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The Influence of Mass Media on Organ Donation and Transplantation in Older People
The Influence of Mass Media on Organ Donation and Transplantation in Older People J. Almela-Baezaa, B. Febrerob,c,*, I. Rosc, M.B. Pérez-Sánchezd, A. Pérez-Manzanoe, J.M. Rodríguezb,c, F. Alconchelb, J.J. Ruiz-Manzanerab, L.A. Martínez-Insfranc, M. Royo-Villanovaa, L. Martínez-Alarcónb,c, A. Ríosb,c, P. Parrillab,c, and P. Ramírezb,c a Faculty of Communication and Documentation, University of Murcia, Murcia, Spain; bTransplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcian Institute of Biomedical Investigations, Murcia, Spain; cDepartment of Surgery, Pediatrics, Gynecology and Obstetrics, University of Murcia School of Medicine, Murcia, Spain; dDepartment of Statistics, Mathematics and Informatics, University of Miguel Hernández, Elche, Spain; and the eDepartment of Evolutionary Psychology and Education, University of Murcia, Murcia, Spain
ABSTRACT Background. Worldwide population aging has resulted in changes in the approach to the organ donation and transplantation (ODT) process, forcing us to include older people on transplant waiting lists and to assess older patients as potential donors. However, this is a sector of the population that has not been studied in great detail in terms of the information they receive about ODT. Objectives. To analyze what kinds of media provide people > 65 years of age with information about ODT and which sources of information affect their attitude about this subject. Methods. A multicentric study was undertaken using a sample of people > 65 years of age stratified by sex and geographic location in southeastern Spain (n ¼ 420). Questions about ODT and methods of receiving information were analyzed using a questionnaire. Statistical analysis was performed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States). Descriptive analyses were performed with a Student t test and c2 test. Results. The questionnaire completion rate was 84% (n ¼ 351). People aged > 65 years received information about ODT, mainly positive, from the television (82%), followed by films (35%), the radio (30%), the press (26%), family (26%), and friends (17%). Receiving information through one of the following sources was associated with a more favorable attitude toward organ donation: the family (76% vs 45%; P < .001), friends (77% vs 48%; P ¼ .01), and the press (62% vs 49%; P ¼ .034). Conclusions. Older people mainly receive information about ODT from the mass media. However, social and family circles have the greatest influence on their attitudes toward organ donation.
T
HE fact that the population is aging has led to changes in the approach to the organ donation and transplantation (ODT) process. This has lead us to include older people on transplant waiting lists and to use a series of expanded criteria for organ donation in older people, with 50% of donors being older than 60 years in 2018 [1]. However, this group is a sector of the population that has not been studied to a great extent in terms of the
ª 2020 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169
Transplantation Proceedings, XX, 1e3 (2020)
information they receive about ODT, given that most studies have been carried out on the general public [2,3]; therefore, it would be interesting to analyze the role played
*Address correspondence to Beatriz Febrero, Crta/MadridCartagena, s/n 30120, El Palmar (Murcia), Spain. Tel: þ34659174716; Fax: 968.36.97.16. E-mail: [email protected] 0041-1345/20 https://doi.org/10.1016/j.transproceed.2019.09.020
1
2
ALMELA-BAEZA, FEBRERO, ROS ET AL Table 1. Sources of Information About ODT Provided to Older People and Its Influence on Their Attitude Toward Organ Donation
Source
Television Films Radio Press Family Friends Magazines/ books/ leaflets Internet Social networks Health care workers or physicians Talks in centers Billboards or notice boards
Percentage Who Received Information From Source (%)
Attitude in Favor of ODT Who Received Information From Source (%)
Attitude in Favor of ODT Among Those Who Have Not Received Information From Source (%)
P Value*
82 35 30 26 26 17 7 5 4 2
53 55 52 62 76 77 65 61% 69 75
44 50 51 49 45 48 55 52% 52 52
.132 .182 .074 034† <.001† .01† .289 .463 .277 .176
1 1
65 67
52 53
.297 .627
Note. P < .05 indicates statistical significance. Abbreviation: ODT, organ donation and transplantation. *Significance of the comparison of attitude toward ODT according to the information received from each of the sources. † Indicates statistical significance reached.
by the media in affecting the elderly population’s willingness to donate organs. The objective of this study was to analyze which media provide information about ODT to people aged > 65 years and how each source of information affects their attitudes toward the donation of their own organs.
occurred when the information came from family members (76% vs 45%; P < .001) or friends (77% vs 48%; P ¼ .01). The other sources of information did not affect attitudes toward ODT (P > .05) (Table 1). DISCUSSION
METHODS An observational sociologic study was conducted. A multicentric study was carried out taking a representative sample of people aged > 65 years stratified by sex and geographic location in southeastern Spain (n ¼ 420). A questionnaire was used to analyze the source of information by which people > 65 years of age receive information about ODT. Their attitude toward organ donation was also analyzed.
Statistical Analysis The data were stored on a database and analyzed using a statistical package. Descriptive statistical analysis was carried out. For the bivariate analysis, Student t test and c2 test were complemented by an analysis of remainders. Values of P < .05 were considered to be statistically significant.
RESULTS
The questionnaire completion rate was 84% (n ¼ 351). People ˃ 65 years of age received information about ODT from the television (82%; n ¼ 287); films (35%; n ¼ 122); the radio (30%; n ¼ 106); the press (26%; n ¼ 91); family (26%; n ¼ 91); friends (17%; n ¼ 60); magazines, books, or leaflets (7%; n ¼ 24); the Internet (5%; n ¼ 18); social networks (4%; n ¼ 14); health workers and physicians (3%; n ¼ 10); talks in centers (1%; n ¼ 6); and billboards or notice boards (1%; n ¼ 3). It has been noted that those who receive information from the press have a more favorable attitude toward donating their organs than those who have not received information this way (62% vs 49%; P ¼ .034). The same
The information received about ODT is one of the factors, among others, that could affect the willingness of the population to donate [2e5]. Most people older than 65 years of age report that they have received information about ODT from the mass media, above all from television. In other groups of the population in our area, the most frequent sources of information about ODT were also audiovisual, mostly from the television [2e7]. Television has an unbeatable advantage in terms of images. In addition, the number of viewers is increasing every day, which means that any television campaign related to ODT will reach a larger proportion of our society [6]. The fact that much information is provided by the television to many people could cause a problem, given that the information transmitted can be negative as well as positive [7] and might not always have a directly positive effect on attitude toward donation [3,4], as has occurred in the present study. What is more, the topics related to ODT dealt with on television are not usually exhaustive, involving testimonies by patients with a history of transplant, patients on the transplant waiting list, information about the organ donation process, and the types of donors [8]. Information provided by other kinds of mass media, such as the press and the radio, play a more important role in other population groups. Sixty-four percent of respondents in the general public have indicated that they receive information from the press, and teachers also state that they receive information about ODT from this source in more than 50% of cases [4]. However, information received from the press does not have an effect on their attitude [4]. This result differed
MASS MEDIA AND ORGAN DONATION
from the older people of this study, where, despite the fact that only one-third of respondents received information from the press, it was the only mass media outlet that encouraged a more favorable attitude. With regard to this means of communication, we do not know the type of information that was provided to the older people, but we can refer to a study carried out in the United States on 712 press articles published during the period of 1 year regarding the subject of ODT, in which it was concluded that more than 80% of this information was positive or at least neutral [9]. Social and family circles are also an important means of providing information about ODT in other population studies [2e5]. In this study, less than one-third of the respondents reported having received information from this source. Overall, however, this is the means that has most repercussions on attitude toward organ donation. A previous pilot study carried out on older people has shown the importance of social and family interaction on ODT in this age group in order to improve their willingness to donate organs [10]. In light of these results, it is necessary to encourage social and family dialogue about the subject of ODT with an aim to improving attitudes toward ODT in older people. In this sense, another means of communication that encourages social and family interaction with ODT is social media (social networks). Social media represents an information source that should be encouraged in older people given that this study showed it to be a little-used channel for ODT information by the elderly. The use of social media makes it possible to cover different scientific topics more extensively [11], in this case, dealing with topics related to ODT such as religion, immigration, and so on [12]. CONCLUSIONS
To conclude, older people mainly receive information about ODT from the mass media, particularly from television. Nevertheless, information provided by social and family circles has the most influence on their attitudes toward organ donation.
3
REFERENCES [1] National Transplant Organization. Memorias e todos los documentos [Memories e all the documents. http://www.ont.es/ infesp/Memorias/Forms/AllItems.aspx; 2019 [Accessed 24.03.19] [in Spanish]. [2] Conesa C, Ríos Zambudio A, Ramírez P, Canteras M, Rodríguez MM, Parrilla P, et al. Influence of different sources of information on attitude toward organ donation: a factor analysis. Transplant Proc 2004;36:1245e8. [3] Scandroglio B, Domínguez-Gil B, Lõpez JS, Valentín MO, Martín MJ, Coll E, et al. Analysis of the attitudes and motivations of the Spanish population towards organ donation after death. Transpl Int 2011;24:158e66. [4] Febrero B, Ríos A, Martínez-Alarcón L, López-Navas A, Almela-Baeza J, Sánchez J, et al. Information received by secondary school teaching personnel about organ donation and transplantation: a study in the southeast of Spain. Transplant Proc 2013;45:3589e91. [5] Ríos A, Febrero B, López-Navas A, Martínez-Alarcón L, Sánchez J, Guzmán D, et al. From where do our children receive information about organ donation and transplantation? Transplant Proc 2010;42:3113e5. [6] Yoo JH, Tian Y. Effects of entertainment (Mis) education: exposure to entertainment television programs and organ donation intention. Health Commun 2011;26:147e58. [7] Harbaugh C, Afana M, Burdick S, East J, Kodali S, Lee J, et al. Portrayal of organ donation and transplantation on American primetime television. Clin Transplant 2011;25:375e80. [8] Quick BL, Kim DK, Meyer K. A 15-year review of ABC, CBS, and NBC news coverage of organ donation: implications for organ donation campaigns. Health Commun 2009;24:137e45. [9] Feeley TH, Vincent D. How organ donation is represented in newspaper articles in the United States. Health Commun 2007;21: 125e31. [10] Febrero B, Almela-Baeza J, Febrero R, Ríos A, González MR, Gil PJ, et al. Importance for the elderly of discussion in the family and society about attitude toward organ donation. Transplant Proc 2018;50:523e5. [11] Pérez-Manzano A, Almela-Baeza J. Gamification and transmedia for scientific promotion and for encouraging scientific careers in adolescents. Comun Rev Científica Comun y Educ 2018;26. [12] Almela-Baeza J, Febrero-Sánchez B, Pérez-Manzano A, Ramírez-Romero P. Prosocial topics and impact of a flipped classroom educational intervention promoting health by creating audiovisual stories. Rev Mediterránea Comun 2018;9:75e84.
ABSTRACT Background. Worldwide population aging has resulted in changes in the approach to the organ donation and transplantation (ODT) process, forcing us to include older people on transplant waiting lists and to assess older patients as potential donors. However, this is a sector of the population that has not been studied in great detail in terms of the information they receive about ODT. Objectives. To analyze what kinds of media provide people > 65 years of age with information about ODT and which sources of information affect their attitude about this subject. Methods. A multicentric study was undertaken using a sample of people > 65 years of age stratified by sex and geographic location in southeastern Spain (n ¼ 420). Questions about ODT and methods of receiving information were analyzed using a questionnaire. Statistical analysis was performed using SPSS version 21.0 (IBM Corp, Armonk, NY, United States). Descriptive analyses were performed with a Student t test and c2 test. Results. The questionnaire completion rate was 84% (n ¼ 351). People aged > 65 years received information about ODT, mainly positive, from the television (82%), followed by films (35%), the radio (30%), the press (26%), family (26%), and friends (17%). Receiving information through one of the following sources was associated with a more favorable attitude toward organ donation: the family (76% vs 45%; P < .001), friends (77% vs 48%; P ¼ .01), and the press (62% vs 49%; P ¼ .034). Conclusions. Older people mainly receive information about ODT from the mass media. However, social and family circles have the greatest influence on their attitudes toward organ donation.
T
HE fact that the population is aging has led to changes in the approach to the organ donation and transplantation (ODT) process. This has lead us to include older people on transplant waiting lists and to use a series of expanded criteria for organ donation in older people, with 50% of donors being older than 60 years in 2018 [1]. However, this group is a sector of the population that has not been studied to a great extent in terms of the
ª 2020 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169
Transplantation Proceedings, XX, 1e3 (2020)
information they receive about ODT, given that most studies have been carried out on the general public [2,3]; therefore, it would be interesting to analyze the role played
*Address correspondence to Beatriz Febrero, Crta/MadridCartagena, s/n 30120, El Palmar (Murcia), Spain. Tel: þ34659174716; Fax: 968.36.97.16. E-mail: [email protected] 0041-1345/20 https://doi.org/10.1016/j.transproceed.2019.09.020
1
2
ALMELA-BAEZA, FEBRERO, ROS ET AL Table 1. Sources of Information About ODT Provided to Older People and Its Influence on Their Attitude Toward Organ Donation
Source
Television Films Radio Press Family Friends Magazines/ books/ leaflets Internet Social networks Health care workers or physicians Talks in centers Billboards or notice boards
Percentage Who Received Information From Source (%)
Attitude in Favor of ODT Who Received Information From Source (%)
Attitude in Favor of ODT Among Those Who Have Not Received Information From Source (%)
P Value*
82 35 30 26 26 17 7 5 4 2
53 55 52 62 76 77 65 61% 69 75
44 50 51 49 45 48 55 52% 52 52
.132 .182 .074 034† <.001† .01† .289 .463 .277 .176
1 1
65 67
52 53
.297 .627
Note. P < .05 indicates statistical significance. Abbreviation: ODT, organ donation and transplantation. *Significance of the comparison of attitude toward ODT according to the information received from each of the sources. † Indicates statistical significance reached.
by the media in affecting the elderly population’s willingness to donate organs. The objective of this study was to analyze which media provide information about ODT to people aged > 65 years and how each source of information affects their attitudes toward the donation of their own organs.
occurred when the information came from family members (76% vs 45%; P < .001) or friends (77% vs 48%; P ¼ .01). The other sources of information did not affect attitudes toward ODT (P > .05) (Table 1). DISCUSSION
METHODS An observational sociologic study was conducted. A multicentric study was carried out taking a representative sample of people aged > 65 years stratified by sex and geographic location in southeastern Spain (n ¼ 420). A questionnaire was used to analyze the source of information by which people > 65 years of age receive information about ODT. Their attitude toward organ donation was also analyzed.
Statistical Analysis The data were stored on a database and analyzed using a statistical package. Descriptive statistical analysis was carried out. For the bivariate analysis, Student t test and c2 test were complemented by an analysis of remainders. Values of P < .05 were considered to be statistically significant.
RESULTS
The questionnaire completion rate was 84% (n ¼ 351). People ˃ 65 years of age received information about ODT from the television (82%; n ¼ 287); films (35%; n ¼ 122); the radio (30%; n ¼ 106); the press (26%; n ¼ 91); family (26%; n ¼ 91); friends (17%; n ¼ 60); magazines, books, or leaflets (7%; n ¼ 24); the Internet (5%; n ¼ 18); social networks (4%; n ¼ 14); health workers and physicians (3%; n ¼ 10); talks in centers (1%; n ¼ 6); and billboards or notice boards (1%; n ¼ 3). It has been noted that those who receive information from the press have a more favorable attitude toward donating their organs than those who have not received information this way (62% vs 49%; P ¼ .034). The same
The information received about ODT is one of the factors, among others, that could affect the willingness of the population to donate [2e5]. Most people older than 65 years of age report that they have received information about ODT from the mass media, above all from television. In other groups of the population in our area, the most frequent sources of information about ODT were also audiovisual, mostly from the television [2e7]. Television has an unbeatable advantage in terms of images. In addition, the number of viewers is increasing every day, which means that any television campaign related to ODT will reach a larger proportion of our society [6]. The fact that much information is provided by the television to many people could cause a problem, given that the information transmitted can be negative as well as positive [7] and might not always have a directly positive effect on attitude toward donation [3,4], as has occurred in the present study. What is more, the topics related to ODT dealt with on television are not usually exhaustive, involving testimonies by patients with a history of transplant, patients on the transplant waiting list, information about the organ donation process, and the types of donors [8]. Information provided by other kinds of mass media, such as the press and the radio, play a more important role in other population groups. Sixty-four percent of respondents in the general public have indicated that they receive information from the press, and teachers also state that they receive information about ODT from this source in more than 50% of cases [4]. However, information received from the press does not have an effect on their attitude [4]. This result differed
MASS MEDIA AND ORGAN DONATION
from the older people of this study, where, despite the fact that only one-third of respondents received information from the press, it was the only mass media outlet that encouraged a more favorable attitude. With regard to this means of communication, we do not know the type of information that was provided to the older people, but we can refer to a study carried out in the United States on 712 press articles published during the period of 1 year regarding the subject of ODT, in which it was concluded that more than 80% of this information was positive or at least neutral [9]. Social and family circles are also an important means of providing information about ODT in other population studies [2e5]. In this study, less than one-third of the respondents reported having received information from this source. Overall, however, this is the means that has most repercussions on attitude toward organ donation. A previous pilot study carried out on older people has shown the importance of social and family interaction on ODT in this age group in order to improve their willingness to donate organs [10]. In light of these results, it is necessary to encourage social and family dialogue about the subject of ODT with an aim to improving attitudes toward ODT in older people. In this sense, another means of communication that encourages social and family interaction with ODT is social media (social networks). Social media represents an information source that should be encouraged in older people given that this study showed it to be a little-used channel for ODT information by the elderly. The use of social media makes it possible to cover different scientific topics more extensively [11], in this case, dealing with topics related to ODT such as religion, immigration, and so on [12]. CONCLUSIONS
To conclude, older people mainly receive information about ODT from the mass media, particularly from television. Nevertheless, information provided by social and family circles has the most influence on their attitudes toward organ donation.
3
REFERENCES [1] National Transplant Organization. Memorias e todos los documentos [Memories e all the documents. http://www.ont.es/ infesp/Memorias/Forms/AllItems.aspx; 2019 [Accessed 24.03.19] [in Spanish]. [2] Conesa C, Ríos Zambudio A, Ramírez P, Canteras M, Rodríguez MM, Parrilla P, et al. Influence of different sources of information on attitude toward organ donation: a factor analysis. Transplant Proc 2004;36:1245e8. [3] Scandroglio B, Domínguez-Gil B, Lõpez JS, Valentín MO, Martín MJ, Coll E, et al. Analysis of the attitudes and motivations of the Spanish population towards organ donation after death. Transpl Int 2011;24:158e66. [4] Febrero B, Ríos A, Martínez-Alarcón L, López-Navas A, Almela-Baeza J, Sánchez J, et al. Information received by secondary school teaching personnel about organ donation and transplantation: a study in the southeast of Spain. Transplant Proc 2013;45:3589e91. [5] Ríos A, Febrero B, López-Navas A, Martínez-Alarcón L, Sánchez J, Guzmán D, et al. From where do our children receive information about organ donation and transplantation? Transplant Proc 2010;42:3113e5. [6] Yoo JH, Tian Y. Effects of entertainment (Mis) education: exposure to entertainment television programs and organ donation intention. Health Commun 2011;26:147e58. [7] Harbaugh C, Afana M, Burdick S, East J, Kodali S, Lee J, et al. Portrayal of organ donation and transplantation on American primetime television. Clin Transplant 2011;25:375e80. [8] Quick BL, Kim DK, Meyer K. A 15-year review of ABC, CBS, and NBC news coverage of organ donation: implications for organ donation campaigns. Health Commun 2009;24:137e45. [9] Feeley TH, Vincent D. How organ donation is represented in newspaper articles in the United States. Health Commun 2007;21: 125e31. [10] Febrero B, Almela-Baeza J, Febrero R, Ríos A, González MR, Gil PJ, et al. Importance for the elderly of discussion in the family and society about attitude toward organ donation. Transplant Proc 2018;50:523e5. [11] Pérez-Manzano A, Almela-Baeza J. Gamification and transmedia for scientific promotion and for encouraging scientific careers in adolescents. Comun Rev Científica Comun y Educ 2018;26. [12] Almela-Baeza J, Febrero-Sánchez B, Pérez-Manzano A, Ramírez-Romero P. Prosocial topics and impact of a flipped classroom educational intervention promoting health by creating audiovisual stories. Rev Mediterránea Comun 2018;9:75e84.