Nannou (2008) had explored how an educational intervention related to organ and tissue donations affected the knowledge and awareness of a randomized two group samples of pre-registration nursing students. This study was a randomized but controlled trial, with two continuous variables of knowledge and awareness of nursing students before and after an educational intervention and compared results to a controlled group who did not have the benefits of the educational intervention. Both groups were equivalent at baseline. Simple analysis of variance, analysis of covariance and multiple regressions were used to determine significance of results. Each category was analyzed as a separate variable. Students were asked to choose a card that indicated to which group they would be assigned to: control or experimental. Both groups were given the pre-test and post-test that had been validated by content and practice experts. A statistically significant difference was found in knowledge and awareness between pre-test and post-test scores in both the controlled group and experimental group.
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Remijn (2009) came out with a questionnaire to survey students’ knowledge and opinions about organ donation and transplantation was conducted on 247 students in 13 separate classrooms. Questions 1–16 of the questionnaire measured general factual knowledge about organ donation and transplantation; questions 17–24 solicited personal experiences regarding organ donation and transplantation; questions 25–29 sought opinions about whether the student would become an organ donor; 24 questions 30–35 sought general demographic information such as age, grade, gender, language spoken at home, ethnicity, and parents’ education level.
Roels (2007) had surveyed pre-registration nursing students’ awareness on organ and tissue donations. The study revealed that 55% to 80% of the nursing students were aware of organ and tissue donations. Pre-registration nursing students had shown deficits in their knowledge about the transplantation process. For example, a recent study suggested that only 64% (N = 260) of the students knew that brain death was different from a coma. Similarly, other studies had documented nursing students as correctly answering between 43% and 48% of the factual questions about organ donation. Encouragingly, a recent intervention on the topic suggests that interventions could improve nursing students’ organ donation knowledge.
Dauphinee (2009) had carried out a study on pre- registration nursing students’ knowledge on organ and tissue donations. A number of 41-questions were administered to 537 first-year and second-year nursing students. Students were also asked about their support on organ donation and the donation trainings they had received. 236 students responded (response rate = 93%). (22%) had read about organ and tissue donations in the newspaper (40% vs 6%, P < .001) and having read articles regarding donation (24% vs 15%, P = .017). Knowledge regarding brain death was lower (P < .001). The researcher suggests that organ donation and transplantation education are associated with improved knowledge in the area and comfort in knowing how to address patients’ questions.
Moroff (2008) had examined on the pre-registration nursing students’ awareness and knowledge in New York. A 10-item questionnaire was given and completed by one thousand students and their mean age was recorded as 23.7 years. The students were divided into groups and were asked to discuss about organ and tissue donations. The discussion on organ and tissue donations ranged in duration of approximately 5 to 19 minutes (M = 12.10, SD = 3.07). Overall, students accurately discussed between 7 and 10 topics (M = 12.99, SD = 2.56) during this time period, with time having no significant influence on the number of topics discussed, r = 0.21, p = 0.07. Thus, students appeared to discuss organ and tissue donation topics based on some individual characteristic. It is encouraging to note that 83% of students explained the importance of family communication regarding one’s preferences for organ donation and 74% explained the role of next-of-kin in the consent process. Results do indicate that students may need for further education with regards to organ donation eligibility and the matching process, as 68% of the students failed to describe brain death at all, whilst 9% described it inaccurately.
Moreover, a study conducted by Panzarella (2008) for Transplant Resource Center of Maryland, on the topic of organ and tissue donation also gave interesting facts. A total of 260 nursing students participated in the online knowledge to measure their knowledge on organ donation Students answered an average of 8.78 (SD = 1.31) questions correctly. Overall, students did not differ in their knowledge on organ donation, based on academic year. The researcher also notes that 43% of the students surveyed (N = 500) did not know organ and tissue donation, although more than half felt that students were aware about organ and tissue donations.
Vleuten (2009) had surveyed pre-registration nursing students’ knowledge and awareness on organ and tissue donation. Most respondents were able to answer all the questions. Most participants agreed that donors might receive on-going support after donation (91%). Nearly half (46%) of respondents supported the use of tissue for research; however, only 28% could recall the topic being discussed at the time of donation. Only 40% of respondents knew of the differences between organ and tissue donations before the donation process. Overall, the study’s findings suggest that in the effort to enhance the student nurses’ knowledge, focusing on education should be given priority. A nurse is the first person to recognize the patient and that a nurse spends more time with the patient. Hence, the nurse possesses preliminary education about organ donation.
2.3 Conceptual Framework.
The study framework is based on Organ Donation Model (ODM) proposed by Miller (2005). ODM define organ donation as when organs are removed from a person who has recently died and transplanted into the body of another living person. It may also be possible for a living person to donate certain organs to another living person. Transplantation is a very successful way of saving and improving the lives of people who are experiencing serious health problems. The goal of Organ Donation Model (ODM) is to create an expert nurse pertaining organ donation. The ODM asserts that the significant determinant in educating the next generation and developing, directing and translating new therapeutic strategies for the future.
According to Miller (2005), the most influential components of this intention were the individual’s awareness of donation and knowledge about donation. Organ donation model (ODM) focuses mainly on knowledge and awareness of organ donation in healthcare workers and their students. A study done by Mogan (2008) on American nursing students knowledge and awareness of organ donation, found that a person would have awareness first, later to get to know more about the topic a person would read further which would lead the person to understand about the organ and donation topic. These two variables are: knowledge and awareness. “Measuring these variables is essential to determine if such changes actually result from the intervention and, in turn, influence changes in commitment” (Susan, 2009). ODM focuses higher rates of organ donation as well as student nurse are aware and increase knowledge once the topic is taught in nursing training. Using the Organ Donation Model (ODM), Albright (2010) revealed that a group of student nurses in England were aware and knowledgeable on organ donation. They found a significant relationship between the knowledge of students’ and their personal awareness on the topics to donate organs.
2.4 Summary
This chapter has highlighted the importance of pre-registration nursing students to have knowledge and aware about organ and tissue donation. In this chapter, it has explained clearly by discussing the definition by various researchers as well studies conducted by other researchers that were pertinent to knowledge and awareness of pre-registration nursing students on organ and tissue donation. It is significant to know pre-registration nursing students knowledge and awareness on organ and tissue donation as nurses plays a key role in promoting organ donation because they are the persons who will meet with the family after a tragic event, when organ procurement is being discussed, and nurses are the one who initiates the process and support the family. Further, lack of adequate training to raise awareness causes lower donor detection and referral rates by the registered nurses
CHAPTER 3
METHODOLOGY
3.1 Introduction
In this chapter the methodology are clearly discuss in detail which include four parts. Firstly, the design of the research is discussed then the respondents are chosen. Third is the research instrument, sampling procedure such as the distribution and collection process of the questionnaire will be explained. Questionnaire is used in this study. Students were give questionnaire by the researcher after class and also students who are in practical were called back to answer the questionnaire. Explanation is given as how they would be classified according to their specific purpose.
3.2 Study design
This study is quantitative cross-sectional surveys which intended to study the knowledge and awareness of pre-registration nursing students on organ and tissue donation. Cross-sectional surveys described as depiction of the populations about which data is gathered. It is used when the purpose of the study is descriptive, often in the form of a survey. Descriptive design is where the researcher collects data on a several variables and dissembles the result as well as gathering information about the present existing condition (Cresswel, 2009). Usually there is no hypothesis as such, but the aim is to describe a population with respect to an outcome (Baron, 2011). Cross-sectional surveys can be carried out using any mode of data collection. In this study questionnaires are used. Questionnaire is a data collection method that used to ask questions of research participants (Jackson, 2011).
3.3 Study setting
This study was done in Surya College Penang and this college is located in Butterworth, Penang. This college is offering Foundation in Science, Diploma in Nursing and Diploma in Medical Laboratory Technology. Students who study at Surya College have a readily available pathway to further their studies at Penang International Dental College (PIDC), Vinayaka Missions University (V.M.U) in India or other educational institutions locally & abroad. Total students in the college are 500. However, pre-registration nursing students are 280 as of the July 2013 intake. Surya Colleges envisages being a premier allied health college in this region. With a strong backing of experienced management team, it aims to be a Centre of excellence that offers quality and affordable education to students from all walks of life in the spirit of 1Malaysia.
3.4 Research Subject
3.4.1 Population
The populations for this study were pre –registration nursing students from Surya College Penang. Total students are 280 and all of them are involve in this study. The populations are from year one students, year two and year three students. A population is the entire aggregation of cases in which the researcher is interested (Gore, 2009).
3.4.2 Sample
A sample is a subset of population elements. Sample size is the number of observations used to estimates of a given population. Sampling is concerned with the selection of individuals from within a statistical population to estimate characteristics of the whole population. In this study, the sampling was done on the population of Surya College pre-registration nursing students. About 280 students are involved in this study. The sampling technique that the researcher used was convenience sampling. Convenience sampling refers to the non-probability process by which the researcher gathers statistical data from the population. When a convenience sample is used, the researcher studies the subjects that are easy for the researcher to gain a feedback as well contribute to minimum effort and less time (Sedda, 2010). Researchers choose convenience sampling to easily gain information and save money and time. The researcher distributed 280 questionnaires where all of the pre – registration nursing students were involve. Informed consent was assumed through the student completing the questionnaires and returning the documents in a standard reply envelope.
3.5 Instrument
The Instrument that the researcher used was organ donation questionnaire (ODQ). The questionnaire was adopted from Goz (2006). The organ donation questionnaire (ODQ) was adopted from Goz because it served a verbal response from people; contains written set of questions or statements. It is designed to gather data from individuals about knowledge and awareness of organ and tissue donation. Questionnaire is a method that serves written or verbal response from people; contains written set of questions or statements. It is designed to gather data from individuals about knowledge, attitudes, believes and feelings (Kibberd, 2006). Furthermore, organ donation questionnaire (ODQ) is relatively direct and a simple method of obtaining data. It can be constructed easily and consumes lesser time to gather information. Further, it enables a widely scattered sample, cost effective, speedy results and there is no room for biasness.
The questionnaire consists of 3 sections. First section is the section “A”. In this section it embodies question on demographic data concerning age, religion, race and the respondents’ current year in the programme. The question in this section is close – ended questions where there is a list of questions that the respondents must choose to answer the questions.
The second part of the questionnaire is the section “B”. It comprises ten questions on knowledge regarding organ and tissue donation. To analyses the knowledge level among pre-registration nursing students, Likert scale which is adopted from Kane (2010) were used in this study. Likert scale measurement on 5 point scale were used to examine how strongly respondents agree or disagree with the statement/questions. The scale has measurements of 5 points that will examine how strongly respondents agree or disagree with the statement/ questions. The scale ranges from 1, which indicates ‘’strongly disagree’’ to 5, which indicates ‘’strongly agree’’. In order to score the scale, each of the categories was assigned a weight of fine. A negative statement, ‘’strongly disagree’’ receives a weight of 5, ’’disagree’’ would be 4,’’ not sure or “indifferent’’, receives 3, ’’agree’’ receives 2 and ‘’strongly agree’’ receives 1. If the statement was in positive form, rating would be reserved accordingly. Then, the respondent’s response were classified according to scores for instance Number of questions × highest score = 10×5 = 50 and Number of questions× lowest score = 10×1 = 10.Thus, the difference is 40.Further, the difference is divided by 3, which is 40/3 = 13. This difference in range is classified as; high level of knowledge with the scoring of 38 – 50, moderate level of knowledge with the scoring of 24 – 36 and low level of knowledge with the scoring of 10 – 22.
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Finally, the third section which is the section “C” It contain questions on awareness regarding organ and tissue donation. To analyse the awareness level among pre-registration nursing students, Likert scale measurement on 5 point scale were used to examine how strongly respondents agree or disagree with the statement/questions. The scale ranges from 1, which indicates ‘’strongly disagree’’ to 5, which indicates ‘’strongly agree’’. In order to score the scale, each of the categories was assigned a weight of fine. A negative statement, ‘’strongly disagree’’ receives a weight of 5, ’’disagree’’ would be 4,’’ not sure or “indifferent’’, receives 3, ’’agree’’ receives 2 and ‘’strongly agree’’ receives 1. If the statement was in positive form, rating would be reserved accordingly. Then, the respondent’s response were classified according to scores for instance Number of questions × highest score = 10×5 = 50 and Number of questions× lowest score = 10×1 = 10.Thus, the difference is 40.Further, the difference is divided by 3, which is 40/3 = 13. This difference is range is classified as; high level of awareness with the scoring of 38 – 50, moderate level of awareness with the scoring of 24 – 36 and low level of awareness with the scoring of 10 – 22.
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