Estudio poblacional internacional en España, Cuba y Estados Unidos sobre la sensibilización hacia la donación de órganos entre la población cubana

Abstract

Introduction: The Republic of Cuba has been one of the Latin American countries with the most important migratory flows in the 20th and 21st centuries, especially to countries such as Spain and the State of Florida in the United States (USA). The scarcity of reliable studies and the difficulty in extracting samples from Cuban immigrants make it difficult to determine their attitude towards organ donation and transplant (ODT). Justification: There are indications that there could be differences in attitude between the same populations that emigrate to different countries, hence the importance of observing if the country of immigration (demographic factor) is decisive when it comes to having a more favorable attitude towards ODT. Objectives: To analyze the attitude towards organ donation of the Cuban population distributed in the Republic of Cuba, Spain and the State of Florida in the USA; determine the psychosocial factors associated with said attitude; to observe if demographic factor is decisive when studying the attitude towards ODT in Cubans. Methodology: An observational, cross-sectional study is carried out. The population is included in three groups: Group 1 (Cubans residing in the Republic of Cuba); Group 2 (Cubans residing in Spain); Group 3 (Cubans residing in the State of Florida in the United States). The sample is stratified by age and sex in each of the groups. To evaluate the attitude towards ODT, the “PCID-DTO Ríos” questionnaire is used, validated for the Hispanic population, in an anonymous and self-administered way. Those in charge of locating the study population and the facilitators of said questionnaire were the collaborators of the International Collaborative Donor Project (PCID) and the immigration aid associations in Spain and the State of Florida. An analysis of the psychosocial profile of each of the groups under study is carried out first. Subsequently, a logistic regression analysis of the total sample is carried out, performing a bivariate and multivariate analysis to determine the psychosocial factors associated with ODT that persist as independent. Results: Of a total of 4,123 respondents (degree of completion <71%), 58.8% of the sample showed a favorable attitude. After evaluating the psychosocial factors associated with attitude, it was found that there was a demographic factor associated with said attitude, with those who emigrated to the State of Florida being less in favor than those who did so to Spain (p <0.001; OR: 1.929). In addition, the following persist as independent variables in the multivariate analysis: 1) Sex; 2) Level of studies; 3) Attitude towards the donation of a relative; 4) Opinion of the couple towards the DTO; 5) Belief of needing a transplant in the future; 6) Carrying out pro-social activities; 7) Knowledge of the concept of Brain Death; 8) Religion of the respondent; 9) Fear of mutilation after donation; 10) Acceptance of a burial after death; 11) Acceptance of an autopsy after death. Regarding these variables associated with attitude, they are similar to those described in western populations, whether they are evaluated in each study group or in the global sample. The same Cuban immigrants in different receiving countries have a different attitude towards ODT. Thus, attitudinal differences should not be sought in factors such as the solidarity of the respondents, but could be more associated with factors such as their