A NIGHTMARE FOR TRANSPLANT PHYSICIANS: BONE MARROW DONOR CANDIDATES WITHDRAWING FROM THE DONATION PROCESS

Öz

OBJECTIVE: Although there have been remarkable developments regarding stem-cell transplantation (HSCT) in Turkey, but the number of people who would like to be stem cell donors is not yet at the desired level. The present study aimed to assess the effect of the training delivered by specialists on the thoughts and decisions of the health employees working in our center on being HSCT donors. MATERIAL AND METHODS: Employees in the health sector who have not received any training in HSCT were included in the study. A half-hour of collective training for all participants was delivered by the General Directorate of Health Services Turkey Stem Cell Coordination Center (TÜRKÖK) on January 11-12, 2018. The present study included 274 health employeeswho attended the training delivered by TÜRKÖK. The pre-testand post-test were applied to determine the socio-demographic characteristics of the participants, their knowledge andattitudes about stem cell transplantation before and after thetraining, and the factors that motivate and prevent them frombeing a donor. RESULTS: Among the 95 participants, who did not think about being a donor before receiving education, the factors that caused them to not want to be a donor the most were their distrust of the health system (16.5%), the worry of causing pain (15.4%), and the thought that being a bone marrow donor had a negative impact on health (13.4%). A statistically significant increase was found in the rate of those who think about becoming a stem cell transplant donor after education (p:,0001), those who think they have enough information about stem cell transplant (p:,0001), those who think they know where to apply to be a stem cell donor (p:,000) those who thought that the society was sufficiently informed about stem cell transplantation (p:,0001). While 67.3% (171 people) of the participants stated that their determination to be a donor would continue until the end of the whole process, 32.7% (83 people) stated that they could stop being a donor. CONCLUSIONS: Our results show that continuing giving such trainings, especially in institutions, will contribute to the increase of the number of stem cell donor volunteers to a sufficient level by raising awareness on the subject and reducing false beliefs in our country.

Anahtar Kelimeler

• HSCT
• Donor
• Knowledge
• Attitude
• Training

TRANSPLANT HEKİMLERİNİN KORKULU RÜYASI: KEMİK İLİĞİ VERİCİ ADAYLARININ DONASYONDAN VAZGEÇMESİ

Öz

AMAÇ: Ülkemizde kök hücre nakli (HSCT) konusunda çok ilerlemeler kaydedilmesine rağmen, nakil vericisi gönüllülerinin sayısı hala istenilen düzeyde değildir. Bu çalışmada sağlık çalışanlarına, kök hücre nakli vericisi olma konusunda uzmanlar tarafından verilecek eğitimlerin, verici olma konusundaki düşüncelerine ve kararlarına etkilerinin değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Kök hücre nakli konusunda önceden herhangi bir eğitim almamış olan, sağlık çalışanları çalışmaya dahil edildi. 11-12 Ocak 2018 tarihlerinde Türkiye Kök Hücre Koordinasyon Merkezi (TÜRKÖK) tarafından, katılımcılara yarım saatlik bir toplu eğitim verildi. Bu çalışmaya TÜRKÖK tarafından verilen eğitimlere katılan 274 sağlık çalışanı dahil edilmiştir. Katılımcıların sosyo-demografik özellikleri, eğitim öncesi ve sonrası kök hücre nakli konusundaki bilgi ve tutumlarını, bağışçı olma konusunda kendilerini motive eden ve engelleyen faktörleri tespit etmeye yönelik ön test ve son test uygulandı. BULGULAR: Eğitim almadan önce verici olmayı düşünmeyen 95 katılımcının, verici olmak istememelerine en çok neden olan faktörler sağlık sistemine güvenmemeleri idi (%16.5), ağrıya neden olma endişesi (%15.4), kemik iliği vericisi olmanın sağlığı olumsuz etkilediği düşüncesiydi (%13.4). Eğitim sonrasında kök hücre nakli vericisi olmayı düşünenlerin (p:,0001), kök hücre nakli ile ilgili yeterli bilgiye sahip olduğunu düşünenlerin (p:,0001), kök hücre vericisi olmak için nereye başvurulması gerektiğini bildiğini düşünenlerin (p:,000), ülkemizde kök hücre nakli ile ilgili toplumun yeterince bilgilendirildiğini düşünenlerin (p:,0001) oranlarında istatistiksel olarak anlamlı artış saptandı. Katılımcıların %67.3’ü (171 kişi) tüm süreç sonuna kadar verici olma kararlılığının devam edeceğini belirtirken, %32.7’si (83 kişi) verici olmaktan vazgeçebileceğini belirtti. SONUÇ: Sonuçlarımız bu tür eğitimlerinin yaygınlaşarak, özellikle kurumlarda verilmeye devam edilmesinin, ülkemizde konu ile ilgili farkındalığı artırıp, yanlış inanışları azaltarak, kök hücre vericisi gönüllüsü sayısının yeterli düzeye ulaşmasına çok önemli katkı sağlayacağını göstermektedir.

Anahtar Kelimeler

• HSCT
• Donör
• Bilgi
• Tutum
• Eğitim

Kaynakça

1. 1. Hazzazi AA, Ageeli MH, Alfaqih AM, et al. Knowledge and attitude towards hematopoietic stem cell transplantation among medical students at Jazan University, Saudi Arabia. Saudi Medical Journal. 2019;40:1045-51.
2. 2. Riezzo I, Pascale N, La Russa R, et al. Donor selection for allogenic hemopoietic stem cell transplantation: clinical and ethical considerations. Stem cells international. 2017;2017;5250790.
3. 3. Feve F, Cambon-Thomsen A, Eliaou J, et al. Economic evaluation of the organization of a registry of haematopoietic stem cell donors. Revue D'epidemiologie et de Sante Publique. 2007;55:275-84.
4. 4. Karakuş V. TÜRKKÖK Projesi Son Durum ve Etik Gerekçeleri. 2017.
5. 5. Chen S H, Wang T F, Yang K L. Hematopoietic stem cell donation. International Journal of Hematology. 2013;97:446-55.
6. 6. Krantz MJ, Coronel SM, Whitley EM, et al. Effectiveness of a community health worker cardiovascular risk reduction program in public health and health care settings. American Journal of Public Health. 2013;103:19-27.
7. 7. Sanner MA. Registered bone marrow donors’ views on bodily donations. Bone marrow transplantation. 1997;19:67-76.
8. 8. Mc Cullough J, Rogers G, Dahl R, et al. Development and operation of a program to obtain volunteer bone marrow donors unrelated to the patient. Transfusion. 1986;26:315-23.

9. 9. Switzer GE, Myaskovsky L, Goycoolea JM, et al. Factors associated with ambivalence about bone marrow donation among newly recruited unrelated potential donors. Transplantation. 2003;75:1517-23.
10. 10. Galanis P, Sparos L, Katostaras T, et al. Factors that influence Greeks' decision to register as potential bone marrow donors. Transplantation proceedings: Elsevier, 2008.
11. 11. Onitilo A, Lin Y, Okonofua E, et al. Race, education, and knowledge of bone marrow registry: indicators of willingness to donate bone marrow among African Americans and Caucasians. Transplantation proceedings: Elsevier, 2004.
12. 12. Aurelio M, Aniasi A, Haworth S, et al. Analysis of the motivation for hematopoietic stem cell donation. Transplantation proceedings: Elsevier, 2011.
13. 13. Aschan J. Allogeneic haematopoietic stem cell transplantation: current status and future outlook. British medical bulletin. 2006;77:23-36.
14. 14. Passweg J, Baldomero H, Gratwohl A, et al. The EBMT activity survey: 1990–2010. Bone marrow transplantation. 2012;47:906-23.
15. 15. Kaya Z, Gültekin KE, Demirtaş OK, et al. Effects of targeted education for first-year university students on knowledge and attitudes about stem cell transplantation and donation. Experimental and Clinical Transplantation. 2015;13: 76-81.
16. 16. Bagcivan G, Ozen N, Bayrak D, et al. Does Being A Cancer Patient or Family Caregiver of A Cancer Patient Affect Stem Cell Donation Awareness? Asia-Pacific Journal of Oncology Nursing. 2020;7:36.
17. 17. Narayanan P, Wolanskyj A, Ehlers SL, et al. Medical students' knowledge, familiarity, and attitudes towards hematopoietic stem cell donation: Stem cell donation behaviors. Biology of Blood and Marrow Transplantation. 2016;22:1710-16.
18. 18. Suluhan D, Eker İ, Yıldız D, et al. Kan bağışçısı gönüllülerin hematopoetik kök hücre donorü olma konusundaki bilgi, tutum ve motivasyonlarının belirlenmesi. TAF Prev Med Bull. 2016;15:512-15.
19. 19. Laver JH, Hulsey TC, Jones JP, et al. Assessment of barriers to bone marrow donation by unrelated African-American potential donors. Biology of Blood and Marrow Transplantation. 2001;7:45-8.
20. 20. Kwok J, Leung E, Wong W, et al. Factors Influencing Hematopoietic Stem Cell Donation Intention in Hong Kong: A Web-Based Survey. Annals of transplantation. 2015;20:604-13.
21. 21. Bosi A, Bartolozzi B. Safety of bone marrow stem cell donation: a review. Transplantation proceedings: Elsevier, 2010.
22. 22. Lacetera N, Macis M, Stith SS. Removing financial barriers to organ and bone marrow donation: The effect of leave and tax legislation in the US. Journal of Health Economics. 2014;33:43-56.
23. 23. Kim M, Shin M. Effect of educational program on knowledge, attitude, and willingness of nursing students for hematopoietic stem-cell donation. International Journal of Environmental Research and Public Health. 2019;16:3696.