The role of affect in attitudes toward organ donation and donor-relevant decisions

Abstract

We argue that affect plays a vital role in attitudes toward organ donation and that reluctance to become an organ donor is likely to be related to the experience of affective ambivalence. Assessing the affect associated with organ donation could help to predict donor-relevant decisions. Results of a confirmatory factor analysis on 464 students showed that affective evaluations can be distinguished both from cognitive evaluations and from overall evaluations. As expected, affective evaluations revealed ambivalence (using the ‘Griffin’ measure of ambivalence) toward organ donation, whereas the two other types of evaluations did not. Results of a follow-up study using logistic regression (n = 85), showed that affective evaluations predicted donor-relevant decisions six months later. The present findings support the proposal to include separate affective evaluations in measures of attitudes to organ donation. More general implications for the measurement and structure of attitudes in health related domains are discussed.

Keywords:

• Ambivalence
• attitudes
• organ donation
• affect
• feelings
• structure of attitudes

Acknowledgments

We would like to thank Denny Borsboom and Ap Dijksterhuis for their valuable comments on this manuscript.

Notes

¹ A sample of Dutch psychology students was used in both studies. This sample is not representative of the general public. However, this does not interfere with the primary purpose of these studies, which was to investigate whether a distinction in components of attitudes can be made in the organ donation domain and whether the inclusion of an affective factor has any additional predictive value.

² Both registered and unregistered donors were included in the sample because no differences in the structure of attitudes were expected (i.e., the structure of the attitude is not expected to vary as a function of whether a person is unregistered or registered).

³ More indirect measures of registering as organ donor were taken because we anticipated that few people would actually decide to register under laboratory conditions.

⁴ A four-factor model, consisting of separate positive and negative affective evaluations, but with the positive and negative evaluations of the cognitive and overall components combined, resulted in fit values that were nearly acceptable:  = 1009, Df = 224, RMSEA = 0.086, SRMR = 0.056, AIC = 1113, and AGFI = 0.82. This model could be defended as an alternative to the proposed six-factor model.

⁵ In fact, we explored this possibility for positive and negative affective evaluations. Based on a median split we divided people into lower and higher affective ambivalence. As anticipated, there was no significant correlation between attitude and donor-relevant decisions for people higher in affective ambivalence. On the other hand, for people with lower levels of affective ambivalence, the correlations between the two donor-relevant decision measures and the affective evaluations were significant (for wanting more information: positive affective evaluation, r = 0.67, p < 0.01, negative affective evaluation, r = −0.65, p < 0.01; for submitting name and address: positive affective evaluation r = 0.52, p < 0.05, negative affective evaluation, r = −0.53, p < 0.05).