Psychological profile of teenagers toward organ donation: a multicentric study in Spain.

BACKGROUND: It is important for teenagers to have a favorable attitude toward organ donation and transplantation (ODT) in order to increase the number of future donors. To determine the attitude of teenagers in the South East of Spain toward ODT and to analyze the psychosocial variables related to this attitude. METHODS: The study population consisted of young teenagers in the South East of Spain. A stratified sample was selected by geographical location, sex and age (n = 4, 117). Attitude was assessed using a validated questionnaire about ODT (PCID-ODT Ríos). Statistical analysis: Student's t-test, Chi-squared test and a multivariate analysis. RESULTS: The questionnaire completion rate was 87% (n = 3572). Attitude toward ODT was favorable in 46% of cases (n = 1633) and undecided in 43% (n = 1543). Several psychosocial variables had a favorable effect on donation: believing that one has good information about ODT (Odds Ratio [OR] 1.706); discussing the subject with the family (OR 1.543) and friends (OR 1.818); carrying out pro-social activities (OR 1.642); having a favorable attitude toward cremation (OR 1.466) and autopsy (OR 1.470); and, finally, not being afraid of scars (OR 4.184). CONCLUSIONS: Teenagers in the South East of Spain are not currently inclined to support organ donation. This attitude is related to many psychosocial factors, mainly connected to not having good information about the subject, not discussing it in social circles and the fear of body mutilation. It would be appropriate to create educational interventional strategies in this group to prevent a negative impact on future donation rates.

Validation of Checklists and Evaluation of Clinical Skills in Cases of Abdominal Pain With Simulation in Formative, Objective, Structured Clinical Examination With Audiovisual Content in Third-Year Medical Students' Surgical Clerkship.

OBJECTIVES: The objective of this study was to develop and validate 6 checklists for evaluating abdominal pain in clinical simulation scenarios; to assess student competencies in managing 6 clinical cases using OSCE, based on faculty evaluations; and to analyze discrepancies between faculty and student evaluations. DESIGN: A practical workshop was designed to address 6 clinical scenarios of abdominal surgical conditions. Four scenarios employed medium fidelity simulators, while 2 scenarios employed standardized patient methodology. Prior to the workshop, students received theoretical audiovisual material. At the conclusion of the workshop, students were evaluated using checklists that assessed communication, privacy, anamnesis, and technical skills. Ten workshops were conducted over 3 years, using the OSCE (Objective Structured Clinical Examination) format for evaluation. SETTING: In the statistical analysis, t-Student tests or ANOVA were employed to ascertain whether there were any significant differences between the groups. In the process of validating checklists for clinical scenarios, 6 experts were asked to evaluate each item on a scale of 1 to 9. To assess the degree of agreement among experts, the intraclass correlation coefficient (ICC) was employed. PARTICIPANTS: The study involved a total of 670 third-year medical students from the University of Murcia (UMU), Spain, who participated in the subject "Medical-Surgical Skills." RESULTS: High levels of appropriateness were observed for the checklist items, with mean scores above 7.5 points, as well as high levels of inter-expert agreement. Students obtained a mean score of 8 points in the evaluation of each clinical scenario. No significant differences were found between faculty and student scores (p < 0.05). CONCLUSIONS: The learning method focused on clinical scenarios of abdominal surgical diseases effectively enhanced the clinical skills of third-year medical students. It used pre-existing audiovisual materials, hands-on workshops with medium-fidelity simulators, and standardized patients. Consistent evaluations from students and faculty confirmed the efficacy of these strategies.

Knowledge of the Brain Death Concept Among Older People.

BACKGROUND: The concept of brain death (BD) is not well understood in the general population; this lack of knowledge is one of the main factors that generates an attitude against organ donation. Older people are a population group that has rarely been studied in relation to organ donation and transplantation (ODT), and it is important to investigate the most important aspects of ODT, such as people's concept of BD. OBJECTIVES: To analyze the level of understanding of the concept of BD in people > 65 years of age and the factors that influence their mode of thinking. METHODS: A multicenter study was carried out with a representative sample of people > 65 years of age, stratified by sex and geographic location in the southeast of Spain (n = 420). Knowledge of BD as well as the influence of other variables were analyzed through a validated questionnaire about ODT. SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software was used for statistical analysis. Descriptive analysis included Student t test and the χ2 test. RESULTS: The questionnaire had a completion rate of 84% (n = 351). In 36% (n = 127) of cases, people ˃ 65 years of age understood the concept of BD. In general, knowledge of this concept has not been associated with other variables including social-family interaction about ODT (P > .05). CONCLUSIONS: Older people do not understand the concept of BD. It is, therefore, necessary to carry out informative campaigns on ODT explaining this concept. This would improve organ donation awareness in this particular group of people.

The Influence of Mass Media on Organ Donation and Transplantation in Older People.

BACKGROUND: Worldwide population aging has resulted in changes in the approach to the organ donation and transplantation (ODT) process, forcing us to include older people on transplant waiting lists and to assess older patients as potential donors. However, this is a sector of the population that has not been studied in great detail in terms of the information they receive about ODT. OBJECTIVES: To analyze what kinds of media provide people > 65 years of age with information about ODT and which sources of information affect their attitude about this subject. METHODS: A multicentric study was undertaken using a sample of people > 65 years of age stratified by sex and geographic location in southeastern Spain (n = 420). Questions about ODT and methods of receiving information were analyzed using a questionnaire. Statistical analysis was performed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States). Descriptive analyses were performed with a Student t test and χ2 test. RESULTS: The questionnaire completion rate was 84% (n = 351). People aged > 65 years received information about ODT, mainly positive, from the television (82%), followed by films (35%), the radio (30%), the press (26%), family (26%), and friends (17%). Receiving information through one of the following sources was associated with a more favorable attitude toward organ donation: the family (76% vs 45%; P < .001), friends (77% vs 48%; P = .01), and the press (62% vs 49%; P = .034). CONCLUSIONS: Older people mainly receive information about ODT from the mass media. However, social and family circles have the greatest influence on their attitudes toward organ donation.

Attitude of Older People Toward Living Donation.

BACKGROUND: Living donation is a potential source of organs that could help to reduce the organ transplant deficit. Given that we have a worldwide aging population, it is important to assess the opinion of older people toward this type of donation. OBJECTIVES: To analyze the attitude of people aged > 65 years toward living kidney donation (LKD) and living liver donation (LLD) and to investigate the variables affecting their attitudes. METHODS: A multicentric study was carried out using a representative sample of people > 65 years stratified by sex and geographic location in southeastern Spain (n = 420). The measurement instrument was a validated questionnaire about LKD and LLD. Statistics were analyzed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States) software. Descriptive analysis was carried out using Student t test, χ2 test, and a multivariate analysis. RESULTS: The questionnaire completion rate was 84% (n = 351) with 88% (n = 310) in favor of LKD, and 89% (n = 311) in favor of LLD. Favorable attitude decreased to 3% when the donation under consideration was unrelated. Attitudes toward LKD and LLD were associated with having received information from the television (P = .016 and P = .045) and from friends (P = .017 and P = .03); accepting an autopsy after death (P = .001 and P = .002); and not being worried about scars (P = .015 and P = .044). In the multivariate analysis, the following variables continued to be significant: having received information from the television (odds ratio [OR], 2) and from friends (OR, 10.3); and the acceptance of an autopsy (OR, 2). CONCLUSIONS: Older people are in favor of both LKD and LLD, assuming it is a related donation. In addition, the information the elderly population receives regarding organ donation and transplantation affects their attitudes.