La población gitana tiene miedos sobre la donación de órganos propios para trasplante / The Roma population's fear of donating their own organs for transplantation

Introducción: La tasa de negativas a la donación entre el pueblo gitano es muy superior a la de cualquier otro grupo social. Objetivo: Analizar la actitud hacia la donación de los órganos propios entre la población gitana residente en España. Métodos: Tipo de estudio: estudio sociológico observacional nacional español estratificado por género y edad. Población a estudio: población gitana con edad≥15 años residente en España. Tamaño muestral: 1.253 encuestados. Instrumento de valoración: cuestionario validado de actitud hacia la donación de órganos para trasplante PCID-DTO Ríos. Trabajo de campo: selección aleatoria en función de la estratificación. Cumplimentación anónima y autoadministrada. Fue precisa la colaboración de personas de etnia gitana. Estadística: test de t de Student, χ2, Fisher y un análisis de regresión logística. Resultados: El grado de cumplimentación fue del 18,2% (n=228). De los que han cumplimentado el cuestionario, están a favor de la donación el 42,1% (n=96), indeciso el 30,3% (n=69) y en contra el 27,6% restante (n=63). De los 1.025 (81,8%) que rechazaron cumplimentar el cuestionario, 1.004 (98%) indicaron que era por miedo a hablar y rellenar un cuestionario que plantee el tema de la muerte y la donación de órganos tras fallecer. Si se considera que los que no han cumplimentado el cuestionario por miedo a la muerte y la donación de órganos tras fallecer no están a favor, los resultados serían los siguientes: el 7,8% (n=96) a favor de donar sus órganos frente al 92,2% (n=1.136) no a favor (en contra o indecisos). Conclusiones: La población gitana presenta un rechazo mayoritario a plantear el tema de la muerte y la donación de órganos tras fallecer. Estos hallazgos muestran que las campañas actuales para promover la donación de órganos no son efectivas en este grupo de población. (AU)

Introduction: The refusal rate for donating organs among the Roma people is much higher than that of any other social group. Objective: To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain. Methods: Type of study: Spanish national observational sociological study stratified by gender and age. Study population: Roma population aged≥15 years living in Spain. Sample size: 1253 respondents. Assessment instrument: validated questionnaire on attitude towards organ donation for transplantation PCID-DTO Ríos. Field work: random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required. Statistics: Student's t test, χ2, Fisher's exact test and a logistic regression analysis. Results: The degree of completion was 18.2% (n=228). Of those who completed the questionnaire, 42.1% (n=96) were in favor of donation, 30.3% (n=69) were undecided and the remaining 27.6% (n=63) were against it. Of the 1025 (81.8%) who declined to complete the questionnaire, 1004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n=96) in favor of donating their organs compared to 92.2% (n=1136) not in favor (against or undecided). Conclusions: A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group. (AU)

The Roma population's fear of donating their own organs for transplantation.

BACKGROUND: The refusal rate for donating organs among the Roma people is much higher than that of any other social group. OBJECTIVE: To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain. METHOD: . TYPE OF STUDY: Spanish national observational sociological study stratified by gender and age. STUDY POPULATION: Roma population aged ≥15 years living in Spain. SAMPLE SIZE: 1,253 respondents. Assessment instrument: Validated questionnaire on attitude towards organ donation for transplantation "PCID - DTO Ríos". Field work: Random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required. STATISTICS: Student's t test, χ2, Fisher's exact test and a logistic regression analysis. RESULTS: The degree of completion was 18.2% (n = 228). Of those who completed the questionnaire, 42.1% (n = 96) were in favor of donation, 30.3% (n = 69) were undecided and the remaining 27.6% (n = 63) were against it. Of the 1,025 (81.8%) who declined to complete the questionnaire, 1,004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n = 96) in favor of donating their organs compared to 92.2% (n = 1166) not in favor (against or undecided). CONCLUSIONS: A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group.

Attitude Toward Organ Donation Among Cuban Residents in Florida.

BACKGROUND: The Cuban population residing in the state of Florida in the United States forms the largest population group of immigrants in that state. It has been described as a population with little awareness of organ donation. The objective is to analyze the factors that Cubans residing in the Florida refer to when expressing an unfavorable attitude toward organ donation and to determine the psychosocial factors associated with the attitude toward organ donation of this population group. METHODS: We performed a cross-sectional observational study. From the Proyecto Colaborativo Internacional Donante (International Donor Collaborative Project), a sample stratified by age and sex of Cubans residing in Florida (N = 1224) is obtained. The sample is analyzed using the validated questionnaire (PCID-DTO-RIOS). The reasons against organ donation were analyzed using a specific multiresponse item, with an open response option. For the analysis of the psychosocial variables, a logistic regression analysis is carried out. RESULTS: A total of 38.2% (n = 468) of the individuals under study declared themselves against organ donation. Of those who were against, the reasons stated were (1) leave the dead in peace (n = 440; 57.6%); (2) religious reasons (n = 192; 25.1%); (3) fear of mutilation (n = 160; 20.9%); (4) assertive refusal (n = 128; 16.8%); (5) apparent death (n = 16; 2.1%); and (6) other reasons (n = 764; 62.4%). CONCLUSIONS: The Cuban population residing in Florida who is against organ donation expresses various reasons. In addition, there are factors associated with the psychosocial profile toward organ donation of this important population group.

African Immigrants Living in Spain: Awareness Toward Organ Donation and the Need for Specific Awareness Campaigns.

OBJECTIVES: The African population is an important, growing population group in Spain. Our objective was to determine attitudes toward organ donation among the African population living in Spain and to determine factors influencing attitudes. MATERIALS AND METHODS: A population sample was taken of Africans residing in Spain, stratified by age and sex (n = 4145). Attitude was assessed using a validated questionnaire, which was self-administered and completed anonymously. Descriptive statistics, the chi-squared test, ttest, and logistic regression analysis were used for data analyses. RESULTS: The questionnaire completion rate was 87% (n = 3618). Attitudes toward donation of one's own organs was favorable in 31% of respondents (n = 1112). Among the remaining respondents, attitude was unfavorable in 40% (n = 1458) and undecided in 29% (n = 1037). Multivariate analysis showed the following variables as being associated with attitude: (1) age (P < .001), (2) having descendents (P < .001), (3) education level (P < .001), (4) belief of respondent that he or she may need a transplant in the future (P = .001), (5) knowledge ofthe concept of brain death (P < .001), (6) attitude toward donation of a family member's organ (P < .001), (7) having spoken with one's family about donation and transplant (P < .001), (8) opinion of one's partner toward organ donation (P < .001), (9) respondent's religion (P < .001), (10) knowledge of the view of one's religion toward organ donation and transplant (P < .001), and (10) fear of possible mutilation of the body after donation (P < .001). CONCLUSIONS: Attitudes toward donation of an individual's organs after death were negative among Africans living in Spain and may be related to psychosocial factors. This group should have priority for receiving organ donation awareness campaigns in Spain.

International Population Study in Spain, Cuba, and the United States of Attitudes Toward Organ Donation Among the Cuban Population.

Cuban immigrants constitute an important group in both the United States and Spain, with different behaviors toward organ donation having been described among the different Latin American nationalities. We analyzed the attitude toward organ donation among the Cuban populations in Cuba, Spain, and Florida. The study population was Cuban immigrants over 15 years of age residing in Cuba, Spain, and Florida, with samples randomly stratified by age and sex. A validated questionnaire on psychosocial aspects of organ donation (PCID-DTO Rios) was used. Census was used as the sampling base in all 3 countries; however, additionally, in Spain and the United States (Florida), we sought the support of immigration support associations to determine the Cuban population without legal documentation. The questionnaire was completed anonymously and self-administered. The completion rate of the study was 74% (4123/5574) among 424 surveyed in Spain, 1224 in Florida, and 2475 in Cuba. The attitude in favor of donating their own organs upon death was 60.6% of those surveyed in Spain, 37.6% in Florida, and 68.9% in Cuba, or 58% of the global sample. Multivariate analysis showed that country of residence was an independent factor associated with attitude toward organ donation (odds ratio, 1.929). Other factors associated with attitude were sex, educational level, performance of prosocial activities, knowledge of the brain death concept, religion, the couple's opinion toward donation, fear of mutilation after donation, and attitude toward manipulation of the body after death. The attitude toward organ donation among Cubans in their country of origin and immigrants in Spain was similar, being significantly different from those who emigrate to Florida, where the attitude is much less favorable.

Usefulness of an organ donation opinion survey as a tool to promote organ donation among the adolescent population.

Opinion surveys on health issues are considered health promotion tools. However, no studies have confirmed this in deceased organ donation for transplantation. This study aimed to analyse the impact of completing an opinion questionnaire about deceased organ donation on the attitude towards organ donation among the adolescent population. This longitudinal study with repeated measurements of attitude towards deceased organ donation was conducted with an adolescent population. The measurement instrument was a validated questionnaire of the attitude towards organ donation (PCID-DTO-Ríos). The study process involved the application of the questionnaire at an initial time, 1 month later, and 6 months later. A total of 1374 adolescents participated in this study. The favourable attitude towards donation was 43.1%, which fell to 41.4% at 1 month (P = 0.145), and to 39.7% at 6 months (P = 0.019). Changes in the attitude were observed in all groups, both 1 and 6 months after the questionnaire was completed. There was no objective relationship between the adolescent's socio-family environment and the effect of completing the questionnaire on their attitude towards deceased organ donation. In conclusion, the opinion questionnaire was not useful for promoting organ donation and did not have a positive effect on adolescents' attitudes towards organ donation in the medium or long term.

Differences in Attitude Toward Organ Donation in the Three Main Cities of Cuba.

BACKGROUND: Cuba is one of the Latin American countries with the highest rates of organ donation. Social and cultural differences among the population throughout the country may also affect attitudes toward donation. Knowledge of these characteristics would facilitate awareness of the population most reluctant to donate and transplant. OBJECTIVE: We sought to analyze the differences in attitudes toward organ donation among Cubans living in the main capitals of Cuba. MATERIALS AND METHODS: Study population. The study group was the Cuban population living in the cities of Cienfuegos (n=636), Havana (n=920), and Santiago de Cuba (n=455), extracted from the database of the International Collaborative Donor Project. Sample of the population. Participants were older than 15 years, and data were stratified by geographic area, age, and sex. Assessment instrument. We used a validated questionnaire of attitude toward organ donation for transplant (PCID-DTO-Ríos), anonymously filled in and self-administered. STATISTICS: Student t test was applied together with the χ2 test, complemented by an analysis of the remainders. RESULTS: The favorable attitude among inhabitants in Cienfuegos was 71.2% (n=453), 68.3% (n=628) among those in Havana, and 69.5% (n=316) among those in Santiago de Cuba (P < .05). The psycho-social profile of respondents favoring organ donation was similar in the 3 cities. CONCLUSIONS: The attitude toward organ donation among the population of the main cities of Cuba was favorable and similar in all of them. The psycho-social profile toward organ donation was similar in the 3 cities.

Multicentric Study to Evaluate Mexican Medical Students' Knowledge of Transplants and Organ Donation.

INTRODUCTION: Transplants and organ donation are greatly aided by future medical professionals having adequate knowledge of this topic. This study aimed to elucidate the level of Mexican medical students' knowledge in the field of transplants and organ donation. MATERIALS AND METHODS: The evaluation instrument was designed and validated. The design used simple sampling with replacement, selecting a random sample of 5 universities from among the institutional members of the Mexican Association of Departments and Schools of Medicine (Asociación Mexicana de Facultades y Escuelas de Medicina [AMFEM]). The sample was composed of 3214 medical students. Measures of central tendency were determined, and the mean scores obtained across the different universities were compared using a Kruskal-Wallis test. The odds ratio was calculated for the students whose school or department included instruction on transplants and donation within their curriculum. Kendall correlation was used for the students' academic grade level and score. All analyses considered a threshold of P < .05. RESULTS: A questionnaire was administered to a sample of 2563 students to evaluate their knowledge of transplants and organ donation. The average score was 4.02 on a scale of 0 to 10 (standard deviation 0.03), with a 95% confidence interval (3.96-4.08). Students whose school or department taught the subject of transplants and donations within their curriculum obtained an odds ratio of 1.44 (P = .0000822). CONCLUSIONS: The findings of this study suggest that medical students in Mexico do not have sufficient knowledge of transplants and organ donation.

Impact of Catholicism on the Attitude Toward the Donation of Organs Among African Residents in Spain.

INTRODUCTION: The African population is one of the largest immigrant groups in Europe. Religious beliefs are deeply rooted in most African societies and condition their attitude toward organ donation. OBJECTIVE: We sought to analyze the influence of Catholicism in the attitude toward organ donation among Africans residing in Spain. MATERIALS AND METHODS: Study participants were born in Africa and were residents in Spain. Data were obtained from the database of the International Donor Collaborative Project, which includes a sample of the population for 15 years, stratified by those who were born in Africa, as well as age and sex. The instrument used was a validated attitude questionnaire toward living kidney donation (PCID-DTO-Ríos). RESULTS: Of the population under study, 13% are Catholics (n = 475) and 80% (n = 2896) are Muslims. The favorable attitude toward the donation of cadaver organs is 53.7% (n = 255) among Catholics compared with 25.6% (n = 742) among Muslims (P < .001). On the contrary, 17.7% of Catholics have an unfavorable opinion (n = 84), while 45.5% (n = 1280) of Muslims have an unfavorable opinion; 28.6% of Catholics and 29.2% of Muslims are undecided. In addition, among Catholics who believe that their doctrine accepts organ donation and transplantation, 70.6% (n = 132) are in favor of donating a corpse compared to those who believe that Catholic doctrine is against (P < .001 ), with only 35% (n = 7) in favor of the donation. CONCLUSIONS: Africans who have converted to Catholicism have a more favorable attitude toward donating their own organs than those who continue in Islam.

Analysis of the Socio-Personal Profile of Latin Americans Living in Spain and the United States: Does It Justify the Differences in Attitude Toward Organ Donation?

INTRODUCTION: There are differences in the attitude toward organ donation between Latin Americans living in Spain and those living in the United States. OBJECTIVE: We sought to analyze the socio-personal factors that can condition the difference in attitude toward donation between Latin Americans living in the United States and those living in Spain. MATERIALS AND METHODS: Participants in the study were Latin Americans living in Spain (group A; n=1237) and the United States (Florida) (group B; n=1450), extracted from the database of the International Collaborative Donor Project (PCID). Inclusion criteria were a sample population stratified by area, country of birth, age, and sex. The instrument used was a validated attitude questionnaire toward living kidney donation (PCID-DTO-Rios.) Participants were randomly selected to be surveyed according to stratification. RESULTS: The attitude in favor of Latin Americans residing in Spain (group A) was 60% (n=745) vs 33% (n=485) of residents in the United States (group B) (P < .001). The socio-personal profile of the Latin Americans in Spain compared with those in the United States indicates that they are mainly women (63.5% vs 43.7%, respectively), younger (31.78 vs 37.31 years, respectively), have more secondary education (21.2% vs 16.3%, respectively) and university studies (11% vs 6%, respectively), are of South American origin vs those who are Mexican and Central American, respectively, and there is a higher percentage of atheists/agnostics (8.1% vs 3.7%). However, the personal profile toward donation is similar in both groups, both for and against organ donation. CONCLUSIONS: The personal social profile of the Latin American resident in Spain is different from that of the resident in the United States. However, the psycho-social profile for and against organ donation is similar in both countries.

Knowledge of the Brain Death Concept Among the Puerto Rican Population Residing in Florida.

INTRODUCTION: Puerto Rican and Cuban populations constitute the largest immigrant groups in Florida. This leads to an increase in their involvement in the organ donation and transplantation process (ODT); however, there is very little understanding about their attitude toward and knowledge of related key aspects such as brain death (BD). OBJECTIVE: Analyze knowledge of the BD concept among the Puerto Rican population residing in Florida. MATERIAL AND METHODS: The population under study is born in Puerto Rico and residing in Florida. Inclusion criteria was the population over 15 years stratified by age and sex. The assessment instrument was a validated questionnaire of attitude toward donation and organ transplantation "PCID-DTO-Ríos." A random selection of people was surveyed according to stratification. Support from immigration assistance associations in Florida was needed to locate potential respondents. Survey completion was anonymous and self-administered. RESULTS: Of the 259 respondents, 35% (n = 90) know the BD concept and consider it the death of an individual, 44% (n = 113) do not know it, and 21% (n = 56) do not consider them death. Variables significantly related to the correct knowledge of BD are as follows: sex (P = .012); marital status (P = .043); and couple's opinion (P = .001) and religion (P < .001). In the multivariate analysis, the variables that persist as significant are being married (odds ratio [OR] = 5.231; P = .002); to know the organ donation and transplantation couple attitude as favorable (OR = 4.819; P = .001) and not being Catholic (OR = 4.090; P < .001). CONCLUSIONS: Only one third of the Puerto Rican population residing in Florida knows the concept of BD and accepts it as the death of a person.

Nicaraguan Population Residing in Florida Attitude Toward Different Types of Organ Donation.

INTRODUCTION: The population of Nicaraguan immigrants is growing in North America; however, they have been little analyzed concerning their attitude toward donation and organ transplantation. OBJECTIVE: To analyze the attitude toward the different types of organ donation among the Nicaraguan population residing in Florida. METHODS: Study population. Nicaraguan population residing in Florida (USA). INCLUSION CRITERIA: Population sample over 15 years stratified by age and sex. Instrument valuation. Attitude questionnaires toward organ donation for transplantation "PCID-DTO-Ríos," "PCID-DVR-Ríos," and "PCID-XenoTx-Ríos." Setting for the study. Random selection of people to be surveyed according to stratification. The assistance of immigrant support associations in Florida was required to locate respondents. RESULTS: Sample composed of 89 participants. In the attitude toward donation of one's own organs after death, 22% (n = 20) were in favor, 41% (n = 36) were against, and 37% (n = 33) were undecided. Regarding the donation of living related organs, 76% were in favor (n = 68), 10% were against (n = 9), and 14% were undecided (n = 12). Finally, regarding attitudes toward the acceptance of organ xenotransplantation, if the results were similar to those obtained with human organs, they were not in favor, with 72% (n = 64) against and 28% (n = 25) doubtful. CONCLUSIONS: The attitude of the Nicaraguan population residing in Florida toward different types of organ donation is unfavorable.