PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
Mr.ARUN JOSE
FIRST YEAR MSc (NURSING)
MEDICAL SURGICAL NURSING
YEAR 2009-2011
PADMASHREE COLLEGE OF NURSING
GURUKRUPA LAYOUT, NAGARBHAVI
BANGALORE – 560 072
0
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
1.
NAME OF THE
Mr. ARUN JOSE
CANDIDATE AND
I YEAR MSc NURSING,
ADDRESS
PADMASHREE COLLEGE OF
NURSING,
NAGARBHAVI,
BANGALORE-560 072.
2.
3.
4.
NAME OF THE
Padmashree College of Nursing,
INSTITUTION
Bangalore.
COURSE OF THE STUDY
I year MSc Nursing,
AND SUBJECT
Medical Surgical Nursing.
DATE OF ADMISSION TO
10- 6 – 2009
THE COURSE
5.
A Study to Assess the Knowledge and
TITLE OF THE STUDY
Attitude of Adults Regarding Common
Misconceptions Involved in Organ
Donation at Selected Urban Community,
Bangalore, With a View to Develop a
Pamphlet.
1
6. BRIEF RESUME OF INTENDED WORK
6.1 INTRODUCTION
"What you leave behind is not what is engraved in stone monuments, but what
is woven into the lives of others."
--Pericles
For all those who are born, there is one event which is certain and inevitable
and that is death. Yet we all live as if we are immortal. When faced with death in the
family or in the course of professional work we are completely unprepared and rudely
shocked out of our illusions. As nurses have been trained to preserve life at all cost
and when any of our patients die we feel defeated but death may sometimes be an
outcome of disease and we all need to have better coping skills to face this reality. The
fact is that death is a natural phenomenon but it is nurse’s responsibility to help others
in sustaining their life1.
Life is a precious one. Various systems in the body are functioning at their
expected level to sustain the life. For the function of each system its main functional
unit, which is organs should function properly. So as a human being it is our prime
responsibility to help peoples who are suffering from problems related to organs in
order to improve or sustain the life. Organ donation is one of the best way by which
people can help others in their life. The process or act by which a person donates
organ for the improvement or saving the life of others is called organ donation. The
person who gives the organ is called the donor while the one who receives is called the
recipient. Organ transplant is done to replace the recipient’s damaged organ with the
working organ of the donor so that the recipient could function normally.
Organ Donation is a boon to medical industry as it has helped in saving the
lives of those who would have died otherwise. There is a great need for human organs
for transplantation. In fact, the need far exceeds the supply of transplantable organs.
Legally, organ donation can take place from living, genetically-related individuals;
from living, unrelated individuals in special circumstances where no unauthorized
payment is made to the donor; or from cadavers. Live donation of a single kidney was
2
the first done in 1954, but live donation of parts of other organs is a relatively recent
innovation in the 1990s.
Worldwide, the demand for organs is growing, as the supply of organs and
tissues for transplantation has not kept pace with demand. In the UK only
approximately 900 individuals become organ donors each year, while over 6000
people are waiting for suitable organs. In the US much the same situation exists, with
70 000 presently on the waiting list and only approximately 5500 cadaveric donors per
year. There are several reasons for the shortage of organs. Perhaps the most common
reason is that people are hesitant to donate organs because they don’t have adequate
knowledge regarding it. In other cases peoples don’t wishes to donate his or her
organs may be due to the false beliefs surrounding organ donation2.
A brief examination of what has been achieved in the last 12 years in India is
as follows,
•
The 1300 cadaver organ transplants have shown that in India are capable of
organizing the chain of events that lead to cadaver transplants.
•
The brain death certification is now widely accepted by clinicians and the
protocols to certify it have been uniformly accepted as laid down by the government.
•
It is possible to not only do kidneys transplants but Indian doctors are skilled
enough to do complex transplants such as liver, heart, lungs and pancreas transplants3.
The two-day symposium on ‘Promotion of Deceased Organ Donation’
conducted at Chandigarh with nearly 200 delegates from all over the country
providing their inputs on spreading awareness on cadaver donation.
In that Life America Chairperson Mrs. Sara Pace Jones said that the number of
people awaiting organ transplants has climbed to more than 100,000 and an average of
18 people die each day waiting for available organs. It is more important than ever for
those who support donation to legally document those wishes. 23 percent people
believe that they don't qualify as donor because of health conditions or age factor. 50
percent people have the misconception that doctors will not try hard if they know of
patient's wish to be an organ donor. This reveals that lake of knowledge is the main
triggering factor which reduces the organ donation4.
3
The following statistics will give a clear cut idea about the need or the demand
of the organ while considering awareness is an effective measure to solve the problem
to a great extend. Approximately 50,000 individuals require cornea of eye. Over 1 lakh
nationwide suffer from renal failure. More than 2.5 lakh die of liver disease annually.
Living donors satisfy only a fraction of the demand. In India only 524 renal, 40 liver
and 30 heart transplants have been performed from cadaver sources. Every year,
almost two lakh people in India need kidney transplants and there are only 4,000
people donating them5.
Many other countries, including e.g. Austria, Belgium, and Singapore, have
introduced ‘opt-out’ or ‘presumed consent’ systems that assume individuals have
granted permission for their organs to be donated, unless they specify otherwise, in
advance of their death. ‘Required request’ or routine enquiry of the next-of-kin of a
potential donor, forms part of state law in the US. It provides for hospitals that fail to
adopt ‘required request’ polices to be denied support from healthcare funding
agencies. WHO has now approved organ donation as a well established therapy’. In
1976 the Royal College of the UK published a comprehensive code for determination
of 'Brain Death'. Now most countries, including India in 1994, redefine death as
cessation of brain stem activity and organs can legally be removed after brain death6.
The Zonal Coordination Committee of Karnataka for Transplantation
(ZCCK) was formed in 2005 to encourage cadaver organ donation. But the state's first
donor came forward only in 2007 and until now Karnataka has had only 12 cadaver
donors who have saved 33 lives. Among those donation 8 was from the urban area and
4 was from rural area. The cadaver organ donation programme is active only in five
states Tamil Nadu, Andhra Pradesh, Gujarat, Maharashtra and Karnataka. With the
centre now proposing to amend rules on organ transplantation, Karnataka will perhaps
be the biggest beneficiary. Of the 33 hospitals licensed to conduct organ transplants,
23 are in Bangalore and less than five hospitals have permission to transplant all
organs. Other states are way ahead of Karnataka. The Multi-Organ Harvesting Aid
Network Foundation in Tamil Nadu and Andhra Pradesh has had more than 200
cadaver donors, saving more than 400 lives. The main reason for the organ shortage in
Karnataka is just because of the misconceptions and lake of knowledge regarding
organ donation.
4
In the past 14 years, more than 1,000 cadaver organ transplantations have
taken place; the majority are kidney and 50% from Tamil Nadu. In Gujarat, the Indian
Renal Foundation campaigning for cadaver organ transplantation has had around 40
donors saving over 70 lives. While the waiting list for some organs like kidneys is
more than 10 years, there is an increasing demand for liver, eyes, heart and pancreas.
The positive attitude towards organ donation will reduce the organ shortage; this can
be achieved by education and motivation7.
The overall health allocation in Indian budget is one of the lowest in
developing countries. There is scope for an increase in health funding. Resources for
advanced medicine need not be provided at the cost of primary care if the state ensures
a proper balance. Thousands with end stage disease can be provided a new lease of life
through cadaveric transplant programs. Hitherto, only the very rich benefited from
donation- of organs by travelling abroad and spending large sums. We should make
organ transplants affordable by the average citizen in our public institutions8.
There is lack of direction, lack of will, lack of motivation from the part of
people regarding organ donation. There has been a lack of initiative from the
Government after the Organ transplantation Act was passed. So there is a great need
for education and motivation both from the part of peoples as well as government
since main reason for organ shortage is just because of improper or incomplete
knowledge of people in donating their organ.
5
6.2 NEED FOR THE STUDY
Modern medical science has achieved what seemed impossible some years
back. Transplantation is one of the most spectacular endeavors till date. Medical
advances have contributed tremendously to its success ratio and have led to a
significant increase in the number of transplants being performed. Around 50,000 such
transplants are performed annually around the world. The management of end-stage
disease of various organs like kidney, liver and heart has thus undergone a paradigm
shift. Transplantation is no more an experiment but established standard therapy by
World Health Organization9
Organ donation will help the peoples, but the main path hinder in the way of
organ donation is myths which surrounding it. From the realms of mythology donation
of organs from one human being to another has always been written about, talked
about and debated about - intensely. But, what is happening in the world of organ
donation and transplantation today? A patient with kidney failure can at least live with
dialysis till an organ becomes available but for a patient with liver or heart failure; the
only hope of living maybe to have an immediate transplant. Are we doing enough to
help these critically ill patients whose number is constantly on the increase? What is
the current status of different transplants in India? Questions will flow like a river, and
then also there is another question that ‘is all those questions can be solved?’
An example or the importance of knowledge regarding organ donation is, when
sixty-year-old Suresh Deshpande decided he would like to donate his organs for
transplant after his death, he was confused about the procedure he would have to
follow. Many people who are considering cadaver organ donation may have found
themselves in a similar predicament. It is vital to understand the concepts of cadaver
donation and brain death. If the healthy organ of a person who has been certified as
brain dead is transplanted into a patient’s body within a specific window of time, the
transplant can provide the patient of end stage organ disease the precious gift of life.
According to the Transplantation of Human Organs Act, 1994, a patient is certified as
brain dead only after stringent tests by a team of accredited specialists10.
Cadaver organ donation can save the lives of thousands of patients in the
country who are waiting for organ transplants. While live donors are the main source
of organ donation in India, the percentage of cadaver organ donation is a meagre 0.05
6
per million populations. In Pune, only 45 cadaveric kidneys have been transplanted
since 1997. Currently, there are around 130 wait-listed patients on the central waiting
list. In various surveys conducted, it has been seen that 72% of the population were
willing to donate eyes, but less than 50% were willing to consider solid organ
donation. 74% of Hindus, 72% Christians, 58% Muslims were willing to consider
organ donation; however the concept of brain death was new to most of the people
surveyed. An audit of 159 brain death patients showed that 19% of the relatives
donated the organs of their loved ones and relatives to help others11.
Low public awareness levels and the lack of coordination between medical
professionals and social workers are responsible for the low response to cadaver organ
donation. The shortage of organs has been due to the reluctance of many family
members to donate due to fear of the surgery causing loss to their health, smaller
nuclear families with unmatchable donors and a deceased donor programme that is
still to evolve fully. This shortage has resulted in an organ trade
Though the first cadaver organ transplant was conducted nearly five years ago
in Karnataka, such donations still remain a sporadic event in the state. Even cricketer
Anil Kumble's decision to pledge his organs to society in case of brain death has not
motivated the programme. Among the prime reasons for the programme being unable
to find its feet are cultural beliefs, the related lack of knowledge regarding cadaver
donations and the myths surrounding it 12
The need for organ is growing at a high rate and the bad luck is that we are not
able to meet the need, this is just because of the misconceptions and lack of knowledge
regarding organ donation. There are over 1.5 lakh people in need of kidneys in the
country, over one lakh need liver and nearly 50,000 need heart transplant. Yet, there
are only about 60 cadaver transplants that take place in the country annually13.
An inadequate number of available kidneys remain the greatest limitation to
treating patients with end-stage renal disease successfully. For those interested in
donating a kidney, the National Kidney Foundation provides written information
describing the organ donation program and a card specifying the organs to be donated
in the event of death14.
7
From the above data it is clear that shortage of organ is a great threat to the
medical field. There are persons who wish to donate their organ but the preventing
factors are their misconceptions, lake of knowledge and false beliefs prevailing in their
community. The researchers own personal experience while working in the clinical
setting in which he has seen patients with ESRD waiting for a donor and many a
times they die waiting for the donor. All these prompted the researcher to select the
present study about common misconceptions involved in organ donation.
6.3 STATEMENT OF THE PROBLEM
A study to assess the knowledge and attitude of adults regarding
common misconceptions involved in organ donation at selected urban community,
Bangalore, with a view to develop a pamphlet
6.4 OBJECTIVES
1. To assess the existing knowledge regarding organ donation among adults
2. To assess the attitude regarding organ donation among adults
3. To correlate knowledge with attitude regarding organ donation among adults
4. To associate knowledge and attitude of adults regarding organ donation with
their selected demographic variables
6.5 OPERATIONAL DEFINITION
1. Knowledge – Awareness and understanding about general information on
organ donation such as types, benefits and risks, religious issues, associated
complication, misuse of organ, legal problems involved in organ donation
2. Attitude- Opinion, beliefs or feelings of adults regarding types ,benefits and
risks, religious issues, associated complication, misuse of organ, legal
problems involved in organ donation
3. Adults- An individual between age group of 20-60yrs residing in a selected
urban community, Bangalore
8
4. Organ donation- The process ,or act by which a person donates organ for the
improvement in the health status of individual or saving the life of others
5. Misconception- The false beliefs of adults regarding types ,benefits and risks,
religious issues, associated complication, misuse of organ, legal problems
involved in organ donation.
6. Pamphlet- Pamphlet is a printed material which contains adequate information
regarding the need, importance, process and legal formalities involved in organ
donation, which will creat awareness and remove their misconceptions.
6.6 ASSUMPTION
1. Demand for organs is growing but it is not in equilibrium with the supply of
organ because people are hesitant to donate organs.
2. Lack of knowledge and common misconceptions regarding organ donation
may have an influence in the level of attitude in donating their organ
6.7 HYPOTHESIS
H1 - There is a significant correlation between the knowledge and attitude of
adults regarding organ donation.
H2 -
There is a significant association between the knowledge and attitude
score of adults with their selected demographic variables.
9
6.8 REVIEW OF LITERATURE
A literature review is a summary of previous research on a topic. Literature
reviews can be either a part of a larger report of a research project, a thesis or a
bibliographic essay that is published separately in a scholarly journal. The purpose of a
literature review is to convey to the reader what knowledge and ideas have been
established on a topic and what are the strengths and weaknesses.
A descriptive study conducted at the Institute for Health Research UK on 90
persons regarding attitude towards organ donation found that no groups were against
organ donation. The interviewees stated that the majority opinion in their faith or
belief group is to permit organ donation, with some actively supporting it. One
complication mentioned by interviewees is that as organ donation is a relatively new
medical procedure, there is no explicit reference to it in many original religious texts.
Consequently positions on the receipt and donation of organs are based on
interpretation. They concluded that even though peoples are ready to donate their
organ misconceptions and lake of knowledge makes the people hesitant to do it15.
A descriptive study conducted at Murcia, Spain on 120 urban peoples found
that the attitude toward organ donation of Europeans were biased against organ
donation because of perceived myths of organ donation and is determined by many
psychosocial factors16.
A descriptive study conducted to assess attitude towards organ donation in an
urban area of Tunisia on 190 peoples were organ donation stays very low. This is due
to family's opposition in brain death situation. Only 20% of persons agree to accept
organ donation after dying. The violation on body integrity after death as well as
religious obstruction are at the head of list of statements advanced in case of organ's
donation refusal 79,9% and 63.1%. They concluded that religious beliefs and myths
are obstacles in the path way of organ donation17.
An experimental study conducted at the Institute for Life Long Learning
Barcelona, regarding attitude of health care students towards organ donation among 90
students. It found that educational programmes on organ donation has impacted
positively on the various essential levels in the process of organ donation and
10
transplantation, with lifelong follow-up and an international network through the
capacity to adapt to specific country needs 18.
A randomised control study conducted on strategies for reducing the renal
transplant waiting list at the Sheffield Kidney Institute, UK among 90 care givers of
patients with road traffic accidents. Renal transplant is the optimum form of therapy
for most patients with end-stage renal failure, because that treatment results in a
significant improvement in the patient's quality of life and is cost-effective. They
concluded that education is an effective measure in changing the false believes and
misconceptions regarding organ donation which can reduce the waiting list for organ
donation19.
A descriptive study conducted at the Department of Communication, Purdue
University on family’s attitude on organ donation. In this study, 78 family pair dyads
(spouses, parent-child pairs, or siblings) were brought into an interaction laboratory set
up like a living room. After being briefed on the study, family members discussed a
series of eight questions about their thoughts and opinions about organ donation. They
found that the myths that seem to be the most actively referenced by the media include
premature declaration of death, the transference of personality traits from donor to
recipient, a US black market for organs, corruption in the medical community, and
corruption in the organ allocation system. Although these are not the only myths that
the generally public holds to be true, the media is a powerful source of support for
these particular myths. They concluded that such myths must be countered effectively
if greater consent for organ donation is to be attained20.
A descriptive study conducted on African Americans' knowledge about organ
donation on 90 students at the School of Communication, Information, and Library
Studies, Rutgers University. In this study, 310 African Americans responded to seven
knowledge items (based on myths and misconceptions about organ donation). They
concluded that 76% of students don’t have adequate knowledge regarding organ
donation and no one is willing to donate their organ in the future, the main reason is
lake of knowledge and prevalence of false beliefs regarding organ donation21.
A randomised control study conducted on improvement in organ shortage
through education at UK among 90 urban peoples. It found that persisting shortage of
11
organs for transplantation is due to the unwillingness of peoples to donate their organ.
The reasons for this enigma are lack of awareness that donation is a common practice,
the persistence of the ‘cult of dead body integrity’ and the myths surrounding
donation. They concluded that a pathway to solving this organ shortage may be
education, to make society understand the need of organs for donation and its role to
resolve this necessity22.
A descriptive study conducted at the Department of Medical Ethics and
History of Medicine, University of Gottingen on public attitudes toward organ
donation and its commercialization on 120 urban peoples. The study found that
current political and legal discourse neglects the central role of reciprocity for lay
people and patients. Lake of awareness and misconception is the main cause for
shortage of organ23.
A descriptive study conducted in Galicia regarding growth rate of organ
donation among urban population between 2000 and 2007, studying age, cause of
death, donation effectiveness, and organs transplanted per donor. Results revealed that
donation rates fluctuated between 29 and 35 donors per million populations during the
study period. The variations in the proportions of organs transplanted between 2000
and 2007 were: kidney, 68.8% to 53.7%, liver 86% to 88.9%, heart 33.5% to 9.9% and
lung 10.8% to 9.9%. They reached in a conclusion that the population in Galicia are
willing to donate their organs and reflect the need for constant motivation to do it24.
A study conducted on global observatory and database on organ donation and
transplantation: world overview on donation activities in Madrid, Spain. The
objectives are to collect, analyze, and disseminate information on legislative and
organizational frameworks and annual aggregated data on donation and transplantation
activities of the World Health Organization (WHO) Member States. In 2007 activity
data of 97 countries have been analyzed. Reported to the database were 21,489
deceased donors. Currently around 100,000 solid organ donations are performed per
year worldwide: 68,250 kidney, 19,850 liver, 5179 heart, 3245 lung, and 2797
pancreas transplantations. They concluded that this kind of tool is necessary to
improve knowledge about the donation and transplantation activities over the world.
Close collaboration with countries is crucial to obtain reliable data and the need for
removing the misconceptions is not an easy task to achieve the goal25.
12
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA
Data will be collected from adults of age group between 20-60yrs who are
residing in a selected urban community, Bangalore.
7.2 METHODS OF DATA COLLECTION
i.
Research design
Non experimental Descriptive co relational research design
ii.
Variables
Study variables:
Level of knowledge and attitude regarding common
misconceptions in organ donation
Demographic variable:
It includes baseline data of adults such as age, gender, education,
religion, family income, occupation, marital status and history of organ
donation
iii.
in the family
Setting
The study will be conducted at selected urban community, Bangalore
iv.
Population
Population consists of all adults residing in a selected urban community,
Bangalore.
v.
Sample
Adults of age group between 20-60yrs who are residing in a selected
urban community, Bangalore are considered as the sample and the sample size
is 90
13
vi.
Criteria for sample selection
Inclusion criteria – The study includes:
•
The adults who are between 20 - 60 years of age
•
Adults of both gender
•
Adults who are able to read and understand English or Kannada
Exclusion criteria - The study excludes:
.
vii.
The adults who are health care professionals
Sampling technique
Probability sampling technique- Systematic random sampling
viii.
Tools for data collection
Section A
Demographic proforma of adults such as age, gender, education, religion, family
income, occupation, marital status and history of organ donation in the family
Section B
Structured questionnaire will be used to assess the knowledge level of adults
regarding common misconceptions in organ donation
Section C
3 point Likert scale will be used to assess the level of attitude of adults
regarding organ donation
ix.
Method of data collection
Phase 1-
After obtaining necessary permission from the concerned authorities
and informed consent from samples, the researcher will collect the demographic
data and level of knowledge regarding common misconceptions regarding organ
donation by structured questionnaire.
Phase 2- Assess the level of attitude of the samples by using 3 point Likert
scale.
14
Phase 3- Based on the results obtained the researcher will prepare and
administer the pamphlet regarding common misconceptions involved in organ
donation
x.
Plan for data analysis
The data collected will be analyzed by using descriptive and inferential
statistics
Descriptive statistics
Frequency percentage distribution, mean and standard deviation
Inferential statistics
Karl pearsons correlation coefficient will be used to correlate
knowledge with attitude.
Chi square test will be used to associate knowledge and attitude with
their selected demographic variables.
Projected Outcome
The researcher will assess the knowledge and attitude of adults regarding
common misconceptions involved in organ donation and based on the existing
knowledge and attitude the researcher will prepare a pamphlet on common
misconceptions regarding organ donation and will be distributed to the samples.
7.3 Does the study require any investigation or intervention to be
conducted on the patient or other human or animals?
Yes, the study requires minimum investigation on knowledge and attitude
because the investigator is planning only for descriptive study and no active
manipulation involved in the study
7.4 Has ethical clearance been obtained from your institution?
Yes, permission will be obtained from the concerned authorities. Informed
consent will be obtained from the research subjects. Confidentiality and privacy of
data will be maintained.
15
8. LIST OF REFERENCE
1. Harish Kumar. Death and organ donation. Amritha Journal of Medicine. 2007
Apr; 24(8):2.
2. Dr. Sunil Shroff. Organ Donation and Transplantation - Tribulations and
Triumphs - An Indian Perspective. J Natl Med Assoc. 2006. Jun; 17(11): 957963.
3. Dr. Raghav Naresh. Organ Donation and Transplantation mythology and
reality - An Indian Perspective. Journal of Clinical Transplant. 2006 Sep;
23(13): 779-786.
4. John DJ. Knowledge and decreased organ donation. Transplant proc. 2001;
18(6): 344-356.
5. Dunstan, GR. The ethics of organ donation. British Medical Bulletin. 1997; 53
(4): 921-939.
6. Eaton S. The subtle politics of organ donation: a proposal. Journal of Medical
Ethics. 1998; 24: 166-170.
7. Nirmala Nagaraj. State could benefit a lot from changed rules. Times of India.
2009 Sep 9; Sec A: 4(col. 3).
8. Robert MC. Budget and organ donation policies. British Medical Bulletin
1999; 66 (7): 587-599.
9. Suresh Ram. Dispelling myths- Organ donation & transplantation. Available
from http://www.indiaprwire.com/pressrelease/health-care/2006082352.
10. Dinesh Guptha. Karnataka still lags in cadaver transplants. Times of India.
2003 Sep 25; Sec B: 3 (col. 5).
11. Vineetha Mokkil. Life and Death. Times of India. 2001 Jun 3; SecA: 3(col.5).
16
12. Mridula chunduri. Shortage in organ availability. Times of India. 2006 Oct27;
Sec A: 2(col.4).
13. Surman OS. Ethics of partial Liver Donation. New England Journal of
Medicine. 2002 Dec; 94(10): 1046-1057.
14. Brenda Bare G, Suzane Smeltzer C. Chronic renal failure in older adults.
10th ed. Philadelphia: Lippincott publishers; 2004.
15. Jason Ronald. Public attitude regarding towards organ donation. J Natl Med
Assoc. 2004 Nov; 98(12): 1120-1127.
16. Joseph Jacob. Attitude toward organ donation of Europeans. Journal of
Transcultural Nursing. 2004 Apr; 16(3): 149-152.
17. Catherine George. Attitude of public towards organ donation in Tunisia. J Natl
Med Assoc. 2001 Nov; 94(9): 1013-1023.
18. Cantarovinch F. Improvement in organ shortage through education. Transplant
Proc. 2002 Jun; 13(11): 1184-1186.
19. Robert DJ. Strategies for reducing the renal transplant waiting list -Sheffield
Kidney Institute. Transplant Proc 1999 Oct; 19(12): 987-993.
20. Jason P, James Hopes. Family discussion about organ donation. Transplant
Proc. 2005 Oct; 19(5): 674-682.
21. Hopes M. African Americans' knowledge and attitude about organ donation.
Journal of Psychosomatic Medicine. 2003 Feb; 12(9): 876-885.
22. Alfred JC. Improvement in organ shortage education an effective measure.
Transplant Proc. 2006 Sep; 23(13): 763-771
17
23. George Philip M, et al. Public attitudes toward organ donation and its
commercialization a serious issue. Journal of Transcultural Nursing. 1997
Mar; 20(16): 896-902.
24. Raghav Kumar P. Growth rate of organ donation among urban population.
Transplant Proc. 2008 Apr; 24(12):1103-1117.
25. Kiran M, Kumar KK, Jyothy S. Organ donation and transplantation- world
overview on donation activities in Madrid. J Natl Med Assoc. 2008 Jun;
21(11): 967-973.
18
9. Signature of the candidate
:
10. Remark of the guide
:
The study has a purpose of assessing
the urban adults’ knowledge and attitude
towards organ donation and has an
implication to nursing practice.
11. Name and designation of guide
: Mrs. Fathima L
Vice principal and HOD of medical
surgical nursing
11.2. Signature
:
11.3. Co-guide
: Miss. Shoba G
Asst. Professor
11.4. Signature
:
11.5. Head of the department
: Mrs. Fathima L
Vice principal and HOD of medical
surgical nursing
11.6. Signature
:
12.1. Remarks of the principal
: The study is feasible and applicable for
the specialty chosen
12.2. Signature
:
19