Demographic and Socioeconomic Variables Associated With Health Care-Seeking Behavior Among Foreign Workers in Malaysia.

Foreign workers in Malaysia face various barriers in accessing health care, which results in many of them being unable to obtain appropriate medical treatment in case of sickness. This study investigates the foreign workers' health care-seeking behavior and the demographic and socioeconomic variables that influence it. Data were collected from 502 foreign workers using a self-administered questionnaire. Multiple logistic regression was used to estimate the influence of demographic and socioeconomic variables on health care-seeking behavior among foreign workers. In cases of severe sickness, 20.5% of foreign workers stated that they will not go or are unlikely to go to a clinic or hospital. The multiple logistic regression revealed that foreign workers' tendency to avoid medical treatment is associated with gender, marital status, monthly income, preferred language of communication, and work classification. Nonetheless, in cases of mild sickness, demographic and socioeconomic variables do not influence foreign workers' health care-seeking behavior.

Living kidney donation: the importance of public education.

A sample of Malaysians in the Klang Valley indicating their decision on becoming unrelated living kidney donors was surveyed regarding huge amounts of financial incentives to be rewarded to them. From the 1310 respondents, 72.1% said "no" on becoming a living donor. The reason "I don't think humans can live with only one kidney" scored the highest (35.6%), and from the 27.9% of the respondents who are willing to donate their organ with the right financial incentive, most of the respondents picked the reasons "I want to do something noble in life" (50%), and monetary reason scored the lowest (6.2%), indicating that financial incentive is not a major reason guiding individuals' decision on becoming living donors. We suggest that the government should put priority at targeting public education to raise the understanding on the risk, safety and the quality of life of donation and transplantation, and improving the public trust on the donation and the surgical methods to carry out transplantation.

A comparison of donor and control group quality of life.

BACKGROUND: Informed consent of prospective donors should include information about the quality of life (QoL) of existing donors, especially those within the relevant country. This study aimed to provide information on Malaysian organ donors' QoL relative to a control group. MATERIAL/METHODS: Using a shorter version of the SF-36, QoL of 80 donors from the University of Malaya Medical Center (UMMC), Malaysia was surveyed and compared to QoL of 80 selected healthy individuals. ANOVA and General Linear Model (GLM) procedure were each applied for the QoL comparison, which was based on gender and age. RESULTS: Donors recorded a better QoL relative to the control group. Comparison across gender revealed that differences are more obvious for males than females. Donor/control comparison across age groups reveals that donors aged 56 and above reported significantly better QoL in most domains relative to other age groups. CONCLUSIONS: Information on donor QoL should be made available to the public to present a comprehensive picture of the consequences of organ donation. Nonetheless, we also argue that, despite the merits of organ donation, caution is required before concluding that donors have better QoL because the present research outcomes may reflect a self-selection bias in which respondents only included donors engaging in regular follow-ups.

Organ Donation Campaigns: Perspective of Dialysis Patient's Family Members.

BACKGROUND: Solving the dilemma of the organ shortage in Malaysia requires educating Malaysians about organ donation and transplantation. This paper aims at exploring the average Malaysian households ' preferred channels of campaigns and the preferred campaigners in a family setting, targeting at the dialysis family members. METHODS: We analyzed the responses of 350 respondents regarding organ donation campaigns. The respondents are 2 family members of 175 dialysis patients from 3 different institutions. The information on respondents' willingness to donate and preferred method and channel of organ donation campaign were collected through questionnaire. RESULTS: Malaysian families have a good tendency to welcome campaigns in both the public and private (their homes) spheres. We also found that campaigns facilitated by the electronic media (Television and Radio) and executed by experienced doctors are expected to optimize the outcomes of organ donation, in general. Chi-square tests show that there are no significant differences in welcoming campaigns among ethnics. However, ethnics preferences over the campaign methods and campaigners are significantly different (P <0.05). CONCLUSION: Ethnic differences imply that necessary modifications on the campaign channels and campaigners should also be taken under consideration. By identifying the preferred channel and campaigners, this study hopes to shed some light on the ways to overcome the problem of organ shortage in Malaysia.

Strategies targeted at motivating unrelated living kidney donation.

BACKGROUND: This paper aimed to assess the willingness of Malaysians with post-secondary education to be living kidney donors. MATERIAL AND METHODS: From the total of 1,310 living kidney donor respondents in Kuala Lumpur and its suburbs, we focused on 688 respondents with post-secondary education. These 688 respondents were asked whether they were willing to become living kidney donors if the government provides a reasonable amount of financial incentive. Those who were not willing to be donors (490) were then asked the reasons for their unwillingness. Six options were given and respondents can choose more than 1 option. RESULTS: Malaysians with post-secondary education remain unconvinced to be living donors even when provided with monetized incentives. The main reason cited was they are not convinced that individuals can live with just 1 kidney. CONCLUSIONS: There is a need for the government to develop new ways to promote organ donation. These include strengthening government coordination of medical procedures and creating public awareness about the safety of living with 1 kidney. Setting up new institutions such as donor clinics, creating a living donor registry, and having independent donor advocates are also instrumental.

Non-organ donors' attitudes toward incentives.

Malaysians indicating that they did not intend to become organ donors upon their death were surveyed regarding interest in non-fungible financial incentives to be granted to surviving family members. Among the 730 (56% of the total sample of 1311) indicating unwillingness to be donors, 29.6% (216/730) subsequently indicated that they would be willing donors if the government introduced policies that, upon their death, "rewarded your (their) family with incentives for your (their) deeds." Among the 69% (504/730) who insisted that they would not become organ donor even with incentive, nearly 80% (404/501) of them were able to identify relevant incentives they thought should be provided by the state to those who make organ donations upon death. The majority of both groups preferred the state provide medical benefits to a surviving family member, suggesting this may be an attractive policy option for the state to raise the deceased organ donation pool.

Factors that hinder organ donation: religio-cultural or lack of information and trust.

OBJECTIVES: This paper examines factors that influence Malaysian persons with a tertiary level of education on their willingness to donate organs. MATERIALS AND METHODS: A survey was done in the Klang Valley (Kuala Lumpur and its suburbs) at several designated locations. A total of 1420 people were approached, and we focused the sample of 688 respondents with a tertiary level of education. Respondents were given 2 sets of answers: (1) a religio-cultural category and (2) a structural category. They were allowed to choose more than 1 reason. RESULTS: Our findings revealed that only 47.5 percent of respondents declined becoming organ donors. The highest frequency recorded was "I am not convinced that my body part will be used beneficially " (30.1%), followed by "I do not have enough access to information " (29.2%), "I want my body to remain intact after death " (16.9%), and "It is against my religion " (9.9%). CONCLUSIONS: Our study revealed that religio-cultural factors are not a prime explanation for the lack of organ donation in the Malaysian case. This study suggests that better procurement methods used by dedicated agencies, as well as better education, could reduce the shortage between organ supply and demand.