Publication: Gestión de la información, conocimiento y actitud hacia la donación y el trasplante de órganos en la tercera edad del sureste de España
Authors
Arias Cánovas, José Alfonso
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Escuela Internacional de Doctorado
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Febrero Sánchez, Beatriz ; Almela Baeza, Javier
Publisher
Universidad de Murcia
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DOI
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info:eu-repo/semantics/doctoralThesis
Description
Abstract
Introducción. El envejecimiento poblacional está modificando de forma progresiva el perfil del donante y del receptor, situando a las personas mayores como un colectivo estratégico para el sostenimiento del sistema trasplantador. En España, este cambio se refleja en el envejecimiento del donante fallecido: en 2024, el 63% de los donantes fueron personas de 65 años o más. Objetivo. Analizar la actitud ante la donación de órganos propios tras el fallecimiento en personas de 65 años o más residentes en la Región de Murcia y explorar los factores asociados, con especial atención al conocimiento y a la gestión de la información sobre donación y trasplante de órganos (DTO). Metodología. Se llevó a cabo un estudio observacional transversal con enfoque analítico mediante un cuestionario estructurado orientado a evaluar la actitud, el conocimiento y la gestión de la información vinculada a la DTO (canales de información y exposición/interés por actividades informativas), junto con variables de interacción social y variables relacionadas con la aceptación de intervenciones post mortem. Se realizaron análisis descriptivos y bivariantes y, posteriormente, un modelo multivariante de regresión logística binaria, expresando la asociación mediante OR e IC95%.Resultados. La muestra analizada (n=351) mostró una actitud favorable a donar en el 53% de los casos, un 25% de rechazo y un 22% de indecisión. Entre quienes aceptaban donar, la motivación predominante fue la solidaridad (96%), seguida de la reciprocidad (58%), la obligación moral (13%) y las razones religiosas (9%). Entre quienes rechazaban la donación, los motivos más frecuentes fueron el temor a una "muerte aparente" (37%), el rechazo a la mutilación corporal tras el fallecimiento (24%) y la creencia de que la edad avanzada invalida al donante (23%). En relación con la gestión de la información, las fuentes más citadas fueron televisión (82%), películas/cine (35%), radio (30%), prensa (26%), familia (26%) y amigos (17%), mientras que revistas/libros/folletos (7%), internet (5%), redes sociales (4%), sanitarios o médicos (3%), charlas en centros (1%) y vallas o carteleras (1%) tuvieron un peso minoritario. Además, la mayoría refirió no haber recibido charlas informativas sobre DTO (95%) y solo un 23% manifestó interés en recibirlas. En el análisis multivariante, se mantuvieron como predictores independientes de actitud favorable: haber hablado sobre DTO con amistades (OR=2,223; IC95%: 1,15-4,298; p=0,017), la aceptación de la cremación (OR=2,508; IC95%: 1,433-4,392; p=0,001) y la aceptación de la autopsia post mortem (OR=2,578; IC95%: 1,540-4,318; p<0,001).Conclusiones. En el marco del envejecimiento poblacional, la actitud hacia la donación en la tercera edad se caracteriza por una aceptación moderada y un volumen relevante de indecisión. La gestión de la información emerge como un eje prioritario, al predominar canales generalistas y redes informales y mantenerse una presencia limitada de fuentes sanitarias y de actividades formativas estructuradas. Los resultados multivariantes subrayan, además, la relevancia del diálogo social y de las actitudes hacia intervenciones post mortem como elementos asociados de forma independiente a una predisposición favorable en este grupo etario.
Introduction. Population ageing is gradually changing the profile of donors and recipients, making older people a strategic group for the sustainability of the transplant system. In Spain, this change is reflected in the ageing of deceased donors: in 2024, 63% of donors were aged 65 or over. Objective. To analyse the attitude towards organ donation after death in people aged 65 and over residing in the Region of Murcia and to explore the associated factors, with special attention to knowledge and management of information on organ donation and transplantation (ODT). Methodology. A cross-sectional observational study with an analytical approach was conducted using a structured questionnaire designed to assess attitudes, knowledge and management of information related to DTO (information channels and exposure/interest in informational activities), together with social interaction variables and variables related to the acceptance of post-mortem interventions. Descriptive and bivariate analyses were performed, followed by a multivariate binary logistic regression model, expressing the association using OR and 95% CI.Results. The sample analysed (n=351) showed a favourable attitude towards donating in 53% of cases, 25% rejection and 22% indecision. Among those who agreed to donate, the predominant motivation was solidarity (96%), followed by reciprocity (58%), moral obligation (13%), and religious reasons (9%). Among those who rejected donation, the most frequent reasons were fear of 'apparent death' (37%), rejection of bodily mutilation after death (24%), and the belief that advanced age invalidates the donor (23%). In terms of information sources, the most frequently cited were television (82%), films/cinema (35%), radio (30%), newspapers (26%), family (26%) and friends (17%), while magazines/books/brochures (7%), the internet (5%), social media (4%), healthcare professionals or doctors (3%), talks at centres (1%) and billboards or posters (1%) were less important. In addition, the majority reported not having received informative talks on DTO (95%) and only 23% expressed interest in receiving them. In the multivariate analysis, the following remained independent predictors of a favourable attitude: having discussed DTO with friends (OR=2.223; 95% CI: 1.15-4.298; p=0.017), acceptance of cremation (OR=2.508; 95% CI: 1.433-4.392; p=0.001) and acceptance of post-mortem autopsy (OR=2.578; 95% CI: 1.540-4.318; p<0.001).Conclusions. In the context of an ageing population, attitudes towards donation among the elderly are characterised by moderate acceptance and a significant degree of indecision. Information management emerges as a priority, with generalist channels and informal networks predominating and a limited presence of health sources and structured training activities. The multivariate results also highlight the importance of social dialogue and attitudes towards post-mortem interventions as factors independently associated with a favourable predisposition in this age group
Introduction. Population ageing is gradually changing the profile of donors and recipients, making older people a strategic group for the sustainability of the transplant system. In Spain, this change is reflected in the ageing of deceased donors: in 2024, 63% of donors were aged 65 or over. Objective. To analyse the attitude towards organ donation after death in people aged 65 and over residing in the Region of Murcia and to explore the associated factors, with special attention to knowledge and management of information on organ donation and transplantation (ODT). Methodology. A cross-sectional observational study with an analytical approach was conducted using a structured questionnaire designed to assess attitudes, knowledge and management of information related to DTO (information channels and exposure/interest in informational activities), together with social interaction variables and variables related to the acceptance of post-mortem interventions. Descriptive and bivariate analyses were performed, followed by a multivariate binary logistic regression model, expressing the association using OR and 95% CI.Results. The sample analysed (n=351) showed a favourable attitude towards donating in 53% of cases, 25% rejection and 22% indecision. Among those who agreed to donate, the predominant motivation was solidarity (96%), followed by reciprocity (58%), moral obligation (13%), and religious reasons (9%). Among those who rejected donation, the most frequent reasons were fear of 'apparent death' (37%), rejection of bodily mutilation after death (24%), and the belief that advanced age invalidates the donor (23%). In terms of information sources, the most frequently cited were television (82%), films/cinema (35%), radio (30%), newspapers (26%), family (26%) and friends (17%), while magazines/books/brochures (7%), the internet (5%), social media (4%), healthcare professionals or doctors (3%), talks at centres (1%) and billboards or posters (1%) were less important. In addition, the majority reported not having received informative talks on DTO (95%) and only 23% expressed interest in receiving them. In the multivariate analysis, the following remained independent predictors of a favourable attitude: having discussed DTO with friends (OR=2.223; 95% CI: 1.15-4.298; p=0.017), acceptance of cremation (OR=2.508; 95% CI: 1.433-4.392; p=0.001) and acceptance of post-mortem autopsy (OR=2.578; 95% CI: 1.540-4.318; p<0.001).Conclusions. In the context of an ageing population, attitudes towards donation among the elderly are characterised by moderate acceptance and a significant degree of indecision. Information management emerges as a priority, with generalist channels and informal networks predominating and a limited presence of health sources and structured training activities. The multivariate results also highlight the importance of social dialogue and attitudes towards post-mortem interventions as factors independently associated with a favourable predisposition in this age group
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