The knowledge, attitudes and perceptions of organ procurement and donation among medical doctors in critical care settings in academic hospitals in Johannesburg, South Africa

Abstract

Background: Statistics for the Johannesburg region demonstrate a low level of cadaveric organ donation within the public health care sector. The reasons for this are not clear. Information gathered in a previous study suggest that urban dwelling South Africans have a good attitude towards donation. It was hypothesized that knowledge, attitudes and perceptions of organ donation within the medical community may be contributing to this, and thus may be identified as a potential target for future intervention in order to effect an increase in donation rates. Methods: A self-administered questionnaire was completed by 105 of a total population of 190 doctors working in critical care, trauma, and accident and emergency departments in three academic hospitals in Johannesburg, South Africa. This cross sectional descriptive survey aimed to determine attitudes, knowledge and perceptions of doctors working in these settings towards organ donation and donor recruitment. Results: 65/105 (61.9%) of respondents had a positive attitude towards donation. This was reflected in their own willingness to donate organs after brain death (95% CI: 51.9-71.2%). The majority (65.7%) were unaware of the presence of protocols for organ donor identification and referrall. Only 46.7% of the respondents knew who to contact from an organ procurement organisation, once a donor is identified. Of the total respondents, 39% had ever managed a donor or contacted the transplant co-ordination team, and 39% knew the criteria for brain death.There was a significant association between a positive answer in the

questions relating to experience questions and actual knowledge of the criteria for brain death. 90/105 (85.7%) agreed that organ donation could assist the family of the donor with the grieving process. The presence of an organ procurement team was felt to be the best option for improving organ donation rates. Conclusion: Doctors in critical care settings demonstrate similar levels of positive attitude towards donation as urban dwelling laypersons. Potential areas of intervention to improve donation rates include clearly defined protocols for donor identification and management, education regarding brain death criteria, and external support for family counselling.