Role of Empathy and Altruism in Organ Donation Decisionmaking Among Nursing and Paramedic Students.

BACKGROUND: Organ transplantation offers patients with organ failure an improved quality of life and a life-saving opportunity. Despite universal acceptance of posthumous organ donation, only a minority of candidates become actual donors. Empathy and altruism as a moral issues can influence organ donation decisionmaking The aim of this study was to assess the role of empathy and altruism in the organ donation decisionmaking process in a group of nursing and paramedic students. METHODS: Our study was conducted with 111 nursing and paramedic students (aged 19-59 years, 84 females and 27 males). Self-administered questionnaires were then used to collect data, including the Individual Questionnaire: Study of Attitudes Toward Transplantation; Davis's Interpersonal Reactivity Index (Empathy); and Questionnaire A-N by J. Sliwak (Altruism). RESULTS: Overall, 99% of respondents accepted the idea of organ donation during life and 98% posthumously. Eighty-one percent opted for donating their organ during life and 88% posthumously. The levels of empathy on the subscales Fantasy, Perspective Taking, Personal Distress, and Empathic Concern were significantly associated with agreement to be a donor, willingness to sign a donor card, and attitude toward organ donation. Altruism was associated with posthumous organ donation and the willingness to sign a donor card. Perspective Taking was a statistically significant predictor of attitude toward organ donation. CONCLUSION: Both empathy and altruism could influence decisionmaking about organ donation in a group of nursing and paramedic students.

Relationship Between Satisfaction With Social Support and Self-Efficacy and the Occurrence of Depressive Symptoms and Stress in Heart Transplant Recipients.

Heart transplantation is a recognized and effective therapeutic method for treating end-stage circulatory failure. Physical factors and psychosocial issues among heart transplant recipients have been addressed in an increasing number of studies. According to the transactional model of stress, social support is one of the resources that facilitate coping with stress. The use of social support is related to a lower severity of depression and stress. The research objective was to assess the relationship between satisfaction with social support and self-efficacy and the occurrence of depressive symptoms and stress in heart transplant recipients. MATERIAL AND METHODOLOGY: The study involved 123 participants, including 30 women and 93 men with mean age of 54.8 years (SD = 13.25). Berlin Social Support Scales, Beck Depression Inventory, and General Self-Efficacy Scale were used in the study. RESULTS: According to the analysis, the degree of depression decreased with increased emotional social support (r = -34; P < .001), instrumental social support (r = -378; P < .01), and perceived support (r=-387; P < .001); the degree of stress decreased with an increase in the application of instrumental support (r= 0.36; P<.001), emotional support (r=-0.31; P<.001), and perceived support (r=0,363; P<.001). The level of self-efficacy had a positive impact on emotional and instrumental support as well as on the perceived and actually received support. A regression analysis proved the level of (instrumental) social support and self-efficacy act as predictors of the incidence of depression (R2 = 0.43; P < .05) and stress (R2 = 0.36; P < .05) among heart transplant recipients. CONCLUSION: The obtained results support the positive impact of social support and self-efficacy on the occurrence of depressive symptoms and stress.

Evaluation of the Motivation to Consent to and to Refuse Organ Donation Among Participants of Educational Meetings Concerning Organ Transplantation.

BACKGROUND: Improvement of the consent rate for solid organ donation from deceased donors is a key component of strategies applied in many countries aiming to increase the availability of organs for transplantation. Attitudes toward living and posthumous donation are favorable. Research shows that the outlook on organ donation and the degree of the willingness to become an organ donor are associated with a wide range of variables. The main objective of this study was to identify factors that influence the willingness to donate organs and the reasons for refusing consent. MATERIALS AND METHODS: The study included 191 participants (135 female and 56 male) aged 16 to 61 years (mean age 26.86 ± 12.88). A cross-sectional study was conducted during educational meetings concerning organ donation that was addressed to students, teachers, and nurses. Survey tools included the Individual Questionnaire: Study of attitudes toward transplantation, consisting of 26 closed questions (with the consent of the Statistical Office in Krakow). RESULTS: In all, 97.4% of the respondents accepted transplantation from living donors, and 95.8% accepted deceased donations. Of the respondents, 78.5% agreed to posthumous life-saving organ donation. There was a significant difference between the respondents' sex, age, social group, place of living, and the reasons for their willingness to donate organs both posthumously and during their lifetime, as well as reasons for refusal. CONCLUSIONS: Our findings showed that the study group in general had favorable views on treatment involving transplantation and declared willingness to make a posthumous organ donation. These views vary depending on demographic variables. The education on the subject of organ and tissue donation has a positive impact on donation and transplantation rates.

Evolution of Organ Transplantation in Poland 1966 to 2014: Dates and Numbers.

BACKGROUND: Several events inspired us to collect data on organ transplantation in Poland (2016: the 50th anniversary of the first transplantation and the 20th anniversary of Polish Transplant Coordinating Center Poltransplant). The paper aims at presenting comprehensive data on all organ transplants, beginning with the first in 1966 (deceased kidney) until the end of 2014. METHODS: Source documents were reports published in Poltransplant Bulletin, a website registry managed by Poltransplant, reports by the Transplantation Council and by the Transplantation Institute of Warsaw. A source data enabled us to establish a preliminary report, presented for verification during the 12th Congress of the Polish Transplantation Society. RESULTS: By the end of 2014, the total number of organ transplants was 26,691. Kidney transplantation is the most common (total number = 19,812). The number of living kidney transplants is low, about 50 per year. The number of liver part transplants from living donors is relatively high, 20 to 30 annually. The program of deceased liver transplantation results in more than 300 transplants yearly. The first heart transplantation was in 1985, but the number of these procedures has been decreasing. No significant increase in the number of lung transplantations was noted. CONCLUSIONS: The number of organ transplantations from deceased donors places Poland in the middle among European countries. The number of living donor kidney transplants is lower than in other countries; therefore a living donor liver transplantation program belongs to leading programs. Progress of lung transplantation has been slow. The development is highlighted by vascularized composite tissue transplantations of the hands and face. The strength of the report lies in its reliability and completeness. Numbers are the unique source of information to be used and referred to in the literature.

Role of Personal Resources in Depression and Stress in Heart Transplant Recipients.

BACKGROUND: Heart transplantation is the primary option for heart failure treatment and increases the survival rate and the quality of life for recipients. However, this surgical intervention induces numerous psychological problems, such as depression and anxiety. Protective factors and personal recourses are a significant force behind healthy adjustment to life stresses. The aim of this study was to assess the role of personal recourses in terms of depression and stress in heart transplant recipients. METHODS: The study involved a sample of 131 post-heart transplant patients. Standardized instruments were used to measure the key constructs: Beck Depression Inventory Short Form for prevalence of depression, Perceived Stress Scale for prevalence distress, and Sense of Coherence (SOC-29), Life Orientation Test, and General Self-Efficacy Scale for measuring personal resources. RESULTS: We found that sense of coherence, optimism, and self-efficacy proved to be significant predictors for the prevalence of both depression and stress. CONCLUSIONS: These result suggest that the assessment of coping strategies and sense of coherence in heart transplant recipients requires exploration. Evaluating coping strategies and sense of coherence before surgery seems significant and begins with developing skills in this domain.

Influence of empathy, beliefs, attitudes, and demographic variables on willingness to donate organs.

BACKGROUND: As organ transplantation has become a more routine medical procedure, there has been a growing interest in studying people's attitudes and knowledge concerning organ donation. Trait empathy and self-interest influence different pro-social behaviors to a great extent; still, their role in the promotion of organ donation registration and willingness to donate organs remains unclear. However, people with higher levels of empathy report more altruistic beliefs. We assessed the influence of empathy, beliefs, and demographic variables on willingness to donate organs. METHODS: We included 191 subjects (135 female, 56 male) aged 16-61 years (mean, 26.86 ± 12.88), who participated in educational meetings concerning organ donation. The group was composed of students, teachers, and nurses. Survey tools included the Individual Questionnaire: Study of Attitudes Towards Transplantation, consisting of 26 closed-ended questions (with the consent of the Krakow Statistical Office) and the Empathy Scale by Mehrabian and Epstein. RESULTS: Of the respondents, 97.4% accept transplantation from living donors, 95.8% accept deceased donations, and 78.5% agree with posthumous life-saving organ donation. The majority of respondents (73%) achieved an average level of empathy, and 20.4% of respondents exhibited considerably higher empathy levels. There was a significant difference between the respondents' sex and their agreement to make a life-saving organ donation. Differences were found among the groups, the attitudes and willingness to donate organs, and between the level of empathy and agreement/consent for organ donation. CONCLUSIONS: Our findings show that the group in general has favorable beliefs about transplantation and declares a willingness to make a posthumous organ donation. These beliefs vary based on demographic variables. Education about organ and tissue donation a has a positive impact on donation and transplantation rates.

Post-transplantation body mass index in heart transplant recipients: determinants and consequences.

BACKGROUND: Heart transplantation (HTx) is an important treatment for end-stage chronic heart failure. After HTx, recipients frequently become obese. Gaining weight measured by body mass index (BMI) has been reported as a common phenomenon for patients before and after solid organ transplantation, becoming specifically significant for the long-term follow up after organ transplantation. In the long term following HTx, overweight and obesity may lead to increased risk of cardiovascular complications, developing metabolic syndrome-a topic well documented in previous studies. AIM: The aims of this study were to calculate the BMI in patients after HTx with follow up in our center and to assess potential predictors for overweight and obesity as well as their consequences. METHODS: A complete assessment of the BMI among all available heart transplant (HT) recipients (n = 169) was performed. Data were retrieved from patients' charts. Data were statistically analyzed. RESULTS: The sample mean age was 55.12 ± 13.34 years, mean years since transplantation being 10.70 ± 5.26 years and the majority of study subjects were males (76.33%). Overall BMI was mean 26.33 ± 3.79. Based on the World Health Organization (WHO) classification, 32.54% were normal, 46.74% were overweight, and 18.34% were obese. We did not observe a statistical difference between BMI before and after transplantation, between immunosuppressive protocol, and receipt of steroids. We observed an association between BMI and level of fasting glucose (r = 0.35; P < .05) and difference between BMI and gender as well as the presence of cardiovascular diseases. CONCLUSIONS: Overweight and obesity after HTx are common and reflect a risk factor for cardiac allograft vasculopathy and other cardiovascular diseases as well as metabolic syndrome among HT recipients.

Psychological predictors (personal recourses) of quality of life for heart transplant recipients.

BACKGROUND: Heart transplantation (HTx) has a significant impact on all areas of the operation, adjustment, and quality of life (QOL) in patients after heart transplantation. In the process of healing and coping with the new situation, it is important to have personal resources. AIM: The main objectives of this study were to assess subjective QOL of patients after HTx and to determine the relationship between personal resources and QOL in this group of patients. MATERIAL AND METHODS: The study included 121 patients who received a heart transplant. A standardized instrument used to measure the quality of life was the World Health Organization (WHO) QOL Brief Questionnaire. The personal resources and deficits were determined using the following research techniques: Antonovsky's Sense of Coherence (SOC), coping strategies for stress (Brief-COPE), Generalized Self Efficacy Scale (GSES), and Life Orientation Test (LOT-R). The data were analyzed statistically. RESULTS: The patients gained an average level of QOL (13.75). The results indicate a positive relationship between the QOL in all its domains and personal resources: a sense of coherence (r = 0.65; P < .05), optimism (r = 0.55; P < .05), self-efficacy (r = 0.58; P < .05), and strategies for coping (active coping [r = 0.41; P < .05], planning [r = 0.42; P < .05; P < .05], and positive revaluing [r = 0.40; P < .05]). The regression model explained 56% of the predictors of QOL in patients after HTx. APPLICATIONS: It is necessary to strengthen personal resources in this group of patients as well as to detect early and treat symptoms of depression and to cope with stress.

Depression and quality of life in terms of personal resources in heart transplant recipients.

BACKGROUND: Heart transplantation is the first option for treatment of heart failure engendering increased survival and quality of life among recipients. However, this surgical intervention causes many psychological problems such as depression and anxiety. Protective factors and personal recourses are significant forces behind healthy adjustments to life stresses. PURPOSE: The aim of this study was to estimate the prevalence of depression among heart transplant recipients. PROCEDURE: The study consisted of a sample of 46 patients after heart transplantation. Standardized instruments used to measure the key constructs were Beck Depression Inventory Short Form for the prevalence of depression, World Health Organization Quality of Life--BREF for quality of life, Sense of Coherence (SOC-29), and Coping Orientation to Problems Experienced BREF to identify coping strategies. The data were analyzed statistically. RESULTS: We found that sense of coherence and coping strategies were significant predictors for quality of life and prevalence of depression, which were significantly associated with each others. Strategies focused on the problem are moderate quality of life with an age of recipient. Recipients who have a tendency to use emotion-focused strategies and are older showed a poorer quality of life, were less satisfied with their health, and displayed a prevalence of depression. CONCLUSIONS: These results suggested that assessment of coping strategies and sense of coherence should be explored in heart transplant recipients with skills training in this domain.

Organ transplant education: the way to form altruistic behaviors among secondary school students toward organ donation.

BACKGROUND: Organ shortage for transplantation is a crucial problem all over the world. Educational intervention may appeal to young people's altruism, increasing organ donation and decreasing the opposition. AIM: This study assessed the influence of an educational program, including organ donation and transplantation, to forming students' altruistic behaviors. METHODS: A total 680 students of 25 secondary schools were asked about their attitudes, intentions, and knowledge about organ donation and transplantation from September 2008 to June 2009 during a 45-minute lesson. RESULTS: In this study, altruistic attitudes were measured through questions about the expression of will to give organs away after death; to give one kidney to relatives; to use the bone marrow from a foreign person; and to sign a donor card. Attitudes were assessed by questions about conversations with relatives, an evaluation of the educational project. More than 1500 donor card were distributed and more than 90% of students wanted to sign them; 73.6% agreed to sign a donor card with the ID card. Before the project, only 8% of students had a signed donor card. Almost everybody is ready to agree to give their organs after death (80.6% male; 92.2% female), or to relatives (100% male; 90.38% female), or bone marrow (80% male; 55.7% female). The students talked to their family, informing them about their decision (36.9% male; 45.9% female). CONCLUSIONS: The proposed educational project successfully encouraged teenagers to make well-considered choices with regard to organ donation and created altruistic behaviors.