Organ Donation while 163 (40%) had inadequate knowledge. These cumulative scores were based on a set of questions for each organ donation; people achieving ≥ 50% score were regarded as being adequately knowledgeable while those achieving less than 50% scores were regarded as being inadequately knowledgeable. Education and socioeconomic status (SES) were both found to have a significant association with knowledge scores of organ donation (Education: p value: .000, SES: p value: 0.038). Table shows the proportion of respondents with adequate and inadequate knowledge in relation to different socio-demographic variables.
Knowledge Score of Organ Donation By Socio-demographic Variables
Eighty one (50.1%) people knew that organs for donation can come from cadavers while 36.5% knew that organs for donation can come from living persons. However, only 23% of the people knew that organs for donation can come from both living persons as well as cadavers. Our study showed that 66.2% people knew that kidneys can be donated, followed by 51.5% who knew that blood can be donated and 46.4% who knew eyes can be donated. Only 26.2% of the people knew that kidneys, blood, heart, eyes, liver, skin, bone marrow and lungs can all be donated.
In response to the query, "who would you like to donate your organs to?", people reported that they would donate their organs to a family member (51.1%), non-smoker (46.8%), non-drinker (55%), younger age person (less than 30 years old, 40.2%), person belonging to their own religion (32.1%) and a person who is mentally sound (43.9%) and without any physical disabilities (36.8%). With regards to knowledge regarding the various risks associated with organ donation, 55.8% people were aware that organ donation is associated with some risk for the donor. However, 28.7% said that organ donation involves no risks. Among the risks, bodily weakness (34.1%) and infection (22.3%) were the two leading causes chosen by the respondents to be associated with organ donation as shown in figure . About 25% knew that organ donation could be associated with all of bodily weakness, infection, bleeding, pain, anxiety and depression.
The attitudes among our study population towards various aspects of organ donation are illustrated in table . With regards to allowance of organ donation in religion, there was an almost tri-modal response distribution with about one third responded "yes", about one third "no" and almost one third "don't know". In response to a separate question directed towards identifying the most important factors that people were going to consider before donating an organ to anyone, the two most important factors that emerged were (1)- religion of the recipient: 94 (29.6%) and (2)- the assurance that their organs would be treated respectfully: 87 (27.4%). One hundred and eighty (56.8%) people opined that organ donation should be promoted. Of the 97 people who felt that organ donation should not be promoted, religious beliefs were cited as the leading cause (45.4%).
Attitude variables regarding Organ Donation
For knowledge status of respondents, the following variables were subjected to the multiple regression analysis: 'education', and 'socioeconomic status'. Table shows that higher education level and higher socioeconomic status emerged as significant independent predictors of knowledge status of respondents.
Multiple logistic regression analysis showing independent predictors of knowledge score of organ donation
For the motivation status of respondents, the following variables were subjected to multiple logistic regression: 'socioeconomic status', 'knowledge score of organ donation' and 'perceived allowance of organ donation in religion'. Table shows that higher socioeconomic status, adequate knowledge scores and perceived allowance of organ donation in religion emerged as significant independent predictors of knowledge status of respondents.
Multiple logistic regression analysis showing independent predictors of motivation to donate
The responses of the respondents with regards to the reasons underlying organ donation are illustrated in figure . Almost 60% believed that the basic aim of organ donation is to save someone's life. Some people responded that organ donation can be done out of compassion/sympathy while others cited monetary benefits as the leading motivation behind organ donation. Still some others though that organs are donated as a responsibility.
With regards to the role of the doctor in the process of organ donation process, about 54% of the respondents felt that the doctor should adequately educate the donor as well as the recipients of the risks involved in organ transplantation and then let them make the decision themselves.
With regards to motivation to donate, 120 (37.7%) people said that they would never like to donate any organ while 198 (62.3%) people were motivated to donate. Of the 198 people who were willing to donate, 70 (35.3%) were highly motivated, 36 (18.2%) were moderately motivated and 92 (46.5%) were weakly motivated to donate. Religion, gender, age and marital status didn't have a significant association with the motivation to donate. However, SES was found to have a statistically significant association with the motivation to donate (p = 0.004). Similarly, knowledge scores for organ donation were significantly associated with the motivation to donate an organ (p = 0.002). In addition, the perception about the allowance of organ donation in religion was also significantly associated with the motivation to donate (p = 0.000).
With regards to consent, 76% respondents thought that the donor should be the one who can give consent for a living donation. Thirteen percent respondents thought that the family should give this consent while 5% opined that spouse should give this consent. Three percent of the respondents each thought that friends and doctor should be the one giving the consent.
For donation after death, 52.8% of the people thought that family should have the right to make decision for organ donation while 26.1% people believe that no one has the right to make this decision; only 6% felt that the doctor should be the one deciding this. In the case of unclaimed bodies, a majority (35.2%) felt that the charitable organizations should have the right to decide on this issue while 22.3% felt that no one has the right to make such decisions. Unclaimed bodies were not taken to mean bodies in morgues or bodies found dead on the street (which are not candidates for harvesting organs); rather they were "the case of a dead body lying in a hospital or prison and not claimed by any of the near relatives of the deceased person within forty eight hours from the time of death of the concerned person" [21
Sixty one percent of the respondents felt that parents or guardians can make decisions on the behalf of mentally retarded persons regarding organ donation. With regards to practices of organ donation, 31% of the people interviewed knew someone who had donated a solid organ; the majority being either family members or friends. In our survey, out of 408 people, 3.5% had themselves donated an organ with only one person having donated a kidney and the remaining ten reported donating blood on one or more occasions. If we simply consider the kidney donation (solid organ donation), the percentage of people who have donated a solid organ falls even further to 0.3%. Television was the leading source of information for most people regarding organ donation as shown in Table . Only a minority of the respondents reported doctors as being their source of information.
Sources of Information (Based on multiple choice questions)