Beliefs and Intention to Organ Donation in Saudi Arabia: An Online Cross-Sectional Survey

Objective: Despite concerted and directed efforts to increase organ donation, the gap between the need for organs for transplantation and the lack of donors has been increasing globally. Studies have shown that donor rates in countries in the Middle East, such as Saudi Arabia, are particularly low despite a relatively advanced healthcare system and supportive government policies. There are multiple psychosocial, cultural, religious, and structural factors, that influence the increase in the organ donation rate, and some of them may be unique to a country such as Saudi Arabia. The theory of planned behaviour (TPB) is an important theory utilised to study how various types of attitudes, beliefs, and norms, influence organ donation intention and practice. In this study, we aimed to explore the normative, behavioural, and control beliefs, among residents of Saudi Arabia. Methods: The current study was a cross-sectional online survey performed from 6 June 2021 to 31 December 2021, using a questionnaire prepared in GoogleTM form among the residents of Saudi Arabia. The questionnaire asked demographic factors and questions to explore the normative, behavioural, and control beliefs, regarding organ donation. Results: This study received 1245 valid responses. Among the study participants, only 19.6% were willing to register as an Organ/Tissue donors. The intention for organ donation showed a statistically significant positive association with beliefs that organ donation is a good thing (123.51, df 4, p < 0.001), could save somebody's life (81.38, df 4, p < 0.001), could have a positive impact on life after death (114, df 4, p < 0.001), and provision of better social support to family (of the deceased) can increase organ donation (68.43, df 4, p < 0.001). Those who expressed normative beliefs that their intention to donate organs strongly depend upon their family's lack of objection to allowing the donation of organs at the time of death (190.76, df 4, p < 0.001), their knowledge about the organ transplantation process (179.35, df 4, p < 0.001), their knowledge about the viewpoint of their religion regarding organ donation (120.345, df 4, p < 0.001), and their knowledge about the registration facilities (241.64, df 4, p < 0.001), were more willing for donating their organs. Perception of worry about the likelihood of getting lesser care from doctors in an emergency if registered as an organ donor (OR = 4.25, 95% CI 1.57-11.51), beliefs that provision of better social support to family (of the deceased) can increase organ donation (OR = 10.49, 95% CI 1.56-70.43), and concern for the emotions of their family members while organ are being taken (OR = 4.37, CI 1.57-12.23), were the strongest predictors influencing a definite intention for organ donation. Conclusion: This study found that most of the components under normative and behavioural beliefs showed positive correlation with a definite intention for organ donation, whereas most of the components under control beliefs showed negative correlation with a definite intention for organ donation, among Saudi population. Based on the study results, there is a need to promote awareness regarding the organ donation process, especially the religious permissibility of organ donation, among general public in order to promote organ donation.