The present study is the first study in Sweden to investigate the relationship between women and men from Bosnia and Herzegovina living in Sweden and their perception and willingness in relation to organ donation. The results in the present study showed that the number of illiterate men was higher than that among women. The number of women with a high school education was higher than that among men, women had higher incomes than men and 90% of all the men were unmarried, while the corresponding figure for women was 60%. This situation was unexpected, and it is not typical of people born in Bosnia and Herzegovina, where men are most frequently highly educated, have a higher income and the ratio between married and unmarried is roughly the same. The reason for this may be that the majority of respondents grew up, graduated and started their first jobs in Sweden and that, apart from the culture from their home country, they also adopted the culture in Sweden. The findings in our study contrast with those in other studies, which showed that men were more educated and informed than women and because of this they had more information and more knowledge about organ donation [27,28]. In the next step of the questionnaire, we looked at gender differences in the definitions of transplantation, information, knowledge, opinion and important factors for organ donation. The present study demonstrated that men and women perceived definitions of organ transplantation differently. Statistically significant differences in being informed and knowing about organ donation were shown in the present study between different genders, where 60% of men answered that they were not sufficiently informed about organ donation, while 73% of women stated their above average satisfaction with information. These findings were comparable with those in another study where the majority of all the informants were adequately informed about organ donation . Knowledge relating to organ donation was higher in women than in men, 66% vs. 56% respectively. Despite gender differences in knowledge about organ donation, this knowledge was high in both men and women. Our findings are in line with those in another study, which showed that 41.5% of all informants had an adequate knowledge of organ donation . Gender differences were also demonstrated in the most important factors relating to organ donation according to the informants, where 37% of the men thought that the health of the body’s recipient is the most important factor, while 77% of women thought that the most important factor is the kinship of the organ donor. Our results also revealed gender differences in the description of usefulness and support in the process of organ donation; 16 men and 27 women agreed completely, while eight men and two women agreed that organ donation is a useful thing and needs to be promoted. The social and cultural roles of men and women differ, and they expressed different opinions regarding the usefulness of and support for organ donation. Women generally feel more responsible and act as caregivers and, as a result, they are much more likely to donate their organs than men. In many countries, the traditional role of women also includes looking after family members when they are ill [30,31]. Religious aspects of donation were described differently according to gender. The women had more knowledge of their religion’s permissive attitude towards organ donation (70% vs 13%) and the majority of women (93%) knew that their religion did not oppose the donation of organs. In the question about reasons why the informants were against organ donation, the answers differed between the genders. In response to this question, 67% of men and 37% of women stated that they did not think about organ donation and 13% of men and 60% of women believed that the body should be intact after death. In other studies, men were found to refuse to donate their bodies after death more often than women , as men were more worried about their physical integrity, believing that desecrating their bodies would bring them misfortune . This is a significant factor in people’s attitude towards organ donation . Gender differences were also demonstrated in the question about the person to whom the informants would donate their organs, where 83% of women and 40% men indicated that they would donate their organs to anyone, while 40% of men and 13% of women would donate to their family members. Motherhood may also give women a sense of duty to volunteer for organ donation to save their spouse, children and other family members. The findings in our study are in line with those in another study which shows that sisters, mothers and wives more frequently donate their living organs to children, brothers, fathers and husbands 30,351]. There is a very interesting study of organ donation between wives and husbands. This study showed that more than 30% of eligible wives were willing to donate their organs to their husbands, while only 7% of husbands were willing to donate their organs to their wives . Moreover, 80% of women and 53% of men were willing to donate to people with other religious affiliations and 43% of men and 3% of women responded that they did not think about donating organs at all. The majority of the women did not know anyone who had donated their organs. The results of the present study also revealed gender differences in the ownership of donor cards. In our study, 66% of the women owned a donor card, while only one of the men owned a donor card. The majority of the women (96%) thought that the donor card was of an informative nature. The findings in our study are in line with those in previous studies, which showed that women were more willing to sign a donor card and donate their organs [32,37]. Other previous studies from low-income and under-developed countries reported results that are contrary to our findings [28,39]. It is difficult to give a specific reason for the stronger response of women to organ donation than that of men. We believe that women are more motivated, because altruism is more pronounced in them, as well as the desire to help a close family member or a person outside the family survive. We must also not forget motherhood and care for the family, which in most cases is found in the mother and in the mother’s arms.
To the best of our knowledge, this is the first study of its kind in western Sweden. However, the study has some limitations, such as its cross-sectional design and the small sample. This makes it difficult to generalise the findings of our study. The other limitation in the present study may be that the first author of the study has the same ethnicity as the informants, and this may have influenced the informants’ answers.