Family Refusal Research Articles

The Concept of Homosexuality and Homosexuals among Late Adolescents

In India, generally studies on dimensions of alternate sexualities, are rare. The social stigma surrounding sexual minorities often acts as a hindrance in the production of research focusing on alternative sexualities. Kerala is the state with the highest literacy rate in India. But, the people of Kerala are still prejudiced towards homosexuality. Recent incidents, such as the legal fight for freedom by lesbian couples when they were separated by family and tortured (Onmanorama, 2022); the queer person's family's refusal to receive his body (The News Minute, 2022), reflects the highly homophobic attitude of the people. The presented study is qualitative and explores the conceptualization of homosexuality among late adolescents in Kerala. The study utilized semi-structured interviews. Using reflexive thematic analysis, four major themes were extracted: (1) Knowledge about homosexuality and homosexuals, (2) Factors determining the attitude toward homosexuality and homosexuals, (3) Behavior toward homosexuality and homosexuals, and (4) Perceived causes of homosexuality. The non-visibility of the LGBTQIA+ community and lack of authentic sources of knowledge were found to be significant barriers to their understanding of homosexuality. Positive portrayal of the LGBTQIA+ community in media and implementation of comprehensive sex education in institutions are recommended to foster a better understanding of homosexuality.

Epidemiological Characteristics and Management of Multi-organ Donors in an Intensive Care Unit: An Eight-Year Retrospective Study.

Patients with brain death are the primary source of organs for transplantation worldwide. Recognizing patients with this diagnosis, providing proper care, and effectively managing them in an intensive care unit (ICU) has been shown to increase donation rates in leading countries. The increasing demand for organs compared to the available number for transplantation heightens the responsibility of caring for potential donors. An observational, cross-sectional, descriptive, and retrospective study was undertaken through the analysis of cases involving multiorgan donors diagnosed with brain death. This data was obtained from the coordination of donation and procurement at the Regional General Hospital 1 of the Mexican Institute of Social Security in Querétaro. The study encompassed the duration from January 1, 2016to December 31, 2023. A database was created in the Excel program and subsequently, the analysis of the variables identified was carried out in the IBM SPSS Statics 25 software (IBM Corp., Armonk, NY). Qualitative variables were analyzed using contingency tables, frequency tables, and statistical correlation tables. For quantitative variables, the analysis included averages, percentages, means, medians, modes, variances, and standard deviations. A total of 83 patients diagnosed with brain death were identified, of whom 56 became multiorgan donors. Thirty patients were excluded from donation, with the majority (19) due to family refusal. The primary age group was 10-20 years, accounting for 23.21% of cases. The mean age was 34.86 years. 71.43%of donors were male and 28.57% were female. The most frequent admission diagnosis was severe traumatic brain injury (46.43%). 56.6%of patients were admitted to the hospital with a Glasgow Coma Scale (GCS) score of 3 points. Brain death diagnosis was confirmed via angiography in 80.4% of cases. The average length of stay was 3.95 days. The average weight was 71.19 kg. The average height was 166 cm, and the mean BMI was 25.30. Forty patients had blood type O positive, accounting for 71.4%. A total of 255 organs and tissues were procured from 2016 to 2023: 103 kidneys, 97 corneas, 41 livers, six hearts, four skin and bone tissue derivatives, three pairs of lungs, and one heart valve. Hormone replacement therapy was not used in 55.4% of cases. Combined thyroid hormone and steroid regimen was used in nine patients (16.1%), and desmopressin was used in 12 patients (21.4%). During ICU stay, 69.6% of patients required norepinephrine to achieve perfusion goals. The epidemiological profile characterizing the multiorgan donor at Regional Hospital 1 in Querétaro was typically male, with a mean age of 34.86 years, no comorbidities, presenting with severe traumatic brain injury upon arrival at the emergency department with a GCS score of 3 points. Norepinephrine was the most commonly used vasopressor, and the majority of patients did not meet hemodynamic criteria for initiating hormone replacement therapy.

Estimated Prevalence of Resident-to-Resident Aggression in Assisted Living

Resident-to-resident aggression in assisted living facilities can result in physical and psychological harm, but its prevalence is unknown. To estimate the prevalence of resident-to-resident aggression, including physical, verbal, and sexual, among residents in assisted living facilities. This study used cross-sectional, observational data from a clinical trial, in which residents of assisted living facilities were monitored for events over a 1-month period. All residents of 14 large facilities randomly selected from 2 geographic locations (N = 1067), except those receiving hospice care (n = 11), were invited to participate; 93 died or moved prior to enrollment. There were 33 family and resident refusals; 930 residents were enrolled. Data were collected between May 30, 2018, and August 11, 2022. The data are from a clinical trial testing the effectiveness of an intervention to reduce resident-to-resident aggression. In addition, the study was designed to assess prevalence using the Time 1 (baseline) data, using a probability sample of facilities to allow for this analysis. Resident-to-resident aggression was identified using a mixed-method, case-finding strategy involving 6 sources: (1) cognitively capable resident reports regarding 22 possible events, (2) direct care staff report, (3) staff member reports collected from event-reporting forms, (4) research assistant observation of events in real time, (5) facility accident or incident reports, and (6) resident records. The prevalence of resident-to-resident aggression among the 930 participants (mean [SD] age, 88.0 [7.2] years; 738 women [79.4%]) during the past month was estimated to be 15.2% (141 of 930 residents; 95% CI, 12.1%-18.8%). The most common forms of aggression included verbal (11.2% [104 of 930 residents; 95% CI, 8.8%-14.2%]), physical (41 of 930 residents; 4.4% [95% CI, 3.1%-6.3%]), sexual (0.8% [7 of 930 residents; 95% CI, 0.4%-1.6%]), and other (70 of 930 residents; 7.5% [95% CI, 5.5%-10.2%]). These categories are not mutually exclusive as residents could be involved with more than 1 type of aggressive behavior. In this cross-sectional, observational prevalence study, resident-to-resident aggression in assisted living facilities was highly prevalent. Verbal aggression was the most common form, and physical aggression also occurred frequently. The effects of resident-to-resident aggression can be both morbid and mortal; therefore, intervention research is needed to prevent it and to treat it when it occurs.

The Importance of Reconstituting the Bodies of Organ and Tissue Donors: a Look at Human Dignity

Introduction: Family refusal to authorize the donation of human organs and tissues has remained high over the years. Among the many reasons for not donating, we highlight the lack of information about the process and the family’s lack of knowledge about the donor’s wishes in life, as well as other issues, such as the appearance of the donor’s body after donation. In this sense, it is necessary to bring to light the aspects that permeate the concepts of death, human dignity, and care for the donor’s image, especially in the case of tissue donors, where the removal may be more noticeable. Objectives: An integrative literature review (ILR) was carried out, seeking to highlight gaps and characterize the process of donating human organs and tissues, with a focus on the reconstruction of the donor’s body and human dignity. In addition, the aim was to describe the experience of a professional from a human tissue bank (BTH). Methods: Using the PICO strategy, the study’s guiding question was drawn up following an IR carried out over the last 10 years, operationalized by controlled descriptors in the SciELO, LILACS, Google Scholar, and PubMed databases. In addition to the search, an experience report was described on the techniques used to reconstruct the donor’s body after the tissues used by a BTH located in the interior of the state of São Paulo were harvested. Results: Nine specific studies were found on donation and the use of prostheses to reconstruct donated areas. The results show the reasons for family refusal, as well as the care taken by the technical teams in reconstructing donors’ bodies. The family’s concern about the donor’s aesthetic situation influences acceptance for donation, so it is necessary to invest in the safety and quality of the services provided by BTH to reduce family refusal for donation. Conclusion: Clear communication and the safety of the processes involved in the procurement of human organs and tissues proved to be the best way to facilitate donation and could thus increase donations.

Meeting the Shortage of Human Cells and Tissues: The Andalusian Quality Assurance Programme for Tissue Donation.

Background A quality assurance programme for the tissue donation process was launched in Andalusia in 2020 to facilitate the integration of tissue donation into end-of-life care, and to respond to the growing need for human tissue for therapeutic purposes. The results of this programme are presented here. Methods After identifying the hospital departments in which to intensify the detection of tissue donors, expanding training activities and designing a specific data collection system for possible tissue donors who do not donate their tissues, the results of the donation activity were quantified and the causes of non-donation were analysed by applying the critical pathway for deceased tissue donation methodology. Results After an initial drop in activity, which coincided with the coronavirus pandemic, the number of tissue donors increased by 48.4% in 2022 compared to 2019. From the eligible donors, 83% were actual tissue donors and 71% were utilised donors. The modifiable causes of tissue donation loss, in order of frequency, were family refusal, followed by organisational or logistical issues, failure to notify or failure to identify possible donors, and failure to complete donor evaluation. Conclusion As a result of the collaboration of the various professionals involved in the programme, tissue donation activity has increased remarkably, the potential and effectiveness of the donation process have been evaluated, and areas for improvement have been identified, which we hope will lead to continuous improvement of the process.

Социальное благополучие как критерий развития наций (к вопросу о методологии оценивания)

Human well-being as a criterion of progress is usually measured by indices of standard of living, quality of life, and human development. These indices are based on methodological individualism and consider human development as an increase in individuals’ prosperity, comfort, freedom, and self-realization. While comparing countries or regions, the object of consideration are aggregated individuals, rather than nations, peoples and territorial communities within which the species Homo sapiens exists. Due to their conceptual scope, the accepted indices do not see an obvious paradox: the maximization of what is considered well-being – standard of living and personal selfexpression – exacerbates the anthropological crisis, namely the destruction of sociality in all historically established forms, the rapid destruction of a family institution and refusal of human individuals to continue the human race. The authors of the article propose a new index to measure human well-being, which is a social production of life and a social order that reduces human suffering. The viability of human community requires population reproduction which is the first condition for social development. But society is not identical to the population, and social well-being presupposes the reproduction of an institutional balance between communal and personal principles. The key to social and population reproduction is the preservation of family as the basic structure of society. Reducing human suffering means minimizing threats to human life and eliminating extreme forms of social oppression. The minimization of threats to human life and safety of social environment are verified by reduction in mortality from external causes and an increase in average life expectancy. To avoid the extremes of social oppression, it is necessary to eliminate poverty and ensure universal education for children. Thus, social well-being, which is being understood and achieved, is a necessary basis for the sustainable development of nations.

Family refusal of skin donation for transplantation: trends and associated factors.

to analyze the trends and factors associated with family refusal of skin donation for transplantation. this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance. 1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively. there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.

Status of epilepsy care delivery and referral in clinics, hospitals, and epilepsy centers in Japan: A nationwide survey.

Collaboration among medical facilities is crucial to deliver comprehensive epilepsy care to a diverse and large population of people with epilepsy. We conducted a survey among medical facilities of various sizes throughout Japan to investigate the status of epilepsy care delivery, functioning, and referral. With the cooperation of the Japan Neurological Society (1428 facilities), Japanese Neurosurgical Society (3489 specialists), and Epilepsy Care Network (948 facilities), a questionnaire was mailed to 5865 locations that provide epilepsy care in Japan. The facilities were classified into clinics (19 beds or less), small hospitals (SH, 20-199 beds), large hospitals (LH, 200 beds or more), and epilepsy centers (EC). The status of epilepsy care delivery, functioning, and referral was compared among the four groups. Responses were received from 1014 facilities (17.3% response rate). After excluding duplicate responses, 957 facilities were analyzed (394 clinics, 149 SH, 388 LH, 26 EC). EC responded "manageable" in more items of epilepsy care functions in general, especially those related to epilepsy surgery, compared to LH with similar facility size. However, EC responded being less manageable in psychiatric service (61.5%), dietary therapy (46.2%), rehabilitation (53.8%), and patient employment support (61.5%). The percentage of facilities that responded "always able to refer" was highest in clinics (67.6%) and the lowest in EC (40%). Referral difficulties were more commonly encountered in EC, and less common in clinics. In EC, the most common reason for inability to refer was patient or family refusal (64%). We have clarified the epilepsy care delivery, functioning, and referral in facilities of various sizes in Japan. This study highlights the issues of downward referral and patient stagnation in EC, which have not received much attention. A nationwide survey of healthcare facilities ranging in size from small clinics to large hospitals in Japan examined medical care delivery and patient referrals related to epilepsy. Compared to other facilities, epilepsy centers provided a variety of medical services to people with epilepsy but were inadequate in addressing psychiatric symptoms, providing dietary therapy, rehabilitation, and patient employment support. Referrals from epilepsy centers to other medical facilities were often refused by patients and their families. This results in patient crowding at epilepsy centers.

Lymphomatoid granulomatosis with infrequent manifestations: case report

Introduction: lymphomatoid granulomatosis is a very rare disease with few reports in the medical literature. Objective: to present the case of a lymphomatoid granulomatosis that constitutes a variety of primary lymphoproliferative neoplasms of the lung and constitutes the first case reported in our hospital. Case presentation: 44-year-old male, veterinarian with a history of health without toxic habits that began with respiratory symptoms, dermatological lesions, constitutional syndrome and flaccid paraplegia. After performing the essential complementary tests which showed pancytopenia; an image suggestive of pulmonary metastasis was found in the chest X-ray, which was corroborated in the pulmonary tomography; also performing magnetic resonance imaging that showed lesion compression at the dorsal level. Pathology studies of the skin and lungs revealed lymphomatoid granulomatosis with spinal cord invasion. The patient received chemotherapy treatment and died abruptly a month after it began. Conclusions: lymphomatoid granulomatosis is a rare disease currently considered as a lymphoid neoplasm associated with Epstein-Barr virus and large B-cell lymphoma. We present the case of a patient with said pathology, accompanied by neurological injury and whose diagnosis was only possible by pathological studies; making it impossible to carry out a necropsy due to family refusal.

Efficiency and the futures market in organs.

There has been considerable debate over regulated organ markets. Especially current markets, where people sell one of their kidneys while still alive, have received increased attention. Futures markets remain an interesting and under-discussed alternative specification of a market-based solution to the organ shortage. Futures markets pertain to the sale of the right to procure people's organs after they die. There is a wide range of possible specifications of the futures market. There are, however, some major unaddressed efficiency concerns. This article presents this class of concerns and discusses the implication for organ futures markets.It identifies a number of inefficiency sources pertaining to crowding out, bad organs, costs and missed opportunities, family refusals,moral hazardand strength of the provided incentive. However, a complete assessment of futures market requires better knowledge regarding the potential reaction from donors, families and health professionals.

The Scenario of organ and Tissue Donation for Post-mortem Transplantation in the 16th Health Region/RS

Introduction: The donation and transplantation of organs and tissues is a topic of multiprofessional interest and an important theme regarding the promotion of public health policies regarding the application of this therapy. Objectives: The objective of this article is to present an analysis of the scenario of organ and tissue donation after death, for transplantation, in the 16th Health Region of Rio Grande do Sul between 2010 and 2020, focusing on evaluating family refusals to donate. Methods: A census survey was carried out of the data referring to the brain death protocols carried out in the period, tabulated in Microsoft Excel, analyzed through the construction of time series and related using the chi-square test. Results: The analysis in the region shows a higher proportion of negatives (57.8 %) concerning acceptances (42.2 %) for organ and tissue donation. However, when only the last years of the period are observed, another reality is seen: from 2017 to 2019, the donation statements corresponded to more than 75 % of the interviewed families. In 2020, however, in an atypical way, no brain death protocols were concluded; therefore, no family underwent the interview for donation. Conclusion: There has been a trend toward an increase in donation percentages over the years, both in the 16th Health Region of Rio Grande do Sul and the rest of the country. However, the number of transplants performed is still lower than the population’s need.

Forensic Autopsy Implementation in Unnatural Deaths to Achieve Material Truth

Uncovering cases of unnatural death is crucial for the purpose of law enforcement. However, the investigation of these cases often faces challenges, particularly when it comes to obtaining information about the causes and circumstances of death, which can be revealed through forensic autopsies based on medical principles. Unfortunately, the rejection of forensic autopsies by the victims' families poses a significant obstacle. This research aims to explore and analyze the legal implications that arise from the family's refusal of a forensic autopsy, with the ultimate goal of ensuring effective law enforcement against families who reject such procedures. Additionally, the study seeks to find solutions for conducting forensic autopsies in order to uncover the material truth behind criminal cases involving unnatural deaths. The research adopts a normative juridical approach, focusing on examining theories, concepts, legal principles, and relevant laws and regulations. Secondary legal materials are analyzed qualitatively through library research techniques. The findings of this study underscore the need for comprehensive legal reforms that address the implementation of forensic autopsies in cases of unnatural deaths, in order to facilitate the pursuit of material truth.

Changing the method of consent to increase the numbers of cadaveric donors in Saudi Arabia: the autonomy paradox

Background: In Saudi Arabia, the gap between the demand and availability of organs persists, with a total of 13,731 patients who remain on the waiting list in 2019. Family refusal is a major obstacle limiting donation since their consent must be obtained prior to the retrieval of organs. The cause of family refusal is mainly due to the unknown wishes of their loved one to become a donor. This analysis aimed to compare three systems of obtaining consent in terms of effectiveness, respect for personal autonomy, and the cultural role of families in Saudi Arabia to ensure feasibility and effectiveness in increasing the number of donors. Policy alternatives and implications: The consent systems include opt-in (explicit consent), opt-out (presumed consent), and mandated choice systems. The mandated choice policy might be the optimal solution to investigate since it could balance the respect for individual autonomy and the cultural role of families in Saudi Arabia. Conclusions and recommendations: Mandated choice could be an option that ensures the respect of personal autonomy while influencing the next of kin's decision to donate the organs. Nevertheless, more research should be conducted to support adopting this policy in the Saudi context. Additionally, a recommendation to decision makers is to utilize the Tawakkalna app to send alerts to the next of kin when a user registers as a donor with the user's consent.

Prevalence of Family Refusal and Associated Factors in Declared Brain Death: A Six-Year Retrospective Study in Northern Cyprus

Kidney transplantation provides a higher quality of life, a longer life expectancy for end-stage renal disease patients, and a lower cost than other treatments. Unfortunately, organ shortage for kidney transplantation is a major obstacle for countries with long waiting lists. Approaches to solving organ shortages with laws and regulations differ between countries. The reasons for these differences are evaluated by considering many factors, such as religious beliefs, sociocultural differences, and distrust in health systems. Until another evidence-based treatment becomes available, efforts to increase dead donor transplants are the main solution to reducing waiting lists. In a retrospective study conducted in our region, we investigated the prevalence and potential correlation of deceased organ transplantation based on family refusal and other issues.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Barriers to Deceased Donor Procurements: The Saudi Experience.

To donate or not to donate: meanings of family refusal to the refusal to donate organs and tissues

Objective: To understand the meanings attributed by family members about the refusal to donate organs and tissues. Methods: A descriptive and exploratory study with a qualitative approach. A semi-structured questionnaire was used for data collection and thematic content analysis was employed for the treatment of the data obtained. The sample comprised by 10 participants was defined by means of the theoretical saturation criterion. Results: There was a tendency for family members to consent to the donation when well-oriented about brain death and the humanistic purpose of the donor, but the main obstacles to refuse donation are as follows: lack of knowledge about organ donation, fear of body mutilation for not knowing how the procedure for removing organs and tissues is performed, bureaucracy with the delay in releasing the body for burial and disagreement between family members. Conclusion: The meanings of family refusal permeate fear, a feeling of emptiness and lack of information about the processes involved in organ and tissue donation, as well as cultural and religious aspects, although despair, pain and lack of empathy of the health teams can also corroborate refusal.

Educational Actions to Raise Student Awareness About the Donation and Transplantation of Human Organs and Tissues

In Brazil, family refusal to donate organs and tissues is the main reason for not performing transplants, making it necessary to implement different educational strategies in diverse populations on this topic. Thus, this study aimed to raise awareness among school-aged adolescents about the method of organ and tissue donation and transplantation. This is a descriptive experience report with a quantitative and qualitative approach to educational actions in the school environment, mediated by the action research method, carried out with 936 students aged between 14 and 18 years from public schools in the interior of Sao Paulo, Brazil. These actions were developed according to the themes identified and worked on through the culture circle, using active methodologies. Two semistructured questionnaires were applied, pre- and postinterventions. For analysis, sample normality tests and Student's t test were used (P < .0001). The topics identified were as follows: clarifications on the legislative history of donation and transplants; diagnosis of brain and circulatory death; bioethical aspects of transplants; reflections on mourning, death, and dying; maintenance and notification of the potential donor; types of viable organs and tissues for donation; and the process from collection to transplantation, among others. Comparative analysis showed statistical differences between pre- and postinterventions. Educational interventions through active methodologies are presented as tools capable of making students aware of organ and tissue donation and transplantation.

Family Refusal of Heart Valve Donation

Impairment of the heart valves can occur due to many diseases that cause deterioration of the contractile function and harm the body, making it necessary for the heart valves to be transplanted. This study's objective was to analyze families' refusal to donate heart valves between 2001 and 2020. This was a cross-sectional study conducted in accordance with the Terms of Family Authorization for Donation of Organs and Tissues from patients diagnosed with brain death by an Organ Procurement Organization in the state of São Paulo. The variables analyzed were sex, age, cause of death, hospital type (private or public), and refusal to donate heart valves. Data analysis was performed using Stata software version 15.0 (StataCorp, LLC, College Station, Tex, United States) in a descriptive and inferential way. A total of 236 people (9.65%) refused to specifically donate heart valves of their relatives, the majority of whom were between 41 and 59 years old. Most potential donors had suffered a stroke and had been in a private hospital. From 2001 to 2009, there was a decreasing trend in males and the age group from 0 to 11 years old, whereas there was an increasing trend in those aged 60 years or older and in the general population. Between 2010 and 2020, there was a downward trend in the 41- to 59-year-old age group and the general population. The specific refusal to donate heart valves was associated with age, diagnosis, and whether the institution was public or private.

328 Incidence and Number of Missed Chemical Venous Thromboembolic Event Prophylactic Doses Predict the Development of Venous Thromboembolic Events in Traumatic Brain Injury Patients

INTRODUCTION: Venous thromboembolic events (VTE) are a major concern in trauma and intensive care, with traumatic brain injury (TBI) patients at an elevated risk. Chemical VTE prophylaxis is used to prevent VTE development. Concerning TBI patients, achieving a fine balance between the risk of worsening hemorrhage and clot development is important. To date, there has been no correlation between the number of missed doses and VTE development in this population. METHODS: Data were retrospectively collected among 818 TBI patients admitted to a level I trauma center between 2015-2020. RESULTS: Overall VTE incidence was 9% (7.6% DVT; 3.2% PE; 1.7% both). Median time to DVT and PE was 7 (IQR: 4-11) and 5 days (IQR: 3-12), respectively. VTE occurred in 37.8% of patients who missed prophylactic doses and 28.4% who did not (p = 0.089). In patients who experienced a VTE, compared to non-VTE patients, missed chemical prophylaxis dosing was primarily due to a pending invasive procedure (44.8% vs. 25.2%, p = 0.02) and the presence of additional bleeding (13.8% vs. 2.8%, p = 0.005). Non-VTE patients missed prophylactic dosing primarily from patient or family refusal (42.1% vs. 3.4%, p &lt; 0.001). VTE incidence was higher in patients receiving invasive neurosurgery (45.9% vs. 30.5%, p = 0.007). Univariate analysis demonstrated 4-6 total missed doses as predicting the highest VTE risk (OR 4.08, 95% CI: 1.53-10.86, p = 0.005). No VTE were seen in &gt;7 missed doses, presumably due to an overall high mortality rate of 13.5%. CONCLUSIONS: This study is novel in showing the incidence and number of missed chemical VTE prophylaxis to predict an increased VTE risk in TBI patients. Our study suggests a threshold of 4 missed doses to be particularly important in this critical patient population.

Intervention programme to improve knowledge, attitudes, and behaviour of nursing students towards organ donation and transplantation: A randomised controlled trial

To develop and evaluate an educational programme aimed at undergraduate training to increase and improve knowledge, attitudes and behaviour towards the organ and tissue donation and transplants (OTDT). The request for OTDT falls on the health personnel and the reduction of family refusals depends on their attitude and competence, which is vital to increase OTDT. The evidence highlights the efficacy of starting training at early stages and the implementation of educational programmes in universities is recommended to reduce family refusals. A randomised controlled trial. A randomised controlled trial with an experimental group (EG) -theory class and round table- and a control group (CG) -theory class- that transitions to a delayed experimental group. A sample of 73 students was distributed in parallel randomised groups. The groups increased their knowledge and improved their attitude, significantly changing their behaviour in the follow-up. These changes in the experimental groups were more significant than in CG in perceived quality of information (z=-4.948; p=<0.001), level of knowledge (EG1 and CG z=-2.245; p=0.025) (EG2 and CG z=-2.215; p=0.027), attitude (EG1 and CG z=-2.687; p=0.007) (EG2 and CG z=-2.198; p=0.028) and behaviour (EG1 and CG t=2.054; p=0.044) (EG2 and CG z=-2.797; p=0.005). The education programme has proven effective, promoting knowledge, change and entrenchment of attitudes, facilitating conversations with families, enabling willingness to donate and increasing potential donors.