Psychosocialpredictors of posthumous organ donation intention: A comparison among Chinese, Japanese, and American adults

Previous studies have shown that the general public exhibits favorable attitudes toward posthumous organ donation, but a low donor card signing rate. Hence, positive attitudes may not be a good predictor of the behavioral commitment to donate organs. This dissertation was a cross-cultural study on the actual behaviors of signing or taking away the donor card (i.e. b&barbelow;ehavioral i&barbelow;ntentions to d&barbelow;onate organs after death (BID). It aimed at proposing an integrative, content-specific but culture-general model for posthumous organ donation. The model was composed of two levels of influences on BID, namely, the proximal level (including self-efficacy toward signing the donor card, general attitudes toward posthumous organ donation, and subjective norm for posthumous organ donation) as well as the distal level (including knowledge regarding posthumous organ donation, altruism, and after-death anxiety). The model was first tested and refined among 517 Chinese college students (Study 1), and was then further validated with 290 Chinese community adults (Study 2) in Hong Kong. The applicability of the model was also examined with a Western control sample of 217 Caucasian American college students (Study 3) and a non-Chinese Asian sample of 670 Japanese college students (Study 4). Psychosocial characteristics of three college samples were then compared, and ethnic differences on predictive values of psychosocial factors on BID were studied (Study 5).; By path analysis, it was found that only self-efficacy and subjective norm, but not general attitudes, significantly predicted individuals' BID across all samples. Moreover, in contrast to the hypothesis, results showed that after-death anxiety predicted self-efficacy but not attitudes. Low after-death anxiety, accurate knowledge regarding organ donation, and high subjective norm promoted self-efficacy. Altruism was the main determinant of attitudes but its indirect impact on BID was weak. The applicability of the model on all four samples was acceptably high, and the configural invariance of the model was generally supported across three ethnic groups.; The ANOVA results challenged the old assumption of underlying similarities in psychosocial characteristics across Asian ethnic groups. As expected, Americans were the most likely to show BID, followed by Chinese, while Japanese had the lowest tendency to show BID. (Abstract shortened by UMI.)...