Despite substantial advancements in transplantation technologies, the disparity between the organ demand and donor availability continues to widen globally. Hong Kong, in particular, exhibits one of the lowest organ donation rates among developed regions. This study aimed to explore the psychosocial and emotional determinants of organ donation intentions among university students in Hong Kong—an important demographic frequently targeted by advocacy campaigns due to their perceived openness to organ donation initiatives.
Using a sample of 280 Hong Kong university students, we examined a comprehensive array of psychosocial and emotional variables, including depressive thinking, altruism, death anxiety, self-efficacy, perceived social support, personality traits assessed via the Big Five inventory, and cultural beliefs related to Buddhism and Karma. Mediation and moderation analyses were used to assess the interplay among these variables in predicting participants' organ donation intentions. Results showed that death anxiety emerged as a significant negative predictor of donation intention, whereas higher levels of self-efficacy and perceived social support positively predicted intentions. Contrary to expectations, altruism, depressive thinking, cultural beliefs, Big Five personality traits, social media exposure, and knowledge about organ donation did not directly predict donation intentions. Further mediation analysis revealed a moderated mediation effect, wherein depressive thinking indirectly reduced intention through increased death anxiety—particularly among individuals with lower self-efficacy.
These findings underscore the prominence of emotional and situational factors, rather than dispositional traits or cultural values, in shaping donation intentions among young adults in Hong Kong. Public health interventions and awareness campaigns should therefore strategically focus on alleviating death-related anxiety, bolstering individual self-efficacy, and enhancing social support networks to foster greater willingness toward organ donation.