<p>Pearson correlation among variables (N = 280).</p>

Despite significant advances in transplantation technologies, the global gap between organ availability and demand continues to widen. Hong Kong, in particular, reports notably low organ donation rates among developed regions. Understanding the psychological barriers to donation is essential for developing effective interventions, particularly among young adults who represent a crucial demographic for establishing lifelong donation commitments. The present study examined the complex interplay of psychosocial and emotional factors influencing organ donation intentions among Hong Kong university students. A cross-sectional survey was conducted with 280 university students in Hong Kong, using validated instruments to assess multiple psychological constructs: depressive thinking, altruism, death anxiety, self-efficacy, perceived social support, Big Five personality traits, and Buddhist and Karmic beliefs. Hierarchical regression and moderated mediation analyses were performed to identify direct and indirect predictors for organ donation intentions. Results showed that higher death anxiety (β = −.133, p = .036) and stronger Buddhist beliefs emphasizing bodily integrity (β = −.22, p < .001) were associated with lower donation intentions, while greater self-efficacy (β = .22, p < .001) and perceived social support (β = .28, p < .001) positively predicted donation intentions. Notably, dispositional characteristics including altruism, depressive thinking, personality traits, and Karmic beliefs did not directly predict donation intentions. However, depressive thinking exerted an indirect negative effect on donation intentions through elevated death anxiety, and this mediational pathway was stronger among participants with lower self-efficacy (index of moderated mediation = .035, 95% CI [.0002,.0013]). These findings highlight the critical roles of emotional and situational factors, rather than stable personality characteristics, in determining organ donation intentions among Hong Kong university students. Public health interventions aiming to reduce death anxiety and strengthen self-efficacy may be particularly effective in promoting organ donor registration among young adults in Hong Kong. Future initiatives should prioritize culturally sensitive approaches that address existential concerns while building confidence in donation decision-making.尽管移植技术已取得显著进展，但全球器官供体可获得性与需求之间的缺口仍在持续扩大。其中，香港在全球发达地区中器官捐献率尤为偏低。明确器官捐献的心理障碍，是制定有效干预措施的关键前提，尤其针对那些作为建立终身捐献承诺核心群体的青年群体。 本研究针对香港大学生群体，探讨了影响其器官捐献意愿的社会心理与情感因素间的复杂交互作用。研究面向香港280名大学生开展横断面调查（cross-sectional survey），采用经过信效度验证的评估工具对多项心理构念进行测评：抑郁思维（depressive thinking）、利他主义（altruism）、死亡焦虑（death anxiety）、自我效能感（self-efficacy）、感知社会支持（perceived social support）、大五人格特质（Big Five personality traits），以及佛教与业力信仰（Buddhist and Karmic beliefs）。通过分层回归（hierarchical regression）与有调节的中介分析（moderated mediation analysis），本研究识别了器官捐献意愿的直接与间接预测因子。 研究结果显示，较高的死亡焦虑（β = −.133, p = .036）与更强调身体完整性的佛教信仰（β = −.22, p < .001）与更低的捐献意愿呈负相关；而更高的自我效能感（β = .22, p < .001）与感知社会支持（β = .28, p < .001）则对捐献意愿具有正向预测作用。值得注意的是，利他主义、抑郁思维、人格特质与业力信仰等特质性特征并未对捐献意愿产生直接预测作用。不过，抑郁思维可通过提升个体的死亡焦虑，对捐献意愿产生间接负向影响；且这一中介路径在自我效能感较低的参与者中更为显著（调节中介指数 = .035, 95% 置信区间 [.0002, .0013]）。 上述研究结果表明，影响香港大学生器官捐献意愿的关键因素为情感与情境因素，而非稳定的人格特质。旨在降低死亡焦虑、提升自我效能感的公共卫生干预措施，或可有效推动香港青年群体完成器官捐献登记。未来相关举措应优先采用贴合当地文化的干预方案，在缓解个体生存焦虑的同时，增强其对捐献决策的信心。