Introduction: Organ Donation has been one of the greatest advances of modern science that has resulted in many patients getting a renewed lease of life. It was included in the top five miracles of the last century. This miracle of Transplantation would not be possible without Organ Donation. Organs can be donated by a living person, after natural death & much more organs can be donated after Brain Stem Death.Since the Transplantation of Human Organs Act (THO Act) also called as Human Organ Transplantation Act (HOTA Act) was passed in India, in 1994, it has been possible to undertake multi-organ transplant activity from Brain Stem Dead donors in India. After natural death only few tissues can be donated whereas after Brain Stem Death almost all organs and tissues can be donated including critical organs like kidneys, liver, lungs.An enormous difference has been created between organ supply and demand because of increase in the incidences of organ failures and lack of supply of organs. The waiting list of patients requiring organs is increasing day by day. Because of high number of road traffic accidents in India there is a lot of potential for deceased organ donations if utilized legitimately. Only few hospitals and committed NGOs in the country have shown that deceased donation as a feasible option.(6)We have 1,40,000 deaths from Road Traffic Accidents(RTA) every year in India, 67% of these patients suffer from head injury that leads to BRAIN STEM DEATH in many instances. This means that every year there are almost 93,000 persons who become brain dead, and are therefore potential organ donors. Hence we have potentially a huge pool of Brain Dead Donors available in India, whereas the actual Organ Donation is very less. Organ Donation rate for cadaver in India is currently 0.05 per million population (50 cadaver donors per year)(1).Spain has highest rate of Organ Donation from Brain Stem Dead Deceased Donors about 32 per million population(1). In India, Tamilnadu tops with rate of 1.3 million Organ Donors per million population(2)(3). The gap between Organs available for Transplantation and number of patients waiting for transplant is widening(3). Lack of knowledge and understanding about organ donations, religious attitudes, and superstitious beliefs have generated fear and mistrust in the minds of the common man (4)and, especially, the terminally ill patients. Studies have been done on Medical and Nursing students towards their perceptions and attitudes about organ donation and to enhance their motivation towards the same(5).Religious convictions are another viewpoint why people don’t consent for organ donation. Many people are not willing to donate as they believe that the organ donated by them may be misused. An assurance that these organs will be utilized for good and not be a commodity in the organ market may encourage organ pledges. Most of the medical students or doctors and hence nursing staff are not exposed to platforms for organ donation and lack of knowledge as to where they are located if any. The knowledge, attitudes, and behaviours of the healthcare professionals are important factors in creating an environment that positively influence organ donation rate.(6)Education programs have recently been suggested as a new approach in solving the organ shortage. The general population and the student population in particular, need to be educated about transplantation and the need to accept the commitment to donate organs (7).This study intends to assess the awareness about Organ Donation among young Nursing students and staff in a tertiary apex institute in a metropolitan area.

Material & Methods:

It was a Cross-sectional study, about 98 nursing students and Nursing staff working in apex medical in Metropolitan area who consented to participate in the study were enrolled in this study using Universal sampling method. A pretested, semi-structured questionnaire was used to collect information by interview.

Step I: Designing of Questionnaire: A semi-structured questionnaire is prepared in accordance with the study objectives which is pre tested & modified.

Step II: Validation of Questionnaire: This questionnaire is modified and validated by appropriate authorities.

Step III: The semi-structured questionnaire was administered to Nursing students and staff after getting necessary permissions from Ethical committee,

STEP IV- Explaining the importance of Organ Donation to the Nursing students and staff using informative slide show presentation and addressed their concerns regarding Organ Donation.

  • At the end of the talk, Donor Cards prepared were provided to determine extent of Organ Donation commitment with reference to filling the Donor Cards.

Results and Discussion:

This study was doneto assess the knowledge & Concerns about Organ Donation in the minds of nursing students in a Tertiary medical college in metropolitan area, with 98 participants consisting nursing students and staff nurses working in medical college who consented to participate in the study.

All the participants were between age group of 20 to 50 years, whereas majority of participants were among 20 to 30 years of age group (51%) since majority of participants were nursing students. Majority of participants were Hindu (77%) by religion, others were Buddhist (22.44%), Muslim (5.1%) and Christian(4.08%)

Among all the participants 83% students were knowing the terminology of Organ Donation, though very few had accurate knowledge about Organ Donation. Only 50% participants said that Organ can be donated by Living Donor as well as after death. (Figure 1)

Only 39% participants were found aware about the fact that brain stem death and Coma are different, however among those very few could tell the exact difference between Coma and brain stem death.Awareness about the most important step in the process of organ donation is Close relative’s consent. Only 52% participants knew that close relatives consent is important before organ donation (Table 2). Although very few participants could enumerate various close relatives permitted for consent according to Legislation.However in case of family dispute regarding decision on Organ donation, organs can not be donated. Only 35% participants were aware about the above important fact.

The process of Organ Donation in India is controlled and regulated by Transplantation of Human Organ and tissues Act, 1994 with several amendments. Only 30% of participants were aware about this fact that Organ donation is regulated by Law (Figure 2). About half of the participants (46%) felt that organ donation is accepted by all religions. Upon asking their willingness to donate their organs after their Brain stem Death,69% participants said YES, while others asked that they will decide after communicating with their families.(Table 4).And about 62% of participants said YES to donate their relative’s organs after their brain stem death. (Table 3)So, from the given study it can be seen that the knowledge regarding organ donation was inappropriate among the participants as compared to willingness to donate their organs.

Conclusions:

  1. Nursing staff is most important care taker of the patients when patients are indoor or in intensive care units.
  2. Though majority of participants were aware of terminology of Organ Donation, they did not have appropriate knowledge regarding the concept.
  3. The knowledge about various types of organ donation and who can donate organs was found to be poor.
  4. The most important type of organ donation i.e. after brain stem death, participants were having very less knowledge about definition of brain stem death and difference between BSD & Coma.
  5. One of the most important step in the process of organ donation is Consent of close relatives, as a caretakernursing staff must be aware of this fact in order to facilitate the process and to provide accurate information to the patients relatives.
  6. The information about legislation that control and regulate organ donation is important and nursing staff should be made aware of this fact in order to provide reliable information to the patients relatives.
  7. There is still confusion among minds of participants regarding religious acceptance of organ donation, as almost half of the participants said that they don’t know about it.
  8. The number of participants willing to donate their organs after their brain stem death was quite satisfactory i.e. 69%, it could have been more if participants have accurate information.

Recommendations:

  1. Regular organ donation awareness activities should be held at nursing colleges level in order to sensitize nursing students regarding importance of organ donation.
  2. Regular sensitisation sessions should be arranged periodically in order to revise the updated knowledge regarding organ donation and legislation to the nursing staff.
  3. Further studies should be conducted in order to find more barriers in the process of Organ donation.

Acknowledgement:

Special thanks to Regional Zonal Transplant Coordination Committee for providing educational materials and support.

References:

1. Shroff D. Organ Donation and Transplantation-Tribulations and Triumphs-An Indian Perspective. J Natl Med Assoc. 2006;4–7.

2. Annadurai K, Mani K, Ramasamy J. A study on knowledge , attitude and practices about organ donation among college students in Chennai , Tamil Nadu -2012. 2013;3(2):59–65.

3. Veerappan I. Deceased Donor Kidney Transplantation in India. healthsciences.ac.in. 2012;1(2):1–8.

4. Reporter S, Khera R, Raman V. Today ’ s Paper » NATIONAL » NEW DELHI. 2014;2–3.

5. Dardavessis T, Xenophontos P, Haidich A-B, Kiritsi M, Vayionas MA. Knowledge, attitudes and proposals of medical students concerning transplantations in Greece. Int J Prev Med. 2011 Jul;2(3):164–9.

6. Vinay KV, Beena N, Sachin KS, Praveen S. Changes in knowledge and attitude among medical students towards organ donation and transplantation.Int J Anat Res 2016, 4(3):2873-77. ISSN 2321-4287

7. K. Chakradhar*, D. Doshi, B. Srikanth Reddy, S. Kulkarni, M. Padma Reddy, S. Sruthi Reddy. Knowledge, Attitude and Practice Regarding Organ Donation among Indian Dental Students.International Journal Org Transplant Med 2016; Vol. 7 (1)

Whether Brain stem death and COMA are different / Number of Students / Percentage
YES / 38 / 38.77
NO / 42 / 42.85
Don’t know / 17 / 17.34
Total / 98

*Table 1: Whether Brain stem death and COMA are different?

Consent of relatives is important / Number of Students / Percentage
YES / 51 / 52.04
NO / 24 / 24.48
Don’t know / 22 / 22.44
Total / 98

*Table 2: Whether Consent of relatives is important?

Are you willing to donate YOUR RELATIVES organs after BSD / Number of Students / Percentage
YES / 60 / 61.85
NO / 37 / 38.14
Total / 97

*Table 3: Are you willing to donate your relative’s organs after their Brain stem death?

Do you PLEDGE your organs here to donate after BSD / Number of Students / Percentage
YES / 68 / 69.38
NO / 2 / 2.04
After consulting family / 27 / 27.55
Total / 97

*Table 4: Do you pledge your organs here to donate after Brain Stem Death?

Figures

*Figure 1: Responses showing types of organ donation

*Figure 2 :Knowledge about LAW