KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS CORNEAL DONATION AMONG DECEASED'S FAMILY IN SINGAPORE

This study aimed to assess the beliefs and knowledge of patients’ next-of-kin (NOK) regarding corneal donation in Singapore and understand their corresponding motivations for deciding to donate their NOK’s corneas. Secondary outcomes include identifying potential platforms for educating the public on corneal donation and organ donation laws, as well as identifying correlations between demographical data and willingness to donate.

In this single study, cross-sectional questionnaire based study lasting from January 2022 to January 2024, 100 NOKs (aged 21 and above) of recently deceased patients, who were eligible under the Hospital Eye Donation Programme (HEDP), were recruited at a single tertiary hospital in Singapore, under informed consent. Corneal donation coordinators, uninvolved in the processing of the data, administered the questionnaire to the 100 NOKs. Completed questionnaires were then processed by independent reviewers.

The questionnaire gathered demographic data, the decision to donate their NOK’s cornea, motivations for that decision, knowledge about corneal donation and the Human Organ Transplant Act (HOTA) as well as their recommended platforms to learn more about eye donation in Singapore. Results were stratified by decision to donate, age, religion and educational backgrounds and statistical analyses were performed using the statistical package IBM SPSS Statistics for MacOS (version 29.0.2.0).

Of the 100 participants, 22 (45.5% female) were willing to donate (WTD), and 77 (53.2% female) were unwilling (UWTD). The primary motivation for WTD was the desire to perform a good deed (n=20, 90.91%), whereas the main reason for UWTD was wanting to keep their NOK’s body intact (n=42, 45.45%). The overall understanding (range, 0-12) of corneal donation (4.48 ±2.08) and HOTA (0.495 ±1.053) was poor. WTD was higher among those over 50 years of age (34.21% vs. 15.25% for ≤50 years, p=0.4484), despite similar knowledge levels. WTD did not vary by educational qualifications, but varied by religion, with Hindus showing the highest willingness (25%) and Muslims the lowest (0%). The preferred education platforms included public talks (n=98) and social media (n=98). A higher proportion of participants were more willing to donate their own corneas, compared to their deceased NOKs.

Many NOKs are unwilling to donate for various reasons, primarily due to poor understanding as well as surrogate decision making. Enhancing education on organ transplant laws in Singapore and promoting earlier conversations on donation can address fears and potentially increase corneal donation rates.