7. Measures to overcome challenges for organ donation

The decisions regarding organ donation based on the personal beliefs (religious, cultural, family, social and body integrity) levels of knowledge about organ donation and previous interaction with the health care team. Many maintained positive attitudes to organ donation despite significant reservations about the organ donation process. Resistance to organ donation found to be less in the case of living donation for family.

There are some religious beliefs that can have both positive and negative influences, these often stemmed from uncertainty or misrepresentation of religious edicts. One solution would be to actively engage religious leaders in the transplant community, especially when it has been reported that, across the major religions, there are very few cases where organ donation can be seen to be inconsistent with religious beliefs. Religious leaders should be made available in hospitals and other transplantation setting to assist families in making decisions regarding organ donation and potentially to remove the misperceptions. Staff members who are involved in approaching families to request consent for donation should be part of the awareness programs and resources about religious concerns. Similarly, cultural sensitivity to issues such as apprehensiveness to discuss death among certain groups or individuals and the importance to many of death rituals may improve dialog regarding organ donation.

Studies have shown that engaging some minority groups in the health care system and creating a sense of belonging and ownership can improve compliance with organ donation. As a consequence, more efforts should be made to create positive interactions within the health care team members, especially for minority groups, to improve the organ donation rates. Although many of the studies have showed that higher socio-economic status and education were associated with a stronger willingness to be an organ donor. Some of the strong reservations held, even among those with generally positive views towards donation, such as concerns that agreeing to donation would discourage doctors from caring so much about saving their lives in case of an emergency or that it would result in the premature removal of their organs or indeed prevent them from having an open coffin at their funerals, are examples of very real barriers that can be readily addressed through information. Through a proper awareness and motivation the donation rates can be improved which can save many lives.

#### 7.1. Psychological care

Psychological consultation is essential for all disease stages enabling patients to better cope with their extraordinarily stressful situation. A need for psychological care was found in up to 50% of transplant patients. Educational and supportive therapies are of utmost importance but also cognitive-behavioral interventions including relaxation techniques can also

be considered. Less common methods like hypnotherapy and "Quality of Life Therapy" have also been utilized for overcoming the challenges.

Moreover, family members as well as caregivers of transplant patients show increased psychological strain before and after transplantation. Family counseling, and psychotherapeutic support, can help reduce psychological strain, thus also maintaining the valuable social support provided by care givers and family members of the transplant patient. Henceforth, the family and care givers should also be considered in psychosocial evaluation to overcome the problems.
