With this study it was aimed to determine the perception of university students regarding organ donation in terms of sociality, education and religion and to make recommendations according to these results and to create the basis for the planned training program regarding this issue.: This study was planned to carry out the study as descriptive and cross-sectional type in Corum/Turkey. No sample selection was made in the study (N=345). Students visiting the university between the dates (15.11.2014-15.01.2015) and wanted to participate as volunteers (N=313) have constituted the sample of the study. Prior to starting the study, the permissions have been obtained. For the statistical analyze during the assessment of obtained findings from the study, the SPSS 15.0 program was used. Significance was evaluated in p<0.05 level. Analyzing the relationship between students’ social, educational and religious perception of organ donation and their thoughts about organ donation “There should be impeding conditions for organ donation in terms of religion.” (p<0.01), and the thoughts of students regarding organ donation there is a statistically significant relationship. Young people have an insufficient perception of organ donation in terms of social and educational aspects, whereas they have a sufficient religious perception. Prejudices that cause negative thoughts should be eliminated. Systematic organizations regarding organ transplantation and donation should be carried out and it should be provided that the students take responsibility in this field.
Organ transplantation is the moving of an organ not performing its tasks from a donor site (living donor, cadaver or a person whose cerebral death has occurred) to another location on the person's own body, to replace the recipient's damaged or absent organ (Goz, & Salk Gurelli, 2007; Kocak et al., 2010). Transplantation operations are carried out by taking organ or tissues from a living donor or cadaver (Goz, & Salk Gurelli, 2007; Marck et al., 2014). The voluntarily permission of one person that his/her tissues and organs should be used for treatments of other patients after his/her life ends medically and the certification of that permission is called organ donation (Akıs et al., 2008; Kocak et al., 2010).
Many countries have created its legal regulations related to organ donation and transplantation. According to the commission meeting rules of Spain, Sweden, Germany and Europe there were made legal reforms regarding organ donation, cerebral death and organ transplantation in European Countries (Dontlu, 2004). The organ transplantation in Turkey is performed in accordance with 29.05.1979 dated “About Organ and Tissue Ablation, Storage and Transplantation” 2238 numbered law and in 1982 revised articles and “Organ and Tissue Transplantation Services Regulation”, which was published on 1 June 2000 in the 24066 numbered official gazette and underwent changes on the following dates 07.03.2005, 24.10.2007 and 11.03.2009. Within this framework related units are notified about organ donation, transplantation and cerebral death via circular letters sent by the Ministry of Health (Kavurmacı, Karabulut, & Koc, 2014). Furthermore the High Council of our country’s Directorate of Religious Affairs has reported in 1980 with the 396 numbered resolution that organ transplantation is permissible and not forbidden by religion (Dontlu, 2004). The most important purpose of organ transplantation is as follows; to save the life and increase the life expectancy and quality of a patient who has reached the end of life due to organ failure (Neate et al., 2015). For this purpose there are studies reporting that in creating the view on organ donation besides education, socioeconomic status and culture, religious beliefs are also an important factor (Kececioglu, 2003; Ozer et al., 2010; Lo´pez et al., 2012; Neate et al., 2015; Da Silva, & Frontera, 2015).
Knowledge of youth’s information and opinions about organ donation are in terms of planning and implementation of more effective tasks is this area really important. In the performed studies (Gok Ozer et al., 2008; Bortz, Ashkenazi, & Melnikov, 2015) is reported that increasing the education level of individuals, keeping organ donation always on agenda, attaching importance on community education and dealing with the topic within the framework of religion have increased organ donation (Savaser et al., 2012).
After having analyzed the existing litearature (Ozmen et al., 2008; Al-Ghanim, 2009; Savaser et al., 2012; Kavurmacı, Karabulut, & Koc, 2014; Zhang et al., 2014); it was seen that university students, the adults of future, do not have sufficient knowledge about organ donation.
What do university students think about organ donation in terms of social, educational and religious?
Purpose of The Study
With this study it was aimed to determine the perception of university students regarding organ donation in terms of sociality, education and religion and to make recommendations according to these results and to create the basis for the planned training program regarding this issue.
Type of Study and Sample
The study population consisted of students visiting university in Corum city of Turkey (N=345), whereas the sample consisted of students visiting the university between the dates (15.11.2014-15.01.2015) and wanted to participate as volunteers (N=313) have constituted the sample of the study. Attainment rate is 90.7%.
This study was planned to carry out the study as descriptive and cross-sectional type.Prior to starting the study, the permission from the University Presidency (10.10.2014-6196) and approval from the ethical committee of Ankara Training and Research Hospital (05.11.2014/E-14326) have been obtained. Additionally the voluntarily participating students were informed about the purpose of the study and a written consent was taken. The questionnaires were filled out in approximately 15 minutes by using the face-to-face interview method.
The questionnaire which was developed in accordance with researchers and literature information has been used to collect data. After the students have filled the questionnaires in a total time of 15 minutes under surveillance of researchers, the survey data have been obtained. The questionnaire consists of two parts. In the first part there are questions to determine the descriptive characteristics of students, whereas in the second part there are questions in order to specify the student’s social, educational and religious perception of organ donation.
Data obtained from this study were analysed in the SPSS package program and for the significant test of the differences between number and percentage, In the evaluation of the obtained data number, percentage and Chi-square test have been used. The outcomes were assessed in the confidence range of 95% and significance level of p<0.05.
Whereas the average age of participating students is 20.41±1.497, the vast majority are (73.8%) girls and 42.8% have graduated from regular high school. It was determined that 79.2% of the students’ families lived the longest time in a city and that 87.2% have a moderate level of income. Furthermore it was identified that 14.7% of students who participated in the study have negative thoughts about organ donation. Within the reasons for negative thinking were 36.9% ecclesiastically inappropriateness and discouragement, 23.9% lack of confidence. Additionally it was ascertained that 96.8% do not donate their organs, 77.3% do not know where to donate organs, but nevertheless 53.7% plan to donate all organs (Table 1).
After having analyzed the social, educational and religious perception regarding organ donation of participating students; Whereas high participation was observed to the following suggestions “Organ donation is vital.”, “The most important obstacle in terms of organ transplantation is the insufficient organ donation.”, “Regarding organ transplantation and donation National Unity is needed.” (Respectively; 95.2%; 90.4%, 88.2%); it was determined that to the following suggestions the most disagree “A person in financial difficulty, should be able to donate his/her kidney against money.”, “During our Bachelor – Undergraduate education sufficient information is given about organ transplantation and donation.”, “Press and broadcast media are informing the society sufficiently about organ transplantation and donation.” (Respectively; %91.4, %81.8, %81.2; Table 2).
Analyzing the relationship between students’ social, educational and religious perception of organ donation and their thoughts about organ donation; it was determined that between the following suggestions “Regarding organ transplantation and donation National Unity is needed.” (p<0.05), “There should be impeding conditions for organ donation in terms of religion.” (p<0.01), “I think to donate an organ while I am healthy.” (p<0.01), “Young individuals are thinking more positively about organ donation in comparison to individuals at an advanced age.” (p<0.01), “The potential positive attitude of my family will fasten my decision making regarding organ donation.” (p<0.01), “The potential positive views of people recognized by community (artists, scientists) will accelerate my positive decision making regarding organ donation.” (p<0.01), “Clergymen should inform and lead concerning organ transplantation and donation.” and the thoughts of students regarding organ donation there is a statistically significant relationship (p<0.05; Table 2).
The obtained findings from this study reveal that family attitude, national unity and information and leadership of clergymen concerning organ donation and transplantation is very important for young people.
In the studies (Al-Ghanim, 2009; Tarhan et al., 2013; Kubat, 2014; Zhang et al., 2014; Bortz, Ashkenazi & Melnikov, 2015) is reported that age, gender, education and socioeconomic status is in terms of organ donation effective and that young people compared to old persons, women compared to men, people with high education level compared to less educated ones have a more positively look to organ donation. In our study was observed that there is no statistically significant relation between wanting to donate organs and age (p=0.983), gender (p=0.792), longest residence place of family (p=0.692) and family’s income level (p=0.399).
People who want to donate an organ in our country shall report their organ donation wish in case of unexpected death to Local Health Authorities and Police Departments (during receiving a driver’s license), Hospitals, Organizations related to organ transplantation. Besides organ donation it is reported that the people have to talk about this topic within their family as required by law. In the study carried out by the students of Kavurmacı, Karabulut, & Koc (2014) it was determined that 47.8% plan to donate their organs but 73.9% do not know how to do organ donation. It is pleasing that 85.3% in our study think positively about organ donation and 65.8% plan to donate their organs (Table 1). Thinking of more organ donating young people in future, this result can be considered as promising. The high rates (%77.3; Table 1) of students not knowing where to do organ donation however is discouraging. This result is showing that students are not informed sufficiently about organ donation. The largely unknown locations where to donate make us think that this is a result of insufficient projects to raise the awareness of public concerning organ donation.
Among the factors preventing organ donation are lack of knowledge, religious beliefs, medical mistrust, fear of organ trade, destroy of physical integrity (Goz, &Salk Gurelli, 2007; Savaser et al., 2012; Kavurmacı, Karabulut, & Koc, 2014; Gungormus, & Dayapoglu, 2014). Whereas Pierini et al. (2009) determined in their study that university students are thinking negatively about organ donation due to fear and lack of confidence (40.4%), this rate was observed to be lower in our study (23.9%; Table 1). Savaser et al. (2012) reported in their study that the first thing among negative thinking about organ donation is that students not want their physical integrity to be destroyed, whereas in our study these were lack of courage and ecclesiastically inappropriateness (36.9%; Table 1).
It was determined that the vast majority of students within the scope of the study think to donate their kidneys (Table 1). The high rate of kidney donation in performed studies and in our study should be explained by the fact that kidney transplantation is more known and performed widespread (Kocak et al., 2010; Marck et al., 2014; Kavurmacı, Karabulut, & Koc ,2014).
In literature (Kocak et al., 2010; Kılıc et al., 2010; Savaser et al., 2012) it is emphasized that visual and print media (television, newspapers, journals etc.) have a significant contribution in getting information about organ donation. In accordance with the obtained findings from performed studies it was observed that students are not aware of the existence of Organ Transplant Coordination System (ONKOS) and therefore it becomes evident that it is not known that ONKOS is a national organization. It is necessary to make the students more aware of the existence of ONKOS, to explain the working area of these organizations and to remedy the community’s lack of information on this subject. It is pleasing that in our study the rate of agreeing students (88.2%) to the suggestion of “Regarding organ transplantation and donation National Unity is needed.” and the related positive thinking concerning organ donation (90.3%) is high (p<0.05; Table 2). Furthermore this result is showing that students are in terms of national unity cooperative in the matter of organ donation and transplantation.
It is necessary that the Directorate of Religious Affairs and clergymen make valid and impressive statements about the religious aspects of organ donation, donate organs themselves and guide the community concerning organ donation (Kılıc et al., 2010; Savaser et al., 2012; Zhang et al., 2014). It is gratifying that in our study the rate of the ones who disagree to the suggestion “There should be impeding conditions for organ donation in terms of religion.” is high (%65.9; Table 2). This finding reveals that students know that organ transplantation and donation is appropriate in terms of religion.
In the performed studies (Ozer et al., 2010; Kavurmacı, Karabulut, & Koc, 2014; Da Silva, & Frontera, 2015) the necessity to increase the number of potential organ donors in future is reported. In order to ensure this situation, the elective course under the name of “organ donation” should be offered and therefore integrated into the curriculum of our country and thus the awareness of students at the university should be increased. The high “Disagree” rate (81.8%; Table 2) to the suggestion of “During our Bachelor–Undergraduate education sufficient information is given about organ transplantation and donation.” indicates the compatibility with the performed study. This result reveals the importance to involve the elective course “organ donation” into the curriculum.
It is stated that it is not easy for people to give up their physical integrity and that the lack of information regarding organ donation and transplantation and the lack of confidence related to it, is causing negative approach on young people (Al-Ghanim, 2009; Kavurmacı, Karabulut, & Koc, 2014). In the study of Savaser et al. (2012) the first thing among the reasons why students do not want to donate organs is the fear of destroying their physical integrity. In our study was determined that 68.7% of students do not think about organ donation while they are healthy and 53.7% disagree to the suggestion “Young individuals are thinking more positively about organ donation in comparison to individuals at an advanced age” (Table 2). These findings are thought to be due to not wanting to destroy their physical integrity and lack of confidence in this regards. These high rates bring the psychological aspects of the subject into question.
Organ donation both method and moral conclusion bring along some differential problems that differ as a matter of results. These problems concern not just medical science but also legal, morality, religion, social and art sciences (Al-Ghanim, 2009; Da Silva, & Frontera, 2015). During the investigation of obstacles concerning organ donation one of the overemphasized issues are religious beliefs. The common belief in our country about the ecclesiastically inappropriateness of organ donation is among the causes of flight (Al-Ghanim, 2009; Savaser et al., 2012). Contrary to the performed studies the high “Agree” rate (70.6%) to the suggestion “Clergymen should inform and lead concerning organ transplantation and donation.” in our study shows the importance of clergymen in this regard. In return the fact that 38.7% “Agree” to the suggestion “The potential positive views of people recognized by community (artists, scientists) will accelerate my positive decision making regarding organ donation.” reveals that clergymen have more influence on young people than those who are accepted by community.
In the performed studies (Lazenby, 2006; Al-Ghanim, 2009; Savaser et al., 2012) the importance of family attitude towards organ donations is reported. In the study of Goz & Salk Gurelli (2007) was determined that students who declined to donate organs not want to sadden their family, whereas in the study of Ozer et al. (2010) it was stated that a large number agree on the suggestion “The potential positive attitude of my family will fasten my decision making regarding organ donation.” 72.2% of students agree to the suggestion “The potential positive attitude of my family will fasten my decision making regarding organ donation.” in our study as in line with literature and this result emphasizes the importance of family attitude towards organ donation, behavior and education.
This study is limited with the findings obtained from 313 students, who are visiting the university and were available during the time of the study students and therefore included in the study. It is thought to conduct more comprehensive studies in future that may reflect the critical thinking skills and increased critical thinking skill level of all students throughout the country.
In line with these results it can be seen that young people, the adults of the future have an insufficient perception of organ donation in terms of social and educational aspects, whereas they have a sufficient religious perception. These study results support the view to provide the students during their educational as well as their social life with comprehensive information regarding organ donation. The positive thinking should be supported by explaining to students the legal, religious and ethical aspects of organ donation. Prejudices that cause negative thoughts should be eliminated. Systematic organizations regarding organ transplantation and donation should be carried out and it should be provided that the students take responsibility in this field.
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18 December 2019
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Kuftyak, E. (2019). Resilience and Adaptation of Adolescents. In Z. Bekirogullari, & M. Y. Minas (Eds.), Health and Health Psychology - icH&Hpsy 2015, vol 5. European Proceedings of Social and Behavioural Sciences (pp. 59-63). Future Academy. https://doi.org/10.15405/epsbs.2015.07.7