Introduction
Corneal pathology is a major cause of visual disability in the developing world.1 Globally, approximately 4.9 million individuals have corneal blindness bilaterally, while 23 million are unilaterally blind.2 The major causes of corneal blindness include corneal ulceration, ocular trauma, bacterial, viral and fungal infections of cornea.3 Corneal blindness is one of the major causes of blindness worldwide.4 Keratoplasty is the surgery which can re-establish sight in a corneal blind. It is a procedure where the damaged or diseased cornea is replaced by a healthy donor cornea from a deceased person. It is a surgery which is totally dependent on eye donation after death. One of the barriers in eye donation is inadequate attention which is due to lack of awareness in the community. Therefore it is important to raise the level of public knowledge regarding eye donation and related issues. Nursing staff of a hospital form the mainstay of health care structure. They spend more time with seriously ill patients and thus possible donors. Hence they can play a major role in motivating the patients and their attendants for this deed. Properly educated nursing staff could be expected to influence rates of eye donation. This study assessed awareness and perceptions of nursing staff towards eye donation and their willingness for the same.
Materials and Methods
A cross-sectional descriptive study was conducted in a tertiary care hospital in South India from June to July 2019 among the nursing staff. Sample size was calculated using estimation of proportion formula with level of significance alpha = 5%, power 1-beta= 80% with 95% confidence interval, the minimum sample size was 55. Thus a total of 55 subjects were included as participants. Institutional ethics committee clearance was obtained before starting the study. Purpose and nature of the study were explained to the subjects and only those who gave written consent were included. A self designed questionnaire in English, validated by subject experts was administered to the participants. They were requested to respond promptly to all the questions. The questionnaire included questions pertaining to age, years of experience of the nursing staff as well as their beliefs about eye donation, willingness to donate eyes and factors preventing or motivating them to donate. The filled questionnaire was collected.
Results
Fifty five participants participated in the study out of which 45(81.8%) was in the age group 21-30 years, 9(16.4%) was from 31-40 years and 1(1.8%) was in the age group 51-60 years. All of them were females and were aware about eye donation. Mean years of experience was 4.4 years. The data regarding responses of the participants are shown inTable 1. Participants who were willing to do motivation of their relatives for eye donation constituted 81.8% (n=45). 18.2% (n= 10) of the participants were not sure about it. Participants who were willing to donate their eyes constituted 72.7% (n=40) whereas those not willing for it constituted 5.5% (n=3).
The response of participants regarding part that is transplanted from donor eye is as given inTable 2. The reasons quoted for willingness to donate eyes and not to donate eyes are as shown in Table 3. Hospital/doctor was found to be the most preferred resource of information on eye donation for 26(47.3 %) followed by television/radio for 12(21.8 %) and newspaper for 9(16.4%). Of the 55 participants, the ideal time of collection of eyes was known to 35(63.6%). The number of participants who considered HIV (Human immune-deficiency virus) to be a contra-indication for eye donation was 40(72.7%), Diabetes was 9(16.4%) and previous eye surgery was 6(11%). The place to be contacted for eye donation was cited as eye bank by 28(51%) followed by hospital (32.7 %)
Table 1
Responses of the study subject on different aspects of eye donation
Table 2
| Cornea | 16(29%) |
| Lens | 20(36.4%) |
| Retina | 6(10.9%) |
| Whole globe | 10(18.2%) |
| I do not know | 3(5.5%) |
Response on what is transplanted to the recipient from the donor eye
Table 3
Reasons quoted by the participants regarding their willingness for eye donation
Discussion
Corneal transplantation provides sight to those people who are affected with corneal diseases. But it is noted that in India the willingness of the people to pledge their eyes for donation is low and this is impacting the rate of surgeries that are being conducted. All the subjects, participated in this study had some knowledge on eye donation and its importance, another survey conducted in South India showed similar conclusion5. 70% of the participants knew about the timeline restriction around eye donation, result showed a strong relation to other similar surveys conducted in Maharashtra6 and New Delhi.7 It is noted that awareness on the timing of eye donation is very important for further procedures preventing unavailability of donor cornea at optimal time. When asked about the resource of information regarding eye donation doctors/hospitals was found to be the most preferred followed by Television /Radio showing that these play a crucial role in creating awareness about eye donation. Creating campaigns regarding eye donation can play a major role in motivating the hospital staff towards eye donation. Similarly more programmes about eye donation should be shown on media to create awareness among the people. Knowledge about the part that is transplanted from the donor eye was poor i.e. about 29 % which is similar to another study8. In our study, 14.5% of the participants believed that eye donation causes mutilation of the face of the person. Majority (72.7%) of the participants were willing to donate their ey es which are comparable to other studies6,7, The main reason behind donating eyes among majority(76.3%) was giving sight to the blind followed by nobility of the task (7.2%). This is similar to other studies.5,6,9 Our study revealed that there is a strong awareness amongst nursing staff with respect to the provision on eye donation and most of the subjects showed willingness to donate and interest to motivate others to do the same. A sizeable amount of subjects showed hesitation in donating their eye due to lack of knowledge and objection from their families. Factors mentioned above are noted as some of the major hurdles in the society.
Influential factors noted above along with others need to be paid attention to and dealt with on a pro active basis while creating awareness about eye donation.
Social media can make a huge impact on creating awareness in today’s dynamic world and other noticeable methods would include active counselling in families. Nationwide programmes should be encouraged by government and NGO’s with the assistance from hospital/nursing staff who should be made to volunteer in such programmes actively. Posters about eye donation may be displayed in the hospitals for awareness to the public. Various efforts are being put at national level to create awareness about the same. The se need to be continued and further reinforced for achieving higher rates of eye donation.
