Developing Knowledge for Organ Donation | Research Study

Developing Knowledge for Organ Donation | Research Study 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 aware ness between pre-test and post-test scores in both the controlled group and experimental group. 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 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 in dicate 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 studys 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. â€Å"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 – registrati on 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 â€Å"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 â€Å"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 â€Å"indifferentâ₠¬â„¢Ã¢â‚¬â„¢, 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 Ãâ€" highest score = 10Ãâ€"5 = 50 and Number of questionsÃâ€" lowest score = 10Ãâ€"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. Finally, the third section which is the section â€Å"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 â€Å"indifferent’’, receives 3, ’’agree’’ receives 2 and ‘’strongly agree’’ receives 1. If the statement was in positive form, rating would be reserved accordingly. T hen, the respondent’s response were classified according to scores for instance Number of questions Ãâ€" highest score = 10Ãâ€"5 = 50 and Number of questionsÃâ€" lowest score = 10Ãâ€"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. Is It Justified To Restrict Freedom Of Expression? Is It Justified To Restrict Freedom Of Expression? Freedom of expression has been a controversial issue for centuries. It has been oppressed and sometimes lead to death for people such as Plato and Thomas Edison who found out and tried to spread the word that the earth is round. In these modern times, there is more liberty for expressing our thoughts, but there are still complaints and cases where it is still being suppressed based on ground of offense. In this paper, I will try to investigate more on that matter and will try to study the case of the Danish Cartoons. The term freedom of expression is sometimes used to indicate not only freedom of verbal speech but any act of seeking, receiving and imparting information or ideas, regardless of the medium used. In practice, the right to freedom of speech is not absolute in any country and the right is commonly subject to limitations, such as on hate speech. In this paper, I will offer observations about some of the arguments used to justify restrictions on free speech and suggest how they might apply in some cases. To do so, I will be focusing on some of John Stuart Mills arguments including the harm principle and the offense principle and their applications in order to justify or not restrictions of free speech. According to the Freedom Forum Organization, legal systems, and society at large, recognize limits on the freedom of speech, particularly when freedom of speech conflicts with other values or rights. Limitations to freedom of speech may follow the harm principle or the offense principle, for example in the case of pornography or hate speech. Limitations to freedom of speech may occur through legal sanction or social disapprobation, or both. John Stuart Mill argued that there ought to exist the fullest liberty of professing and discussing, as a matter of ethical conviction, any doctrine, however immoral it may be considered. Mill argues that the fullest liberty of expression is required to push arguments to their logical limits, rather than the limits of social embarrassment; which is true and this is a good method if we wanted to persuade our opinions to someone. However, Mill also introduced what is known as the harm principle, in placing the following limitation on free expression: the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. Mills continues to propose that freedom of speech may be restricted in the very limited circumstances in which it is likely to cause harm to others in the form of a violation of their rights. In his example, he states that one may publish the view that corn dealers are starving the poor, but ones expression of this view in front of an angry mob that will likely provoke them to riot and attack the corn dealers may be prohibited. And obviously, the interests of the corn dealers might be damaged in case that view is printed in a newspaper, but will probably not lead to a violation of their rights as in the case of the speech prior an angry mob. The publication of the view poses no immediate, illegitimate threat to the lives or property of corn dealers. Thus, in this case, freedom of expression is justified. The overall point here is that a healthy, flourishing democracy relies upon access to a wide range of opinions and sources of information. Both laws and cultural trends are currently working to silence opinions in a manner which will impede the ability of democracies to properly function. Mills point about the necessity of freedom of expression for the pursuit of truth is thus intimately connected to the proper functioning of democracy. Although we may find an opinion offensive, silencing that opinion through either laws or cultural forces entails harms so great that the offensive opinions must be allowed to be expressed. Mill is right to object to the silencing of opinions, and his work helps us to see how our modern world is doing harm to the pursuit of truth in ways that we may not be aware. Another similar case to Mills example and one of the most recent controversial issues, took place In September 2005 when the Danish newspaper, Jyllands-Posten, published 10 editorial cartoons that were perceived by many as direct mockery of the prophet Muhammad and a denigration of Islam. In various cartoons, Muhammad was portrayed as having horns, wearing a turban in the shape of a bomb, and endorsing terrorism. This publication resulted in widespread condemnation from diverse quarters and was met with violent reaction from some. The Danish Islamic Organization sought censure and prosecution of the publication under Danish and international law. This case raises the issue of whether and when local and international law is justified in restricting freedom of expression. Would the government of Denmark have been justified in restricting the publication of the cartoons or exacting punishment for their publication? Should other governments have restricted the subsequent republication of these cartoons in other newspapers, magazines, and on the internet? Should publication of similar material be protected in the future? In the following, I will try to answer these questions. Before starting and answering these questions, it is essential to keep in mind two things. First of all, freedom of speech is not supreme but is still is an important value. It is one of the very numerous values that may be deficient compared to other values. Thus, any attempt of defending or prohibiting speech involves a balancing of conflicting interests and values. Second, each country has its own laws which vary in the limitations they place on the speech. The United States of America has perhaps the most liberal laws when it comes to protecting the free speech. Many other countries have more restrictive laws, especially regarding the hate speech. However, regardless of liberality of laws regarding free speech, the memory of a person may be an indicator in selecting the type of speech that may be restricted, since the memory may contribute to an assessment of the meaning and importance of the offense and harm that the speech may cause. And quite often, the message that the act of freedom of expression sent does not remain a long time in the memory of third parties, thus making the life span of that idea very short. And, according to Mills argument, these cartoons did not cause any immediate or illegitimate threat to public health so the cartoons are justified. In the case of the Danish cartoons, I do not believe that there was any kind of violation. This is purely an expression of thought. There exist many cases where the freedom of expression offended its recipient. We can name the case of some mockeries of the President of the United States of America or any other important political figure on numerous American TV programs such as the late night shows. Even here in Lebanon, some sketches mock our political leaders or even political parties, yet nothing is being done against it which is a sign of tacit consent. This does not mean freedom of expression should be banned. On the contrary, sometimes these mockeries may provide third parties some information he/she did not know before and could point out to a flaw that the third parties could improve on. A decent society, is one that honors freedom concretely. However, in many cases, the harm that resulting from the response to the speech might be so significant and uncontainable, that the government would be justified in limiting the speech to protect third parties. Making funny sketches, mocking or drawing caricatures is one thing. Death threats, bomb scares, burning embassies, deadly riots, and boycotts are another. In such exceptional cases, the harm principle may justify restricting speech. There should be an equilibrium between the importance and mitigation of the harm and value of protecting the speech. The well being of the society should be the top priority even if it includes restricting freedom of expression. In addition and in most cases, a persons identity can be easily related to his religion or his set of beliefs. So even bare knowledge of actions deemed unacceptable from a religious point of view can be considered as a personal deep offense. In such cases, the reasonableness requirement subjects the individual who wants to engage in the offending conduct to a higher standard of proof. He must prove that the value of his behavior makes it not only reasonable but also reasonable enough to outweigh the seriousness of any offense that he might cause. The offended party, however, need prove nothing about the value of what is believed to be disrespected. He need only show that he and others hold the relevant beliefs about value and that when their belief system is confronted with particular kinds of behavior, then experience serious offense. These days, with technologies emerging in an unprecedented way, social networking has become an important part of our everyday life. Web sites such as Facebook, Twitter or blogs created by an average person are an escape from reality to a place where freedom of expression is highly valued. On Facebook, groups can be created where people with same interests and goals can join. They can open discussion boards and share their ideas, offending or not may it be. However, even on sites like these there are limits for what you can say and post. If someone has offended you, you have the option to report him. But such as in real life, Facebook asks you for a justification in order to go through the reporting process. Another condition is that the user should be reported by many others in order for Facebook to look at that case, because one person cannot be offended unless the speech is directed to him, rather an entire population being offended is another thing. Furthermore, just because someone calls me out if I treat them badly doesnt mean I have no right to say whatever I said to offend. It just means that if I choose to use that kind of expression I may have to deal with the social repercussions. And sometimes the good effects of offensive speech can outweigh the harm caused by the offense itself. With that in mind, theres no reason to withhold a freedom of expression in order to generate more benefits. In that context benefit could be a social benefit, economical, political, religious, etc Moreover, most of us at some point in our life made fun of, criticized and judged, for example, oversized people, little people, or any other condition that we do not deemed as being normal. On the other hand, these people are not harmed but are rather bothered by these comments. This type of expression can be easily defended but we may want to consider that the limits of our freedom of expression ends when we trespass or offend someone else. We can conclude by confirming that offence does not justify restrictions on freedom of expression but those expressing offensive ideas must consider the possibility that they may push away their potential audience. Remarkably, many people seem to consider such refusal by private citizens to endorse certain ideas with which they disagree to be a form of censorship. Of course it is not, unless they attempt to use the law to suppress those ideas. Also, we could argue that offense does not justify restrictions of freedom, but it justifies the need for manners, respect for others, ethics, empathy, and social consciousness. And by writing this paper, I am expressing my freedom of thoughts hoping that it will affect positively all third parties. So lets express suitably our basic human right!