METHODS: To measure caregiver burden and functional disability of the care recipient, we employ the Zarit Burden Interview (ZBI) and the Barthel Index, respectively. Then we utilized the ordinary least squares (OLS) methodology and estimated four regression models. Models 1, 2, and 3 examined the impact of the variables of the caregiver burden, responsibility and love, and the quality of the caregiver-caregiver recipient relationship, respectively, on family caregivers' willingness to care. Model 4 was the full model. To testify whether the caregiver burden is likely to act as a mediator, path analysis was used, and the path was adjusted and verified.
RESULTS: According to the survey, in Shanghai, only half of the caregivers had a very high care willingness to care for disabled older relatives, while nearly one-tenth of the caregivers had a low willingness. It was the caregiver burden rather than the functional disability of older adults that harms family caregivers' willingness to care. Responsibility and caring out of love were positively related to care willingness. Relationship quality was the most important influencing factor, explaining 10.2% of the variance in care willingness. Path analysis demonstrated that responsibility, caring out of love, and relationship quality directly and through the mediation of caregiver burden indirectly affected care willingness.
CONCLUSION: Our results revealed that reciprocal altruism presented by the quality of the caregiver-care recipient relationship had a significantly positive impact on family caregivers' willingness to care. In addition, the caregiver burden was found not only directly affected care willingness, but also acted as a mediator. To promote the perfection of laws and policies, comprehensive samples of different types of cities should be included and the measurement of key variables could be further improved in future studies.
METHODS: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.
ETHICAL CONSIDERATIONS: The study was approved by the University of Malaya ethics committee.
RESULTS: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.
CONCLUSION: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.
Patients and Methods: The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors.
Results: Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent.
Conclusion: This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.