Knowledge, Attitudes, and Predictors of Posthumous Organ Donation Card Registration in University Student

Masoudy, Gh.; Saeidinejad, F.; Ansari, H.; Izadirad, H.

doi:10.58209/hehp.13.4.703

Knowledge, Attitudes, and Predictors of Posthumous Organ Donation Card Registration in University Student

Authors

Gh. Masoudy ¹

F. Saeidinejad ²

H. Ansari ¹

H. Izadirad ¹

¹ Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

² Department of Biostatistics Epidemiology, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran

10.58209/hehp.13.4.703

Abstract

Aims: Donation after brain death serves as the most effective source of transplantable organs. However, Iran experiences a concerning disparity between potential and actual donors, with an alarming shortfall in conversion rates despite numerous annual brain death cases. This study aimed to evaluate knowledge, attitudes, experiences, and predictors of organ donor card registration among non-medical students in southeastern Iran.

Instrument & Methods: This cross-sectional study employing multi-stage random sampling was conducted from June 2022 to June 2023 at the University of Sistan and Baluchestan. Data collection utilized a validated questionnaire with strong content validity (content validity ratio>0.8, content validity ratio>0.62) and internal consistency (Cronbach’s alpha: 0.71 for knowledge, 0.70 for attitude). Analysis incorporated descriptive statistics and analytical methods, including logistic regression, with significance set at p<0.05.

Findings: Among 320 participants (mean age: 22.49±2.11 years), females predominated (53.4%). Most students pursued Bachelor’s degrees (90.6%) in Social Sciences (51.6%). Only 11.9% were registered donors. Knowledge levels were primarily moderate (53.1%), while attitudes were largely positive (96.6% moderate-to-good). The regression model (Nagelkerke R²=0.52) identified personal experiences as the sole significant registration predictor (odds ratio: 3.86, 95% confidence interval: 2.43-6.13, p<0.001).

Conclusion: Personal experience with organ donation is the main predictor of registering for a posthumous organ donation card among non-medical students, while knowledge and attitudes do not predict behavior, highlighting an intention–behavior gap.

Keywords

Knowledge

Attitude

Organ Donation

Students

Subjects

Social Determinants of Health

1- Alwahaibi N, Al Wahaibi A, Al Abri M. Knowledge and attitude about organ donation and transplantation among Omani university students. Front Public Health. 2023;11:1115531.

2- Kolagari S, Bayei J, Asoodeh V, Rajaee S, Mehbakhsh Z, Modanloo M. Knowledge and attitude of Iranian medical university students about organ donation and transplantation: A cross-sectional study. Ethiop J Health Sci. 2022;32(1):127-36.

3- Bayraktar N, Bayraktar Ü. A cross-sectional study of university students' awareness, knowledge, and attitudes on organ donation and transplantation in Northern Cyprus. Medicine. 2024;103(26):e38701.

4- Harish V, Ushasree, Chitra B. Blockchain-based management for organ donation and transplantation. INTI J. 2024;2024.

5- Carola V, Morale C, Vincenzo C, Cecchi V, Errico L, Nicolais G. Organ donation: Psychosocial factors of the decision-making process. Front Psychol. 2023;14:1111328.

6- Ahmed MM, Ibrahim RM, Younis NM. Nursing students' attitudes about organ donation in university of Mosul/Iraq. J Curr Med Res Opin. 2024;7(5):2430-7.

7- Etheredge HR. Assessing global organ donation policies: Opt-in vs opt-out. Risk Manag Healthc Policy. 2021;14:1985-98.

8- Almutairi S. Knowledge, attitude, and willingness towards organ donation among medical and health sciences students in central region, Saudi Arabia. Transpl Res Risk Manag. 2020;12:23-8.

9- Abbasi P, Yoosefi Lebni J, Nouri P, Ziapour A, Jalali A. The obstacles to organ donation following brain death in Iran: A qualitative study. BMC Med Ethics. 2020;21:83.

10- Stock PG, Nagral S, Rondeau E, Gawronska S, Groverman J, Barbari A, et al. Transplantation in the context of migration and refugees: A summary of the DICG and TTS Ethics Committee Workshop, Buenos Aires, Argentina, September 2022. Transplantation. 2024;108(7):1476-87.

11- Hawthorne WJ. Ethical and legislative advances in xenotransplantation for clinical translation: Focusing on cardiac, kidney and islet cell xenotransplantation. Front Immunol. 2024;15:1355609.

12- Latifi M, Rakhshanderou S, Najafizadeh K, Rocheleau CA, Ghaffari M. A theory-driven organ donation campaign: A field intervention among university students in Iran. Clin Transplant Res. 2024;38(2):90-7.

13- Naidoo JP, Kumar N, Dayaratna OC, Wijayapura AS, Hemachandra PDM, Aithal AP. Perception, knowledge, and attitude on organ donation among the medical and nonmedical students. Indian J Transplant. 2023;17(4):425-30.

14- Iniesta-Sepulveda M, Lopez-Navas AI, Gutierrez PR, Ramirez P, Rios A. The willingness to donate organs in medical students from an international perspective: A meta-analysis. Transpl Int. 2022;35:10446.

15- Chakradhar K, Doshi D, Reddy BS, Kulkarni S, Reddy MP, Reddy SS. Knowledge, attitude and practice regarding organ donation among Indian dental students. Int J Organ Transpl Med. 2016;7(1):28-35.

16- Yamin S, Alshahwan HF, AlSamhori JF, Alfreahat O, Alhalbouni A, Alwarawrah Z. Organ donation through the eyes of Jordanian medical students. Transplantology. 2024;5(3):208-15.

17- Mohebi S, Mohammadi Zavareh M, Sharifirad G, Gharlipour Z, Heidari H. Knowledge and attitude about organ donation among students of Qom University of Medical Sciences: A cross-sectional study. Iran J Forensic Med. 2017;23(1):53-61. [Persian]

18- Parsa P, Taheri M, Rezapur-Shahkolai F, Shirahmadi S. Attitudes of Iranian students about organ donation: A qualitative study. BMC Med Ethics. 2019;20(1):36.

19- Tavakoli Ghuchani H, Mohammadi Y, Tabei M. Comparison of knowledge and attitude of medical and nonmedical students regarding organ donation in Ferdows City during 2015-2016. J North Khorasan Univ Med Sci. 2017;9(3):305-10. [Persian]

20- Rezaei H, Jorvand R, Ghiasi N, Sayadi H, Abedzadeh Zavareh MS. The role of a theory-based educational intervention among youth in encouraging to register organ donation cards. Health Educ Health Promot. 2023;11(3):455-60.

21- Dibaba FK, Goro KK, Wolide AD, Fufa FG, Garedow AW, Tufa BE, et al. Knowledge, attitude and willingness to donate organ among medical students of Jimma University, Jimma Ethiopia: Cross-sectional study. BMC Public Health. 2020;20(1):799.

22- Lewis A, Koukoura A, Tsianos GI, Gargavanis AA, Nielsen AA, Vassiliadis E. Organ donation in the US and Europe: The supply vs demand imbalance. Transpl Rev. 2021;35(2):100585.

23- Olawade DB, Marinze S, Qureshi N, Weerasinghe K, Teke J. Transforming organ donation and transplantation: Strategies for increasing donor participation and system efficiency. Eur J Intern Med. 2025;133:14-24.

24- Symeou S, Avramidou E, Papalois V, Tsoulfas G. Global transplantation: Lessons from organ transplantation organizations worldwide. World J Transpl. 2025;15(1):99683.

25- Alaamri M, Hanbali NM, Alsulami WH, Almaabadi TS, Barashid MS, Alhofaian A, et al. Knowledge, attitudes, and barriers of organ donation in Jeddah City, Saudi Arabia: A cross-sectional study. Saudi J Kidney Dis Transpl. 2023;34(6):558-69.

26- Darlington D, Anitha FS, Joseph C. Study of knowledge, attitude, and practice of organ donation among medical students in a tertiary care centre in South India. Cureus. 2019;11(6).

27- Abdo N, Alnajjar Z, Alawneh Y, Tashtoush Z, Diab L, Salman R, Al-Khasawneh SM, Al Amer Z, Baker M. Knowledge about and Attitude toward Organ Donation and Brain Death among Medical Students in Jordan: A Crosssectional Study. JAPA Acad J. 2025;3(1):38-44.