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Body and Organ Donation: Perception among Medical Students and Medical Health Professionals in a Tertiary Care Centre |
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Maitreyee Kar, Dipankar Bhaumik, Chinmaya Kar 1. Associate Professor, Department of Anatomy, North Bengal Medical College and Hospital, Siliguri, West Bengal, India. 2. Assistant Professor, Department of Anatomy, North Bengal Medical College and Hospital, Siliguri, West Bengal, India. 3. Medical Officer, Department of Regional Blood Transfusion Centre, North Bengal Medical College, Siliguri, West Bengal, India. |
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Correspondence Address : Dr. Maitreyee Kar, C/o Dr. C Kar, Alphonsa School Road, Kalamjote, Sushrut Nagar, District Darjeeling-734012, Siliguri, West Bengal, India. E-mail: drmkar0@gmail.com |
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ABSTRACT | ||||||||||||||||||||||||||||||||||||||||||||||||||
: Introduction: Cadaver is a very important teaching tool in anatomy not only for development of basic knowledge but also for development of psychomotor skill by dissection. Voluntary body donation is the major source of cadaver in India now. Organ donation is the last avenue for end stage of organ failure. Therefore, body and organ donation is not only the gracious act but also need of the hour. As the medical students and medical health professionals are intimately related to the destiny of organ and body donation they should play vital role in the body and organ donation. Aim: This study aimed to explore the knowledge and attitude of medical students and medical health professionals regarding body and organ donation in a tertiary care centre in India. Materials and Methods: After obtaining permission from institutional ethics committee 1st year MBBS students and various groups of health professionals (junior doctors, senior doctors, nursing staff and medical technicians) were approached. The questionnaires were analysed qualitatively. Results: Among 227 participants 181 (79.73%) were willing to donate their organ and /or body. All nursing staff (100%), 86.74% senior doctors, 82.66% junior doctors, 70% medical technicians and 63.76% 1st year MBBS students expressed positivity towards the practice. But none filled up pledge form. Conclusion: The medical students and medical health professionals are potential donors. So, they must be approached for pledge form (for voluntary organ and body donation) submission. The medical students should be motivated for body and organ donation from the very beginning. | ||||||||||||||||||||||||||||||||||||||||||||||||||
Keywords : Attitude, Body bequest program, Cadaver, Co-donation, Willingness | ||||||||||||||||||||||||||||||||||||||||||||||||||
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DOI and Others :
DOI: 10.7860/IJARS/2017/30369:2335
FINANCIAL OR OTHER COMPETING INTERESTS: None. Date of Online Ahead of Print: Sep 12, 2017 Date of Publishing: Oct 01, 2017 |
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INTRODUCTION | ||||||||||||||||||||||||||||||||||||||||||||||||||
Study of anatomy is very important in medical profession and availability of cadaver plays very crucial role in teaching to develop basic knowledge and perception of anatomy. Though imaging techniques and simulations including computerised simulations of the body are also available but they have their own advantages and disadvantages (1). So, cadaver study is playing its pivotal role in Anatomy teaching despite of existence of many alternatives (2).There is shortage of cadaver supply in different Medical institutes of India. Moreover, the condition is becoming worse with gradually increasing number of medical colleges (3).“Historically, there were five ways of acquiring cadavers to enrich the learning of anatomy: illegal grave digging, unwilled claimed cadavers, purchased cadavers, unclaimed cadavers and donated cadavers (other Keywords: Attitude, Body bequest program, Cadaver, Co-donation, Willingness synonyms are anatomical donation, body donation and body bequest)”(4). At present, the medical colleges rely on last four means. Among them for dissection purpose voluntary donation of cadaver is a valuable source of cadaver procurement. Not only that donation of various organs for transplantation purpose is also another noble step which is directly related to patients’ benefit. Organ transplantation is the most preferred treatment modality for end-stage organ disease and organ failures. Each year large number of patients wait for organs to be donated for transplantation (5). So, it is the need of the hour that more and more number of people should be motivated to donate bodies and organs through various approaches. In this context the present study was done to explore the knowledge, attitude and practice of the medical students and medical health professionals regarding body and organ donation in a tertiary care centre of India. Objectives To determine knowledge and attitude of the medical students and medical health professionals for body and organ donation. To determine the facilitating or inhibitory factors for body and organ donation among them. | ||||||||||||||||||||||||||||||||||||||||||||||||||
Material and Methods | ||||||||||||||||||||||||||||||||||||||||||||||||||
This cross-sectional study was conducted at a tertiary health care centre of North Bengal between January to May 2017. After attaining permission from IEC, the questionnaire was self -prepared. There were two open ended questions and six close ended questions (Table/Fig 1). Seven experts participated to validate the questionnaire. A pilot study was also conducted to pre-test it. 1st year MBBS students, junior doctors, senior doctors, nursing staff and technicians were approached. Inclusion Criteria 1. Those who filled up the questionnaire completely 2. Those who gave informed consent 3. Medical health professionals and 1st year MBBS students of both genders 4. Subjects irrespective of their geographical, social, economic and religious status. Exclusion Criteria 1. Those who did not fill up the questionnaire. 2. Those who did not give informed consent. In all 238 people gave informed consent to participate in this study. Among them 11 questionnaires were incomplete. By method of complete enumeration and after discarding the persons who fulfilled exclusion criteria 227 participants were finally included as study sample. The filled-up questionnaires were analysed qualitatively and calculation was done accordingly. | ||||||||||||||||||||||||||||||||||||||||||||||||||
Results | ||||||||||||||||||||||||||||||||||||||||||||||||||
Among 227 participants 69 were 1st year MBBS students,75 were interns just after passing final year MBBS Examination, 38 were senior doctors, 35 were nursing staff and 10 were medical technicians (Table/Fig 2). Among 227 participants 124 were male and 103 were female. 105 (84.67%) males and 76 (73.78%) females were willing to donate organ and/or body (Table/Fig 3). Out of 227 participants 181 (79.73%) were willing to donate organ and/or body. 100% nursing staff, 86.84% senior doctors, 82.66% interns, 70% technicians and 63.76% 1st year students were willing to donate organ and/or body. (Table/Fig 4). To analyse the reason of willingness it was reflected that 27.02% wanted to do it for the sake of medical education purely. Total 75.13% participants wanted to serve the mankind by helping others. The reason of willingness was not specific in 12.7% participants (Table/Fig 5). Among 46 participants who were non-willing for organ and/or body donation only 12 (26.08%) expressed that obstacle was at family level. Ten (21.73%) informed that unwillingness was due to religious ground. One 1st year student informed that the age was too early to decide about donation of cadaver and/ or organ (Table/Fig 6). Among the willing participants while analysing the source of motivation it was revealed that medical persons inspired them for voluntary donation of organ and/or cadaver in 74(40.88%). In 42(23.20%) willing participants media played very important role to motivate them and sufferings of family members was the sole reason for willingness among 34(18.78%) cases (Table/Fig 7). No participants filled up the pledge form for voluntary body or organ donation. | ||||||||||||||||||||||||||||||||||||||||||||||||||
Discussion | ||||||||||||||||||||||||||||||||||||||||||||||||||
The importance of organ or body donation is the need of time. For anatomy teaching the availability of cadavers cannot be denied despite different modern tools (1).The condition is getting worse in India with gradual increase of number of medical colleges. The medical colleges must depend on the body donation as source of cadavers. Therefore, motivation of the people for body donation play very important role in anatomy teaching. Organ transplantation is the last option in end stage organ failure. Particularly the medical health professionals should lead the society in this regard and they should be forerunner regarding organ and body donation. There are various studies across the world regarding the attitude of general populations, University students, engineering students and even anatomists and MBBS students. But on literature search, no such study amongst the medical health professionals who are intimately involved in body and organ donation was found out except one in Denmark that was conducted among ICU staff (6). Spain showed highest rate of body donation (7). The distribution of willing participants of the present study has been compared to the previous studies in (Table/Fig 8) (2),(6),(7),(8),(9),(10),(11),(12),(14). The higher percentage of willing population revealed in the present study can be contributed to the proximity of the target population to the recipient or beneficiary of the organ and body donation. Among the males, the percentage of willing participants were higher (84.67%) compared to the willing participants among females (73.78%) (Table/Fig 3). This finding was corroborative with another Indian study (14). But one interesting finding was that 100% nursing staff expressed positive responses towards body and/or body donation and all the nursing staff were female (Table/Fig 4). So, they are the potential donor and must be addressed for conversion of their willingness into the actual act of pledge form submission. This finding was corroborative to the finding of another study which found out that if a person had been engaged in a female-gendered occupation, he or she was more likely to co-register (14). Body co-donation can be used as one policy to increase organ and body donation. Comparatively, lower percentage of willing population among the 1st year MBBS students compared to the other groups in this study brings into focus that the 1st year students must be taught the importance of cadaver in Anatomy teaching from the inception of the dissection class. Anatomists and medical students should practise dissection in a professional manner. The first classroom session in anatomy should be focused on the humanities to express gratitude to body donors for their contribution. An educational plan should be formulated such that the first class in anatomy begin with a thanksgiving ceremony for donors, as well as a moment of silence as followed in Nanjing Medical University at China (15). This will inspire the 1st year MBBS students to show the proper respect for donors, as well as to comfort donors’ relatives. Special care should be taken to ensure the responsible and respectful treatment of donors’ bodies in the daily activities of the dissection lab. Not only paying respect to the human anatomical gift i.e., cadaver, proper care to cadavers, limited access to laboratory, following safety measures at dissection hall and preservation of tissues and organs are other ethical ways in cadaver dissection by the medical students in medical colleges (16). To analyse the cause of motivation it was found that 136 (75.13%) were willing to donate body and /or organ to serve the mankind and to help others, 49(27.07%) were willing for improvement of medical education and 16(08.88%) willing participants did not mention any specific reason. Among the participants who were non-willing, most of them did not reveal the cause of not donating body and /or organ. Only 12 persons informed that family background was the obstacle and 10 persons showed that religious cause was obstacle for body and/or organ donation. In this respect, there is an interesting conclusion of a study which revealed that organ transplantation has an acceptable therapeutic value from viewpoint of certain religion too provided some criteria are fulfilled (17). On further scrutiny among the willing participants it was found that for 74(40.88%) participants’ medical persons, themselves were the source of motivation or willingness. 42(23.20%) willing persons demanded that print or electronic media played important role behind their motivation for body and /or organ donation. Sufferings of the family members were the main reason for willingness in 34(18.78%) cases. Campaigning of voluntary organisations was the reason of willingness in 17(09.39%) participants. Another important point which was revealed that despite of 79.73% willing participants none filled up the pledge form. So, it was very evident that there was wide gap between ideal situation and actual behaviour of the participants. Therefore, this gap must be bridged for effective voluntary body and /or organ bequest program. LIMITATION This study could not take into consideration of the knowledge and attitude of general population. After implementation of recommended policies like body or organ co-donation, initiation of the class of 1st year with thanks giving ceremony, practising dissection in professional manner etc., the knowledge and attitude of the same population should be assessed. | ||||||||||||||||||||||||||||||||||||||||||||||||||
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Original article / research
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