RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARANATAKA.
“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE REGARDING ORGAN DONATION AMONG ADOLOSCENTS IN A SELECTED PRE UNIVERSITY COLLEGE AT BANGALORE KARNATAKA.”
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
Ms DIVYA A.P.
BANGALORE CITY COLLEGE OF NURSING
BANGALORE-560043 (KARNATAKA).
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRESS / Ms DIVYA A.P.M.Sc (N) Ist Year
Bangalore City College of Nursing
Bangalore- 560043.
2. / NAME OF THE INSTITUTION / Bangalore City College Of Nursing
Bangalore.
3. / COURSE OF THE STUDY AND SUBJECT / M.Sc (N) Ist year
Community Health Nursing
4. / DATE OF ADMISSION / 20/06/2012
5. / TITLE OF THE SUBJECT / “A study to assess the effectiveness of structured teaching program on knowledge regarding Organ donation among Adolescents studying in a selected Pre University college at Bangalore Karnataka.”
6. BRIEF RESUME OF THE INTENTED WORK
INTRODUCTION:
“ Don’t think of Organ donations as giving up part of yourself to keep a total stranger alive. It’s really a total stranger giving up almost all of themselves to keep part of you alive”
- Ldo Rosten
The transplantation of an organ from one body to another is known as the organ transplant. The person who gives the organ is called the donor while the one who receives is called the recipient. Organ transplant is done to replace the recipient’s damaged organ with the working organ of the donor so that the recipient could function normally. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be re-grown from the patient's own cells (stem cells or cells extracted from the failing organs). Organs or tissues that are transplanted within the same person's body are called auto grafts. Transplants that are performed between two subjects of the same species are called allograft. Allografts can either be from a living or cadaveric source.1
Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, and veins. Worldwide, the kidneys are the most commonly transplanted organs while musculoskeleletal transplants outnumber them by more than tenfold.Organ donors may be living or brain dead. Tissue may be recovered from donors who are cardiac dead - up to 24 hours past the cessation of heartbeat. Unlike organs, most tissues (with the exception of corneas) can be preserved and stored for up to five years, meaning they can be "banked". Transplantation raises a number of bioethical issues, including the definition of death, when and how consent should be given for an organ to be transplanted and payment for organs for transplantation. Other ethical issues include transplantation tourism and more broadly the socio-economic context in which organ harvesting or transplantation may occur. A particular problem is organ trafficking.2
Organ Transplantation is a boon to medical industry as it has helped in saving the lives of those who would have died otherwise. There is a great need for human organs for transplantation. In fact, the need far exceeds the supply of transplantable organs. This disparity has led to the formulation of various legislations, attempting to regulate the scare resources (transplantable human organs) and to help establish an equitable system to allocate the organs where they can do the most good.Worldwide, the demand for organs is growing, as the supply of organs and tissues for transplantation has not kept pace with demand. In the UK only approximately 900 individuals become organ donors each year, while over 6000 people are waiting for suitable organs. In the US much the same situation exists, with 70 000 presently on the waiting list and only approximately 5500 cadaveric donors per year.3
There are several reasons for the shortage of organs. Perhaps the most common reason is that people are hesitant to donate organs because they don’t have adequate knowledge regarding it. In other cases peoples don’t wishes to donate his or her organs may be due to the false beliefs surrounding organ donation4. In 2001, Laura conducted a study to find out the factors that enhance or inhibit organ donation. It showed that a number of discussions and knowledge enhancement are associated with a family’s willingness to consent for organ donation. Another study was conducted by Michelle in 2008 to find out the students attitude towards organ donation .It was found that 74% student nurses already signed a donor card and only 43% of medical students. The study concluded that student nurses seem to be in favour of organ donation, with many willing to sign a donor card. 38
The source of information about organ donation and transplant influenced attitudes of children. . Rios A (2010) conducted a study in Spain regarding the means by which children were informed about organ transplantation. Television (86%) was the major source of information, followed by 56% from magazines. Attitudes were more favourable among adolescents who have received positive information through the mass media.39
One of the main problems with donation is that it requires two people, the donor and their family member. The donor must talk with their family member about their feelings on donation and the family member must decide to respect those feelings when the time comes to make the decision. If this process is not done and most of the time it is not, then nobody gets to use the organs. This process has created a medical crisis in the United States today, and there are many people working together to resolve this problem.Thus with proper education, this problem can be resolved.7
6.1 NEED FOR STUDY:
Medical Science is expanding its horizons by leaps and bounds and edging towards
newer successes by unveiling God’s miraculous mystery – Human being and primarily human
body. In case any of the organs of the human body fails to function, medical science can extend
its functioning for some time, but when an end stage failure is reached, just like a machine whose
parts are changed, the failed organ needs to be replaced. One of the miraculous discoveries of
medical science has brought a ray of hope in the lives of these needy patients by transplanting
these functioning organs from the bodies of brain dead patients to these patients. This is cadaver
organ transplantation8.
The demand for viable organs outweighs the supply. Statistics indicate that approximately every 18 minutes, someone is added to the national waiting list for organ transplant. There are about 50,000 patients dying of heart ailment every year. At AIIMS, at any point of time there are 30-40 patients waiting for heart transplant. As per a general survey report carried out by a social service organization, there are roughly about 600 brain deaths annually in Delhi but unfortunately there have been very few (about 12 only) brain dead cadaver donors in last 2 years, where all vital organs were donated. There are about 50,000 heart cases, 60,000 liver cases and 90,000 End Stage Renal Disease cases requiring transplantation. Human Organ Transplantation Act was passed in Indian Parliament in 1994 and notified on February 4, 1995. Yet India lags far behind the rest of the world, in organ donation and transplantation9.Studies have shown that the major reason for poor performance of organ transplant programme is lack of awareness amongst public which has generally contributed for poor donor pool, but also lack of awareness, positive attitude and motivation amongst medical professionals. Clearly, it is important to provide good information at the youngest age possible10
Modern medical science has achieved what seemed impossible some years back. Transplantation is one of the most spectacular endeavors till date. Medical advances have contributed tremendously to its success ratio and have led to a significant increase in the number of transplants being performed. Around 50,000 such transplants are performed annually around the world. The management of end-stage disease of various organs like kidney, liver and heart has thus undergone a paradigm shift. Transplantation is no more an experiment but established standard therapy by World Health Organization11
Organ donation will help the peoples, but the main path hinder in the way of organ donation is myths which surrounding it. From the realms of mythology donation of organs from one human being to another has always been written about, talked about and debated about - intensely. But, what is happening in the world of organ donation and transplantation today? A patient with kidney failure can at least live with dialysis till an organ becomes available but for a patient with liver or heart failure; the only hope of living maybe to have an immediate transplant. Are we doing enough to help these critically ill patients whose number is constantly on the increase? What is the current status of different transplants in India? Questions will flow like a river, and then also there is another question that ‘is all those questions can be solved?’
An example or the importance of knowledge regarding organ donation is, when sixty-year-old Suresh Deshpande decided he would like to donate his organs for transplant after his death, he was confused about the procedure he would have to follow. Many people who are considering cadaver organ donation may have found themselves in a similar predicament. It is vital to understand the concepts of cadaver donation and brain death. If the healthy organ of a person who has been certified as brain dead is transplanted into a patient’s body within a specific window of time, the transplant can provide the patient of end stage organ disease the precious gift of life. According to the Transplantation of Human Organs Act, 1994, a patient is certified as brain dead only after stringent tests by a team of accredited specialists12.
Cadaver organ donation can save the lives of thousands of patients in the country who are waiting for organ transplants. While live donors are the main source of organ donation in India, the percentage of cadaver organ donation is a meagre 0.05 per million populations. In Pune, only 45 cadaveric kidneys have been transplanted since 1997. Currently, there are around 130 wait-listed patients on the central waiting list. In various surveys conducted, it has been seen that 72% of the population were willing to donate eyes, but less than 50% were willing to consider solid organ donation. 74% of Hindus, 72% Christians, 58% Muslims were willing to consider organ donation; however the concept of brain death was new to most of the people surveyed. An audit of 159 brain death patients showed that 19% of the relatives donated the organs of their loved ones and relatives to help others13
Low public awareness levels and the lack of coordination between medical professionals and social workers are responsible for the low response to cadaver organ donation. The shortage of organs has been due to the reluctance of many family members to donate due to fear of the surgery causing loss to their health, smaller nuclear families with unmatchable donors and a deceased donor programme that is still to evolve fully.Though the first cadaver organ transplant was conducted nearly five years ago in Karnataka, such donations still remain a sporadic event in the state. Even cricketer Anil Kumble's decision to pledge his organs to society in case of brain death has not motivated the programme. Among the prime reasons for the programme being unable to find its feet are cultural beliefs, the related lack of knowledge regarding cadaver donations and the myths surrounding it 14
The need for organ is growing at a high rate and the bad luck is that we are not able to meet the need, this is just because of the misconceptions and lack of knowledge regarding organ donation. There are over 1.5 lakh people in need of kidneys in the country, over one lakh need liver and nearly 50,000 need heart transplant. Yet, there are only about 60 cadaver transplants that take place in the country annually15.
An inadequate number of available kidneys remain the greatest limitation to treating patients with end-stage renal disease successfully. For those interested in donating a kidney, the National Kidney Foundation provides written information describing the organ donation program and a card specifying the organs to be donated in the event of death16.
From the above data it is clear that shortage of organ is a great threat to the medical field. There are persons who wish to donate their organ but the preventing factors are their misconceptions, lack of knowledge and false beliefs prevailing in their community. The researchers own personal experience while working in the clinical setting in which she has seen patients with ESRD waiting for a donor and many a times they die waiting for the donor. All these prompted the researcher to select the present study about common misconceptions involved in organ donation
6.2 REVIEW OF LITERATURE:
The review of literature of the present study is organized under the following headings.
A) Studies related to organ donation in general