Cognitive obstacles against organ donation: The influence of negative attitudes,norms, and traditional beliefs on Chinese people's intention to donate organs after death

In China, the organ supply is severely insufficient to cover all people on the waiting list for donated organs, and numerous patients die awaiting transplant. To achieve a better understanding of cadaveric organ donation in Chinese culture, this study examined 300 Chinese adults, in both Fujian Province and Macao, regarding attitudes towards organ donation, subjective norms about organ donation and traditional beliefs about the body and death, examining the influences of these factors on respondents' donation intentions. Multiple hierarchical regression results suggest that more negative attitudes, unfavourable norms and traditional beliefs lead to lower donation intentions. Copyright © 2010 John Wiley & Sons, Ltd.     

Discussion of posthumous organ donation in Chinese families

Since family permission is necessary for organ procurement to occur in China, family discussions about posthumous organ donation are crucial for increasing the actual organ donation and transplant rate. However, this study found that among 298 Chinese young adults, most of them (88%) were reluctant to talk about organ donation with their families. Based on the Theory of Reasoned Action, this study investigated communication within families about organ donation. Psychological factors included intention, attitude, subjective norm, death anxiety, and knowledge. As expected, the subjective norm was more powerful than attitude in explaining family discussions among Chinese people. Death anxiety, but not misconception, also significantly lowered the likelihood of family discussion. It is concluded that future campaigns for lessening death anxiety and promoting the social norm for organ donation must be conducted in Chinese societies, in order to encourage family discussions and improve the donation rate.     

College Students' Knowledge,Attitudes, and Behaviors Regarding Organ Donation: An Integrated Review of the Literature1

The current paper provides an integrated review of research literature on college students' knowledge, attitudes, and intentions regarding organ and tissue donation (OTD). Findings across 27 studies indicate that (a) students reported a lack of information and knowledge on OTD; (b) 23% reported signing an organ card or state organ donation registry; (c) positive attitudes were reported toward donation; (d) surveyed students indicated a willingness to become organ donors; and (e) 36% reported having conversations with family about OTD. Self‐efficacy and normative influence theory are recommended as promising theoretical approaches to studying OTD in college student samples.     

Real Donors, Real Consent: Testing the Theory of Reasoned Action on Organ Donor Consent

In an attempt to apply the theory of reasoned action (TRA) to the process underlying organ donor consent, participants completed questionnaires concerning their affective responses to organ donation, as well as their intentions to donate. Participants were given the opportunity to sign an organ donor card. Those who chose to sign the card had more positive attitudes about donation, perceived donation as something that their reference group would encourage, and had stronger intentions to consent to signing a card. The current investigation extends the organ donor literature by using a true behavioral outcome measure indicating consent. Moreover, the pattern of results between attitudes, norms, intention, and behavior illustrates the usefulness of applying the TRA to yet another health-related behavior.     

Knowledge and attitudes of Polish university students toward organ donation and transplantation

Although the number of patients needing organ transplantation systematically increases, recent years have seen a considerable shortage of donors. The level of knowledge and attitudes toward donation are critical factors in achieving the required balance between supply and demand. This pilot study assessed the knowledge, opinions, and behaviors related to organ donation and transplantation among 625 students representing eight different fields of study from the University of Rzeszow in south-eastern Poland. Although the participants provided evidence of knowledge about human organ donation and transplantation, they were aware of the main organs of the human body for potential transplants, and generally showed positive attitudes; only 24% of the subjects indicated their willingness to register as a donor; only 3% stated that they had already registered and had a donor card. The findings suggest that good intentions do not translate into action and that Poland needs to develop a nation-wide, up-to-date, and youth-oriented health education program that builds on favorable attitudes toward organ donation and transplantation.     

Similarities and Differences Between African Americans’ and European Americans’ Attitudes,Knowledge, and Willingness to Communicate About Organ Donation1

While little is known about African Americans’ attitudes and knowledge about organ donation, even less is known about how African Americans’ attitudes, values, and beliefs affect their behavior and behavioral intentions regarding organ donation; or how African Americans’ views are similar to or different from those of European Americans. Adults working 2 sites of a national corporation were randomly selected to complete a survey about organ donation willingness, intention to sign an organ donor card, knowledge and attitudes toward organ donation, and level of altruism. Results indicate that African Americans differ significantly from Whites on several individual attitude and knowledge items. However, the basic relationship between knowledge, attitudes, values, and behaviors regarding organ donation between the 2 groups appears the same. Furthermore, these results indicate that future organ donation promotion campaigns must focus on increasing basic knowledge and countering myths about organ donation for both populations.     

Parents' attitudes and expectations regarding science education: comparisons among American, Chinese-American, and Chinese families

This study examined the differences in attitudes toward science education among American, Chinese-American, and Chinese parents and students. Parents' expectations for their high school children's science performance were also compared among the three cultural groups. It was found that both Chinese parents and students had more positive attitudes toward science education than did their American counterparts. Chinese parents placed greater emphasis on self-improvement, set higher standards, and more often helped their children to learn science than did American parents. The attitudes of the Chinese-Americans appeared to show the influences of both their Chinese heritage and American culture. Overall, a high positive correlation was found between parents' and students' attitudes toward science education.     

Value Priorities and Organ Donation in Young Adults

This research identifies major personal values among American university students that predict organ-donation registration with the Department of Motor Vehicles. Participants responded to a factual test of their knowledge about organ donation, indicated whether or not they had registered as posthumous donors, and filled out a personality inventory measuring their personal values (Schwartz, 1992, 1994). The data indicated a high level of factual knowledge about organ donation; and the greater the level of knowledge, the more likely participants were registered to donate their organs. Also, participants higher in benevolence, universalism, achievement, and stimulation were more likely to have registered to donate their organs. The results are discussed in terms of the need to develop more effective health-communication campaigns by using specific health-education messages tailored to students majoring in different disciplines or to people in various occupations as a means of increasing their willingness to donate.     

The influence of confidence on associations among personal attitudes, perceived injunctive norms, and alcohol consumption

Social norms theories hold that perceptions of the degree of approval for a behavior have a strong influence on one's private attitudes and public behavior. In particular, being more approving of drinking and perceiving peers as more approving of drinking, are strongly associated with one's own drinking. However, previous research has not considered that students may vary considerably in the confidence in their estimates of peer approval and in the confidence in their estimates of their own approval of drinking. The present research was designed to evaluate confidence as a moderator of associations among perceived injunctive norms, own attitudes, and drinking. We expected perceived injunctive norms and own attitudes would be more strongly associated with drinking among students who felt more confident in their estimates of peer approval and own attitudes. We were also interested in whether this might differ by gender. Injunctive norms and self-reported alcohol consumption were measured in a sample of 708 college students. Findings from negative binomial regression analyses supported moderation hypotheses for confidence and perceived injunction norms but not for personal attitudes. Thus, perceived injunctive norms were more strongly associated with own drinking among students who felt more confident in their estimates of friends' approval of drinking. A three-way interaction further revealed that this was primarily true among women. Implications for norms and peer influence theories as well as interventions are discussed.     

Gender Differences in Family Communication About Organ Donation

In this study we investigated gender differences in willingness to donate organs and conversations with family members about organ donation. Results from a snowball sample of 353 men and 488 women (average age = 41–50) indicated that men are less willing to donate and less likely to have conversations about organ donation. When such conversations do occur, men are less likely to include within them topics of conversation that are associated with more positive responses from family members. Women are more likely to include a mention of their desire to donate organs, discussion of the need for organs, and an explanation of why they would/would not like to donate their organs. They are also more likely to mention moral/altruistic/religious reasons for donation or to tell/use a narrative in the discussion. Men, however, more commonly discussed whether signing a donation card would affect medical care. Women report higher agreed compliance from family members. Directions are provided for future research and campaign development by taking these differences into consideration.     

Close relationships between Asian American and European American college students

The authors examined attitudes and behaviors regarding close relationships between European and Asian Americans, with a particular emphasis on 5 major subgroups of Asian Americans (Chinese, Japanese, Korean, Vietnamese, and Filipino Americans). Participants were 218 Asian American college students and 171 European American college students attending a culturally diverse university. The European Americans did not differentiate among the various subgroups of Asian Americans. Their attitudes regarding close relationships were less positive toward Asian Americans than toward Mexican and African Americans, a finding contrary to the prediction of social exchange theory (H. Tajfel, 1975). In contrast to the European Americans' view of homogeneity among Asian Americans, the 5 major subgroups of Asian Americans expressed a distinctive hierarchy of social preference among themselves. Results are discussed in terms of their implications for future research on interethnic relations involving Asian Americans.     

The Relationship of Promotion Focus,Need for Cognitive Closure,and Categorical Accessibility in American and Hong Kong Chinese University Students

Categorical accessibility is a cognitive factor that limits the extent of creative conceptual expansion. In the present study, we sought to establish the categorical accessibility norms in five conceptual domains among American and Hong Kong Chinese university students. In addition, we predicted that the tendency to access normatively inaccessible exemplars in a conceptual domain is positively related to the motivation to maximize the likelihood of attaining positive outcomes (promotion focus) and negatively related to the need for cognitive closure. We obtained the predicted relationships among both American and Hong Kong Chinese university students. These findings were discussed in terms of their implications for promoting creativity across cultures.     

Organ donation and culture: a comparison of Asian American and European American beliefs, attitudes, and behaviors

The well-known gap between organ-donor supply and demand in the United States is particularly acute for Asian Americans. Lower participation in organ donation programs by Asian Americans has been hypothesized as one explanation for this observation. This study finds that, relative to European Americans, Asian Americans hold more negative attitudes toward and participate less frequently in a large, urban organ-donor program. The study also hypothesizes and tests possible reasons for subcultural differences in attitudes toward donation. Two cultural belief constructs hypothesized to more strongly predict Asian American attitudes and behaviors appear to impact both groups equally. Reasons for these results along with public policy implications and future research directions are discussed.     

American Muslim Physician Attitudes Toward Organ Donation

Religious beliefs and values impact Muslim patients' attitudes toward a variety of healthcare decisions, including organ donation. Muslim physician attitudes toward organ donation, however, are less well studied. Utilizing a national survey of physician members of the Islamic Medical Association of North America, relationships between religiosity, patterns of bioethics resource utilization, and sociodemographic characteristics with attitudes toward organ donation were assessed. Of 255 respondents, 251 answered the target question, “in your understanding, does Islamic bioethics and law permit organ donation?.” 177 respondents (70%) answered positively, 30 (12%) negatively, and 46 (18%) did not know. Despite the overwhelming majority of respondents believing organ donation to be permitted by Islamic bioethics and law, fewer than one-third (n = 72, 30%) are registered donors. Several sociodemographic features had a positive association with believing organ donation to be permitted: ethnic descent other than that of South Asian, having immigrated to the USA as an adult, and male sex. When using a logistic regression model controlling for these three variables as potential confounders, the best predictor of Muslim physicians believing organ donation to be permissible was utilization of an Imam as a bioethical resource (odds ratio 5.9, p = 0.02). Religiosity variables were not found to be associated with views on the Islamic permissibility of organ donation. While Muslim American physicians appear to believe there is religious support for organ donation, only a minority sign up to be donors. Greater study is needed to understand how physicians' attitudes regarding donation impact discussions between patients and physicians regarding the possibility of donating and of receiving a transplant.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

The role of affect in attitudes toward organ donation and donor-relevant decisions

We argue that affect plays a vital role in attitudes toward organ donation and that reluctance to become an organ donor is likely to be related to the experience of affective ambivalence. Assessing the affect associated with organ donation could help to predict donor-relevant decisions. Results of a confirmatory factor analysis on 464 students showed that affective evaluations can be distinguished both from cognitive evaluations and from overall evaluations. As expected, affective evaluations revealed ambivalence (using the ‘Griffin’ measure of ambivalence) toward organ donation, whereas the two other types of evaluations did not. Results of a follow-up study using logistic regression (n?=?85), showed that affective evaluations predicted donor-relevant decisions six months later. The present findings support the proposal to include separate affective evaluations in measures of attitudes to organ donation. More general implications for the measurement and structure of attitudes in health related domains are discussed.     

Different attitudes toward humor between Chinese and American students: evidence from the Implicit Association Test

Although cross-cultural research indicates that Chinese people demonstrate less humor than do Americans, little research addresses the reasons. This cross-cultural difference may be largely due to different implicit attitudes toward humor held by Chinese and Americans, deeply rooted in the two cultural traditions. Both self-report evaluation and the Implicit Association Test (IAT) were used to compare Chinese and American attitudes toward humor. Although 60 Chinese undergraduate students showed no significant difference from 33 American exchange students in explicit attitudes toward humor, the former associated humor more frequently with unpleasant adjectives and seriousness with pleasant adjectives on the IAT; the opposite pattern was found for the American group. This indicated a negative implicit attitude toward humor among the Chinese students.     

Effects of Refutational Messages,Thought Provocation,and Decision Deadlines on Signing to Donate Organs1

Across three experiments college students were given refutational messages or other treatments encouraging signing drivers' licenses to donate bodily organs in case of accidental death. An attitudinal measure (willingness to sign) predicted observed signing behavior, but relatively weakly. A measure of behavioral expectation to sign or not to sign predicted more strongly. A discussion with family was encouraged, the impact of that discussion also predicted signing but less strongly so. In Study 1 groups given a refutational message signed at no greater rates than a group given a control message. In Study 2 a refutational message group and a group asked to think about donating for 2 min signed at higher rates than a true control group. In Study 3 groups asked to decide whether or not to sign by a certain date and time signed at a higher rate than a refutational message group as in earlier studies. These procedures are recommended for organ donation signing campaigns.     

Close Relationships Between Asian American and European American College Students

Abstract

The authors examined attitudes and behaviors regarding close relationships between European and Asian Americans, with a particular emphasis on 5 major subgroups of Asian Americans (Chinese, Japanese, Korean, Vietnamese, and Filipino Americans). Participants were 218 Asian American college students and 171 European American college students attending a culturally diverse university. The European Americans did not differentiate among the various subgroups of Asian Americans. Their attitudes regarding close relationships were less positive toward Asian Americans than toward Mexican and African Americans, a finding contrary to the prediction of social exchange theory (H. Tajfel, 1975). In contrast to the European Americans' view of homogeneity among Asian Americans, the 5 major subgroups of Asian Americans expressed a distinctive hierarchy of social preference among themselves. Results are discussed in terms of their implications for future research on interethnic relations involving Asian Americans.