RESUMEN
The German post-mortem organ donation rate has been low, since transplantation scandals attracted media attention in 2012. Therefore, the objective of this article is to address the willingness to document attitudes (e.g., organ donor card) towards organ donation, factors influencing the willingness to document the individual will and knowledge of organ donation among the German public. Data of surveys on attitudes towards organ and tissue donation in Germany conducted between 2010 and 2016 by the Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung) were analysed. Using binary logistic regression, factors influencing the method for documenting the individual will were identified. In the 2016 survey, 35.7% of all respondents had documented their will in the form of an organ donor card or an advance health care directive. Female gender, younger age, higher level of education, discussion of organ donation with next-of-kin/friends, grasping the concept of death and knowledge of organ donation increase the likelihood of possessing an organ donor card. Being male increases the likelihood of documenting the individual will using an electronic health insurance card. Older respondents or respondents with lower level of education lack knowledge about organ donation. Persons with extensive knowledge are more likely to possess an organ donor card and to consent to donate organs of next-of-kin. Further measures to increase knowledge of organ donation among the general public should be discussed. The influence of gender on the willingness to use different methods to document attitudes needs to be evaluated.
Asunto(s)
Donantes de Tejidos , Obtención de Tejidos y Órganos , Actitud , Estudios Transversales , Femenino , Alemania , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
OBJECTIVE: In 2018 Germany had the lowest rate of post-mortem organ donation in the Eurotransplant network. Healthcare trainees and students will be important advisors on organ donation for patients in the future. This study aimed to examine 1) attitudes and knowledge about post-mortem organ donation, 2) how past transplantation scandals have affected those attitudes and 3) how satisfied respondents were with the knowledge provided on the courses. METHODS: A cross-sectional study was conducted between 20 March and 8 July 2019â¯at a university hospital and nursing schools in Berlin and Potsdam, Germany. Study participants were 209 medical students, 106 health sciences students and 67 trainee nurses. RESULTS: Of the respondents 29.3 and 50.8% knew the tasks of the German Organ Transplantation Foundation and Eurotransplant, respectively. All brain death questions were correctly answered by 56.3% of the medical students, 25.7% of the health sciences students and 50.9% of the trainee nurses (Fisher's exact test pâ¯< 0.001, Cramer's Vâ¯= 0.242). Transplantation scandals had damaged attitudes towards organ donation for 20.7% of the medical students, 33.3% of the health sciences students and 13.6% of the trainee nurses (χ2-test pâ¯= 0.001, Cramer's Vâ¯= 0.164). Asked whether post-mortem organ donation was sufficiently addressed in their courses, 39.5% of the medical students, 60.4% of the health sciences students and 51.9% of the trainee nurses said this was not or tended not to be the case (Kruskal-Wallis H-test pâ¯< 0.001, Spearman's rho râ¯= -0.112). CONCLUSION: Given the knowledge gaps identified and the respondents' dissatisfaction with the knowledge they received, organ donation should be better integrated into curricula and training programs.
Asunto(s)
Enfermeras y Enfermeros , Trasplante de Órganos , Estudiantes de Medicina , Obtención de Tejidos y Órganos , Estudios Transversales , Alemania , Conocimientos, Actitudes y Práctica en Salud , Humanos , Encuestas y CuestionariosRESUMEN
BACKGROUND: Health-related quality of life is a multidimensional concept to assess the impact of medical interventions from an individual perspective. This concept is important to evaluate benefits of heart transplantation. This systematic review was conducted to determine (1) posttransplant health-related quality of life in heart transplantation patients and (2) influencing factors of health-related quality of life. METHODS: A systematic review of cross-sectional, prospective and mixed methods studies published from November 2007 to November 2017 was conducted on PsycINFO, PSYNDEX and PubMed using a combination of the keywords heart transplantation, heart transplantation patient, quality of life, and health-related quality of life. RESULTS: A total of 14 studies with a cross-sectional design, 6 studies with a prospective design and 2 mixed-methods studies were identified. The stability of health-related quality of life up to 10 years after transplantation has been reported. Most often generic scales, such as SF-36 (8) and WHOQoL-BREF (7) were used for data collection. Demoralization, depression, pain, gastrointestinal symptoms, sexual dysfunction, and poor oral health influence health-related quality of life negatively, whereas social and family support have a positive impact. CONCLUSION: Although health-related quality of life is positively influenced by transplantation, further research regarding gender differences is needed. Disease-specific scales were rarely used.
Asunto(s)
Trasplante de Corazón , Calidad de Vida , Receptores de Trasplantes , Adulto , Estudios Transversales , Humanos , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
BACKGROUND: German post-mortem organ donation rates have been declining since 2010. Several transplantation scandals led to a negative portrayal of organ donation in the media. Spain, the UK and the Netherlands achieved a rise in organ donation rates while retaining organ donation legislation. METHODS: A systematic review of publications focusing on (1) organ donation legislation, (2) data on post-mortem organ donation rates and (3) measures to increase post-mortem organ donation rates in Europe was conducted in November 2017 in PubMed, PsycINFO and Web of Science. Quality parameters of the World Bank and the World Health Organization (WHO) were studied to analyze national health services, frequent causes of death and life expectancy. RESULTS: Quality parameters of national health services were similar in all countries. The Netherlands and Germany have an opt in system. An increase of 37.4% in post-mortem organ donation rates from 2008 to 2015 in the UK was accomplished through the establishment of a donation task force, adopting parts of the Spanish model, while maintaining an opt in system. Spain has the highest organ donation rate worldwide (39.7 per million persons in 2015). The implementation of transplantation coordinators and the change in legislation in Germany in 2012 has so far shown no effect. Public awareness of organ donation in the Netherlands increased following various information campaigns. CONCLUSION: Donation after cardiac death (DCD), expanded donor criteria, increasing public awareness and introduction of an organ donor register should be discussed as measures to increase organ donation rates in Germany.
Asunto(s)
Obtención de Tejidos y Órganos/legislación & jurisprudencia , Obtención de Tejidos y Órganos/estadística & datos numéricos , Autopsia , Muerte , Alemania , Humanos , Países Bajos , Trasplante de Órganos , España , Reino UnidoRESUMEN
BACKGROUND: The German post-mortem organ donation rate has dropped by one third since 2010. Furthermore, 958 patients died in 2015 in Germany while waiting for an organ. To decrease organ shortage, an amendment of the transplantation law was established in 2012. An information package including an organ donor card is sent to all German citizens via the postal service. A voluntary national transplantation register was introduced in 2016 to improve transparency in the organ donation process. The influence of several transplantation scandals starting in 2012 on organ donation rates is in question. Therefore, the objective of this article is to discuss approval and objections to post-mortem organ donation among the next of kin of potential donors and the general public in Germany. METHODS: Binary logistic regression of data from the 2014 survey by the Federal Centre for Health Education on attitudes towards organ and tissue donation in Germany was conducted, aiming to identify influencing factors on the likelihood of organ donor card possession. Additionally, data of the German Organ Transplantation Foundation on post-mortem organ donations in Germany in 2014 were studied to highlight reasons for approval and objections by next of kin of potential and explanted post-mortem organ donors. Methods of documentation of the deceased's will according to data of the German Organ Transplantation Foundation were analyzed. RESULTS: Male gender and lack of knowledge about organ donation decrease the likelihood of having an organ donor card. Of the respondents in the survey of the Federal Centre for Health Education 71.0% would donate their own organs, whereas only one third possess an organ donor card. Health insurances and physicians are the most important providers of organ donor cards in Germany. An increase in the percentage of organ donor card possession following the amendment of the transplantation law could not be observed by 2016. Fear of organ trade and unjust organ allocation are the main reasons for rejecting organ donation among the general public. Previous transplantation scandals are a primary reason for a negative change in attitudes. Main reasons for objection among the next of kin of potential organ donors are known objections of the deceased and the lack of knowledge about the will of the deceased. In addition, only 58.1% of all explanted organ donors documented their will in written or verbal form. CONCLUSION: Education on organ donation can be a means to increase organ donation rates. The effects of the change in legislation and the establishment of the transplant register need to be evaluated. Further research regarding the influence of religion, especially among religious minorities, on organ donation rates in Germany needs to be conducted to identify possible obstacles. Moreover, the use of social networks to address potential organ donors has proven to increase registration numbers and could easily be implemented in Germany.