Medical Professionals’ Knowledge, Sensitivity, and Attitudes Towards Social and Ethical Aspects of Stem-Cell Donation, Therapy, and Research: Implications for Healthcare Risk Management

Figures & data

Table 1 Background Characteristics of Respondents (N= 260)

Variable		Frequency	Percentage
Gender	Female	102	39%
	Male	158	61%
Age	20–39 years	141	54%
	40–59 years	119	46%
Profession	Clinician	98	38%
	Pharmacist	78	30%
	Nurse	84	32%
Nationality	Saudi	234	90%
	Non-Saudi	26	10%
Religious Orientation	Islam	243	94%
	Others	17	6%

Table 2 Work Experience of Medical Professionals in Stem Cells Donation, Therapy, and Research (N= 260)

Profession	Are You Aware What are Stem Cells?		Work Experience in Stem Cell Donation		Work Experience in Stem Cell Therapy		Work Experience in Stem Cell Research
	Yes (n=256; 98.5%)	No (n=4; 1.5%)	Yes (n=27; 10%)	No (n=233; 90%)	Yes (n=67; 26%)	No (n=193; 74%)	Yes (n=124; 48%)	No (n=136; 52%)
	n(%)	n(%)	n(%)	n(%)	n(%)	n(%)	n(%)	n(%)
Clinician	98 (38%)	0 (0%)	20 (74%)	78 (34%)	46 (70%)	52 (27%)	65 (52%)	33 (24%)
Pharmacist	81 (32%)	3 (75%)	6 (22%)	78 (33%)	11 (17%)	73 (38%)	34 (28%)	50 (37%)
Nurse	77 (30%)	1 (25%)	1 (4%)	77 (33%)	9 (14%)	69 (36%)	25 (20%)	53 (39%)
χ^2 (p-value)	χ^2 = 3.85(ns)		χ^2 = 18.4***		χ^2 = 38.6***		χ^2 = 23.1***

Notes: p-value significance: ***p<0.001.

Abbreviation: χ², Chi-square.

Table 3 Mean Scores on Knowledge, Sensitivity Towards Social and Ethical Aspects, Acceptance and Rejection Attitudes Towards Stem Cells Donation, Therapy and Research (N= 260)

Scales	^aItems	^bM (S.D)
Knowledge about stem-celldonation, therapy and research (M= 15.27; S.D.=2.84) (95% CI = 14.92–15.61)	Know diseases that are currently being treated in reliable ways by using stem cells including umbilical cord stem cells, embryonic and adult stem cells	3.60 (0.64)
	Know the potential benefits of stem-cell donation	3.73 (0.53)
	Know the potential risks of stem-cell research	3.51 (0.63)
	Know about the Saudi Stem Cell Donor Registry	2.89 (1.14)
	Know about other organizations which collect stem cells from donors in Saudi Arabia	1.50 (1.28)
Sensitivity towards social and ethical aspects of stem cell donation, treatment, and research (M= 22.29; S.D.=2.54) (95% CI = 21.98–22.60)	Embryonic stem cell research that involves fetal destruction is immoral, illegal, and unnecessary	3.88 (0.57)
	Witnessed several irregularities in stem cell research and treatment	2.27 (1.15)
	Action is needed to regularize stem cell therapy in Saudi Arabia	3.80 (0.59)
	Patient’s consent is necessary for both stem cell donation and transplantation	3.94 (0.38)
	Healthcare practitioners can apply stem-cell-based treatments that are proven effective with testing on animals and human cells in laboratories	2.68 (1.05)
	Healthcare practitioners can apply stem-cell-based treatments that are proven effective in the laboratory in absolute terms	1.60 (0.92)
	Negative competitive environment in pharmaceutical industry is hindering progress in stem cell research	0.15 (0.63)
	Ethical approval from an ethics committee is necessary before conducting research	3.96 (0.33)
Acceptance Attitudes (M= 15.65; S.D.=1.06) (95% CI = 15.52–15.78)	Stem-cell donation is necessary for better prospects in transplantation and interventions	3.86 (0.42)
	Pregnant mothers should be allowed to store cord blood stem cells for future purposes	3.93 (0.36)
	Donation of stem cells is necessary to advance research in this area	3.93 (0.38)
	Stem cell transplantation should be implemented on a large scale	3.90 (0.422)
Rejection Attitudes (M= 4.86; S.D.=1.95) (95% CI = 4.62–5.10)	Stem-cell transplantation is valuing certain lives over others and should not be practiced	1.12 (0.826)
	Stem-cell transplantation may open the door to the destruction of innocent human life	0.18 (0.73)
	Government must prevent all research on embryonic stem cells from embryos or aborted fetuses	3.34 (1.12)
	Studies on stem cells are unnecessary and a waste of time and resources	0.22 (0.71)

Notes: ^aItems on scales are rated on a 5-point Likert Scale with 0=Strongly Disagree to 4=Strongly Agree; ^bMean Scores.

Abbreviation: S.D., Standard Deviation.

Table 4 Mean Differences in Knowledge, Sensitivity, Acceptance and Rejection Attitudes of Healthcare Professionals Towards Stem-Cell Donation, Treatment and Research in Saudi Arabia (N= 260)

Variable	Categories	Knowledge	Sensitivity Towards Social and Ethical Aspects	Acceptance Attitudes	Rejection Attitudes
		M (S.D)	M (S.D)	M (S.D)	M (S.D)
Gender	Female	14.75 (3.09)	22.55 (2.89)	15.40 (1.42)	5.20 (2.56)
	Male	15.60 (2.62)	22.12 (2.27)	15.82 (0.71)	4.65 (1.40)
t-test (p-value significance)		t=2.30*	t=1.33 (ns)	t=2.72*	t=1.98*
Age	20–39 years	14.59 (2.67)	22.16 (2.85)	15.49 (1.32)	4.88 (2.40)
	40–59 years	16.07 (2.84)	22.44 (2.11)	15.85 (0.59)	4.84 (1.24)
t-test (p-value significance)		t=4.29***	t=0.86 (ns)	t=2.88*	t=0.16 (ns)
Profession	Clinician	17.40 (2.33)	22.99 (2.25)	15.79 (0.67)	5.20 (1.82)
	Pharmacist	14.48 (2.14)	22.18 (2.13)	15.47 (1.06)	4.69 (1.96)
	Nurse	13.44 (2.36)	21.57 (2.98)	15.35 (1.37)	4.62 (2.07)
F-test (p-value significance)		F=72.81***	F=7.51***	F=4.76**	F=2.46 (ns)
Nationality	Saudi	15.24 (2.96)	22.14 (2.54)	15.63 (1.09)	5.01 (1.89)
	Non-Saudi	15.46 (1.42)	23.62 (2.09)	15.85 (0.78)	3.54 (2.04)
t-test (p-value significance)		t=0.64 (p=ns)	t=2.84*	t=0.96; (p=ns)	t=3.72***
Religious Orientation	Islam	15.28 (2.90)	22.24 (2.51)	15.63 (1.11)	4.95 (1.91)
	Others	15.00 (1.93)	22.94 (2.92)	16.00 (0.00)	3.59 (2.21)
t-test (p-value significance)		t=0.39 (p=ns)	t=1.09 (p=ns)	t=5.25***	t=2.81*
Work experience in stem-cell donation	Yes	16.89 (2.25)	24.78 (2.59)	15.74 (0.76)	5.48 (4.08)
	No	15.08 (2.85)	22.01 (2.37)	15.64 (1.09)	4.79 (1.53)
t-test (p-value significance)		t=3.18**	t=5.69***	t=0.44 (ns)	t=0.87 (ns)
Work experience in stem-cell therapy	Yes	17.46 (2.17)	23.52 (2.93)	15.85 (0.61)	4.79 (2.56)
	No	14.50 (2.65)	21.86 (2.24)	15.59 (1.17)	4.89 (1.71)
t-test (p-value significance)		t=8.23***	t=4.81***	t=2.35*	t=0.34; (ns)
Work experience in stem-cell research	Yes	16.90 (2.22)	23.44 (2.17)	15.87 (0.57)	4.71 (2.28)
	No	13.77 (2.51)	21.24 (2.39)	15.46 (1.34)	5.00 (1.59)
t-test (p-value significance)		t=10.59***	t=7.76***	t=3.29*	t=1.17 (ns)

Notes: p-value significance: ***p<0.001; **p<0.01; *p<0.05. Values in Italics represent non-significant values.

Abbreviations: M, Mean; S.D., Standard Deviation.

Table 5 Multiple Linear Regression Analysis to Determine the Predictors of Knowledge and Sensitivity Towards Social and Ethical Issues in Stem Cell Donation, Treatment and Research (n=260)

	Knowledge as Outcome Variable			Sensitivity as Outcome Variable
	B (95% CIs)	Std. Error	β	B (95% CIs)	Std. Error	β
(Constant)	11.48 (10.31–12.65)	0.595		21.43 (20.1–22.7)	0.669
Gender (Male)	0.27 (−0.26–0.81)	0.271	0.047	−0.29 (−0.89–0.30)	0.305	−0.057
Age (Older group)	0.002 (−0.55–0.56)	0.284	0.000	0.054 (−0.68–0.57)	0.319	0.011
Profession (Clinician)	2.97 (2.23–3.71)	0.372	0.507***	0.039 (−0.86–0.78)	0.418	0.007
Profession (Pharmacist)	0.75 (0.09–1.41)	0.332	0.124*	0.77 (−1.15–0.78)	0.373	0.144*
Nationality (Non-Saudi)	0.89 (−0.26–2.04)	0.587	0.094	−0.71 (−2.06–0.59)	0.660	−0.084
Religion (Non-Muslim)	0.26 (−1.12–1.64)	0.705	0.023	0.99 (−0.56–2.55)	0.792	0.097
Work experience in stem-cell donation	−0.57 (−1.47–0.31)	0.455	−0.062	1.74 (0.74–2.75)	0.512	0.210**
Work experience in stem-cell therapy	0.59 (−0.15–1.33)	0.379	0.091	0.085 (−0.92–0.75)	0.426	0.015
Work experience in stem-cell research	2.34 (1.71–2.96)	0.317	0.412***	1.81 (1.11–2.51)	0.357	0.358***
Model statistics	F(9, 259) = 32.393, p < 0.001, R2 = 0.534			F(9, 259) = 9.77, p < 0.001, R2 = 0.260

Notes: ***p<0.001; **p<0.01, *p<0.05.

Abbreviation: ns, non-significant.

Table 6 Multiple Linear Regression Analysis to Determine the Predictors of Acceptance and Rejection Attitudes Towards Stem Cell Donation, Treatment and Research (n=260)

	Acceptance Attitude as Outcome Variable			Rejection Attitude as Outcome Variable
	B (95% CIs)	Std. Error	β	B (95% CIs)	Std. Error	β
(Constant)	15.23 (14.6–15.84)	0.308		3.57 (2.47–4.66)	0.556
Gender (Male)	0.303 (0.026–0.580)	0.141	0.139*	−0.755 (−1.25–0.256)	0.253	−0.189**
Age (Older group)	0.313 (0.023–0.602)	0.147	0.146*	−0.162 (−0.684–0.361)	0.265	−0.041
Profession (Clinician)	0.121 (0.259–0.501)	0.193	0.055	−0.902 (0.217–1.58)	0.348	−0.224*
Profession (Pharmacist)	0.310 (−0.029–0.649)	0.172	0.136	0.351 (−0.260–0.962)	0.310	0.084
Nationality (Non-Saudi)	0.178 (−0.421–0.776)	0.304	0.050	1.64 (0.568–2.72)	0.549	0.253**
Religion (Non-Muslim)	0.417 (1.13–1.32)	0.365	−0.097	−0.012 (−1.31–1.28)	0.659	−0.001
Work experience in stem-cell donation	0.168 (0.633–0.296)	0.236	−0.048	−1.164 (0.326–2.01)	0.425	−0.182**
Work experience in stem-cell therapy	0.142 (0.528–0.244)	0.196	−0.058	0.049 (−0.648–0.746)	0.354	0.011
Work experience in stem-cell research	0.481 (0.158–0.805)	0.164	0.226**	−0.493 (−1.07–0.091)	0.296	−0.126
Model statistics	F(9, 259) = 3.416, p < 0.01, R2 = 0.110			F(9, 259) = 9.77, p < 0.001, R2 = 0.260

Notes: **p<0.01, *p<0.05.

Abbreviation: ns, non-significant.