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Williams LA, Tzelios K, Masser B, Thijsen A, van Dongen A, Davison TE. A virtual reality paradigm simulating blood donation serves as a platform to test interventions to promote donation. Sci Rep 2024; 14:10334. [PMID: 38710774 DOI: 10.1038/s41598-024-60578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Effective interventions that support blood donor retention are needed. Yet, integrating an intervention into the time-pressed and operationally sensitive context of a blood donation center requires justification for disruptions to an optimized process. This research provides evidence that virtual reality (VR) paradigms can serve as a research environment in which interventions can be tested prior to being delivered in blood donation centers. Study 1 (N = 48) demonstrated that 360°-video VR blood donation environments elicit a similar profile of emotional experience to a live donor center. Presence and immersion were high, and cybersickness symptoms low. Study 2 (N = 134) was an experiment deploying the 360°-video VR environments to test the impact of an intervention on emotional experience and intentions to donate. Participants in the intervention condition who engaged in a suite of tasks drawn from the process model of emotion regulation (including attentional deployment, positive reappraisal, and response modulation) reported more positive emotion than participants in a control condition, which in turn increased intentions to donate blood. By showing the promise for benefitting donor experience via a relatively low-cost and low-resource methodology, this research supports the use of VR paradigms to trial interventions prior to deployment in operationally-context field settings.
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Affiliation(s)
| | | | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Australia
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, Australia
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Amanda Thijsen
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, Australia
| | - Anne van Dongen
- Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
| | - Tanya E Davison
- Monash Art, Design and Architecture, Monash University, Melbourne, Australia
- Research and Innovation, Silverchain, Melbourne, Australia
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2
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Predicting Vasovagal Reactions to Needles from Facial Action Units. J Clin Med 2023; 12:jcm12041644. [PMID: 36836177 PMCID: PMC9965413 DOI: 10.3390/jcm12041644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Merely the sight of needles can cause extreme emotional and physical (vasovagal) reactions (VVRs). However, needle fear and VVRs are not easy to measure nor prevent as they are automatic and difficult to self-report. This study aims to investigate whether a blood donors' unconscious facial microexpressions in the waiting room, prior to actual blood donation, can be used to predict who will experience a VVR later, during the donation. METHODS The presence and intensity of 17 facial action units were extracted from video recordings of 227 blood donors and were used to classify low and high VVR levels using machine-learning algorithms. We included three groups of blood donors as follows: (1) a control group, who had never experienced a VVR in the past (n = 81); (2) a 'sensitive' group, who experienced a VVR at their last donation (n = 51); and (3) new donors, who are at increased risk of experiencing a VVR (n = 95). RESULTS The model performed very well, with an F1 (=the weighted average of precision and recall) score of 0.82. The most predictive feature was the intensity of facial action units in the eye regions. CONCLUSIONS To our knowledge, this study is the first to demonstrate that it is possible to predict who will experience a vasovagal response during blood donation through facial microexpression analyses prior to donation.
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Thijsen A, Masser B, Davison TE, van Dongen A, Williams LA. Beyond fear: A longitudinal investigation of emotions and risk of a vasovagal reaction in first-time whole-blood donors. Transfusion 2023; 63:163-170. [PMID: 36310443 DOI: 10.1111/trf.17169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Fear is a recognized predictor of vasovagal reactions (VVRs) in blood donors. However, less is known about the role of other emotions, including positive emotions, that donors might experience. The aim of this study was to identify the emotions experienced in center that predict onsite VVRs, and to determine at what point during the donation appointment, the experience of these emotions is most influential. STUDY DESIGN AND METHODS A sample of 442 first-time whole-blood donors (57.7% female; mean ± SD age 30.7 ± 11.7 years) completed a survey in the waiting area and before venepuncture in the donation chair to assess their current emotional experience. The survey data were matched with routinely-collected demographic, donation, and donor adverse event information. A generalized estimating equations model was used to identify emotions associated with the occurrence of a VVR. RESULTS A total of 56 (12.7%) participants experienced a VVR. The occurrence of a VVR was significantly associated with lower love/closeness/trust (OR: 0.53, 95%CI: 0.34-0.82) and higher scared/fearful/afraid (OR: 1.96, 95%CI: 1.18-3.25) states. Significant interaction effects suggested that the effect of scared/fearful/afraid decreased while stressed/nervous/overwhelmed increased from the waiting area to before venepuncture on the likelihood of a VVR. DISCUSSION To effectively reduce donor VVR risk, blood collection agencies need to address a broader range of emotions at different points during the donation process.
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Affiliation(s)
- Amanda Thijsen
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia.,Monash Art, Design and Architecture, Monash University, Melbourne, Victoria, Australia
| | - Anne van Dongen
- Psychology, Health, and Technology, Twente University, Enschede, the Netherlands
| | - Lisa A Williams
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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Orru' S, Poetzsch K, Hoffelner M, Heiden M, Funk MB, Keller-Stanislawski B, Oberle D. Blood Donation-Related Adverse Reactions: Results of an Online Survey among Donors in Germany (2018). Transfus Med Hemother 2021; 48:272-283. [PMID: 34803571 DOI: 10.1159/000516049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/19/2021] [Indexed: 01/28/2023] Open
Abstract
Introduction According to German legislation, reports of suspected serious adverse reactions (AR) associated with the donation of blood and its components are continuously being evaluated by the Paul-Ehrlich-Institut. This survey aimed at providing a more complete picture of the AR associated with the donation of blood and blood components. Materials and Methods Eligible donors had the opportunity to anonymously report all AR occurring during or after their last donation by completing an online questionnaire. Reported AR were classified according to the Standard for Surveillance of Complications Related to Blood Donation. Donors' self-assessment of AR seriousness was compared with the official severity classification as laid down by German legislation. Besides a descriptive statistical analysis, a multiple logistic analysis was performed to identify risk factors for AR. Results A total of 8,138 data records were evaluated. Slightly more males (57.9%) participated in the survey and, except for donors aged ≥60 years, all age groups were equally represented. The majority of participants were whole blood donors (85.4%), repeat donors (97.2%), and stayed under observation in the blood establishment (BE) for more than 5 min (63.1%) after donation. Most participants did not report any reaction (72.5%), whereas 2,237 reported at least one AR (27.5%), 475 of whom underwent apheresis and 1,762 donated whole blood. Most AR occurred after leaving the BE (64.4%). Only a minority of participants required medical treatment (5.1%) or assessed the experienced AR as serious (3.9%). The most frequently reported donor AR were haematoma and other local reactions (57.6%). Vasovagal reactions without and with loss of consciousness were developed in 17 and 2% of the participants, respectively, whilst 7.6% experienced citrate reactions. New AR (i.e., allergic reactions and symptoms associated with iron deficiency) were reported as well. The occurrence of AR was linked to risk factors (i.e., female gender, young age, first-time donation, and thrombocytapheresis). Discussion This survey yielded a more comprehensive AR spectrum, revealed a prolonged time to symptom onset, and identified risk factors for AR. This novel information could be implemented in an amended informed consent addressing common and rare AR.
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Affiliation(s)
- Stefano Orru'
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Kay Poetzsch
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Marcus Hoffelner
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Margarethe Heiden
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | - Markus B Funk
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Doris Oberle
- Safety of Medicinal Products and Medical Devices Division, Paul-Ehrlich-Institut, Langen, Germany
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5
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Gilchrist PT, Thijsen A, Masser BM, France CR, Davison TE. Improving the donation experience and reducing venipuncture pain by addressing fears among whole-blood and plasma donors. Transfusion 2021; 61:2107-2115. [PMID: 33904178 DOI: 10.1111/trf.16407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fear of blood donation is implicated in vasovagal reactions, donor recruitment, and retention. This study examined the extent to which fear among donors is associated with various donor outcomes in an Australian sample, and whether fear can be addressed on-site to reduce adverse reactions and improve the donation experience. STUDY DESIGN AND METHODS Six hundred and sixty-four donors (age M = 33.4, SD = 12.7; 55% female) participated in a two-center, pragmatic, parallel group, individually randomized controlled trial. Following donor registration and consent, whole-blood (n = 539) and plasma (n = 125) donors were assigned to one of four Conditions: control; fear assessment; fear assessment + brochure; fear assessment + brochure + tailored conversation focused on any self-reported fear and coping strategies. Post-donation questionnaires assessed the donors' experience including positive support, donor self-efficacy, anxiety, fear, venipuncture pain, and vasovagal reactions. RESULTS Fear among donors predicted higher venipuncture pain, post-donation anxiety, and vasovagal reactions and remained significant after controlling for other established predictors (i.e., total estimated blood volume, age, sex, and donation experience). Mediational analyses showed that exposure to brochures (with or without the tailored conversation) was associated with less pain, with this effect mediated by donor perceptions of more positive support. Venipuncture pain was also associated with vasovagal reactions, reduced likelihood of return within 6 months, and less satisfaction with the donation experience. CONCLUSION The current results underline the importance of interventions to address fear among both whole-blood and plasma donors to secure the safety and well-being of donors and the blood supply.
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Affiliation(s)
- Philippe T Gilchrist
- Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia.,Centre for Emotional Health, Macquarie University, North Ryde, New South Wales, Australia
| | - Amanda Thijsen
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Barbara M Masser
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia.,School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
| | | | - Tanya E Davison
- Clinical Services and Research, Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
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6
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Gilchrist PT, Masser BM, Horsley K, Ditto B. Predicting blood donation intention: the importance of fear. Transfusion 2019; 59:3666-3673. [DOI: 10.1111/trf.15554] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 08/31/2019] [Accepted: 08/31/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Philippe T. Gilchrist
- Department of PsychologyMacquarie University North Ryde New South Wales Australia
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research LaboratoryUniversity of Cambridge Cambridge United Kingdom
| | - Barbara M. Masser
- School of PsychologyUniversity of Queensland St Lucia Queensland Australia
- Clinical Services and ResearchAustralian Red Cross Blood Service Brisbane Queensland Australia
| | - Kristin Horsley
- Behavioural Medicine Lab, Department of PsychologyMcGill University Montréal Québec Canada
| | - Blaine Ditto
- Behavioural Medicine Lab, Department of PsychologyMcGill University Montréal Québec Canada
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7
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Masser B, Ferguson E, Merz EM, Williams L. Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood. Transfus Med Hemother 2019; 47:175-185. [PMID: 32355478 DOI: 10.1159/000501917] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/03/2019] [Indexed: 11/19/2022] Open
Abstract
Background Research on the recruitment and retention of blood donors has typically drawn on a homogeneous set of descriptive theories, viewing the decision to become and remain a donor as the outcome of affectively cold, planned, and rational decision-making by the individual. While this approach provides insight into how our donors think about blood donation, it is limited and has not translated into a suite of effective interventions. In this review, we set out to explore how a broader consideration of the influences on donor decision-making, in terms of affect, memory, and the context in which donation takes place, may yield benefit in the way we approach donor recruitment and retention. Summary Drawing on emerging research, we argue for the importance of considering the implications of both the positive and the negative emotions that donors experience and we argue for the importance of directly targeting affect in interventions to recruit nondonors. Next, we focus on the reconstructed nature of memory and the factors that influence what we remember about an event. We discuss how these processes may impact the retention of donors and the potential to intervene to enhance donors' recollections of their experiences. Finally, we discuss how our focus on the individual has led us to neglect the influence of the context in which donation takes place on donor behavior. We argue that the amassing of comprehensive large data sets detailing both the characteristics of the individuals and the context of their giving will ultimately allow for the more effective deployment of resources to improve recruitment and retention. Key Messages In suggesting these directions for future research, our want is to move beyond the ways in which we have traditionally described blood donation behavior with the aim of improving our theorizing about donors while improving the translational value of our research.
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Affiliation(s)
- Barbara Masser
- School of Psychology, The University of Queensland, St. Lucia, Queensland, Australia.,Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Eva-Maria Merz
- Department of Donor Medicine, Sanquin Research, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lisa Williams
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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8
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France CR, France JL, Conatser R, Lux P, McCullough J, Erickson Y. Predonation fears identify young donors at risk for vasovagal reactions. Transfusion 2019; 59:2870-2875. [DOI: 10.1111/trf.15424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/10/2019] [Accepted: 06/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Pete Lux
- Mississippi Valley Regional Blood Center Davenport Iowa
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9
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Esplendori GF. Adverse reactions to whole blood donation, basic human needs and nursing diagnoses: a reflection. Rev Esc Enferm USP 2018; 51:e03284. [DOI: 10.1590/s1980-220x2017005003284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/29/2017] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT A theoretical-Reflective study with the objective to reflect on human needs regarding the imbalance of whole blood donors considering adverse reactions to the donation, and the existing nursing diagnoses that best meet the imbalance needs. The following needs were pointed out according to the signs and symptoms of adverse reactions and based on the Theory of Basic Human Needs: skin and tissue integrity, emotional security, pain perception, body mechanics, oxygenation, physical integrity, physical comfort, elimination, neurological, electrolytic and vascular regulation. By observing NANDA International’s Definitions and Classifications, adaptations to the existing nursing diagnoses and suggestions for new headings have been proposed. We conclude that some of the needs are interrelated, such as vascular regulation, oxygenation and physical integrity. Thus, more contextualized nursing diagnoses related to the needs of whole blood donors are needed, given the specific nature of the situation generating imbalances such as: ineffective systemic vascular regulation characterized by self-reported dizziness, cutaneous pallor and arterial hypotension related to vasovagal reaction.
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10
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Thijsen A, Masser B. Vasovagal reactions in blood donors: risks, prevention and management. Transfus Med 2017; 29 Suppl 1:13-22. [DOI: 10.1111/tme.12488] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/19/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Thijsen
- Clinical Services and ResearchAustralian Red Cross Blood Service Sydney New South Wales Australia
| | - B. Masser
- Clinical Services and ResearchAustralian Red Cross Blood Service Brisbane Queensland Australia
- School of PsychologyThe University of Queensland Brisbane Queensland Australia
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11
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Martens RJH, Geijselaers SLC, Stehouwer CDA, Henry RMA. Timing of syncope during blood sampling - The Maastricht Study. Eur J Intern Med 2017; 43:e46-e47. [PMID: 28571895 DOI: 10.1016/j.ejim.2017.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 05/24/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Remy J H Martens
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center+, Maastricht, The Netherlands; NUTRIM School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
| | - Stefan L C Geijselaers
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
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12
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Harrison JM, Gilchrist PT, Corovic TS, Bogetti C, Song Y, Bacon SL, Ditto B. Respiratory and hemodynamic contributions to emotion-related pre-syncopal vasovagal symptoms. Biol Psychol 2017; 127:46-52. [PMID: 28456564 DOI: 10.1016/j.biopsycho.2017.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 04/10/2017] [Accepted: 04/22/2017] [Indexed: 02/05/2023]
Abstract
Vasovagal reactions are conventionally understood as resulting from systemic changes in cardiovascular activity; however, there exists a complementary perspective focused on specific changes in cerebral vasoconstriction associated with hyperventilation-induced hypocapnia. The present study investigated the role of cardiovascular and respiratory activity in self-reported pre-syncopal vasovagal reactions to a surgery video in a sample of 49 healthy women. Participants who indicated more previous real-life episodes of dizziness reported experiencing significantly more symptoms in the laboratory consistent with a vasovagal response. They also showed lower total peripheral resistance and higher pre-ejection period in general, suggesting lower sympathetic nervous system activity. Significant decreases in end-tidal carbon dioxide (PETCO2) occurred during the surgery video among susceptible participants, without significant increases in respiration rate. Further, participants who experienced reductions from the neutral video in PETCO2, systolic blood pressure, or both, reported vasovagal symptoms during the surgery video. The results suggest that patterns of respiration associated with decreases in PETCO2 may contribute to vasovagal symptoms reported in non-clinical groups as well as those with blood-injection-injury phobia and are associated with susceptibility to dizziness.
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Affiliation(s)
- Johanna M Harrison
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Ave. Docteur Penfield, Montreal, Quebec, H3A 1B1, Canada.
| | - Philippe T Gilchrist
- Wolfson College, University of Cambridge, Cambridge CB3 9BB, United Kingdom; MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, 2 Wort's Causeway, Cambridge, CB1 8RN, United Kingdom
| | - Tiana S Corovic
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Ave. Docteur Penfield, Montreal, Quebec, H3A 1B1, Canada
| | - Curtis Bogetti
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Ave. Docteur Penfield, Montreal, Quebec, H3A 1B1, Canada
| | - Yuqing Song
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Ave. Docteur Penfield, Montreal, Quebec, H3A 1B1, Canada
| | - Simon L Bacon
- Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, Montreal, Quebec, H4 B 1R6, Canada
| | - Blaine Ditto
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Ave. Docteur Penfield, Montreal, Quebec, H3A 1B1, Canada
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13
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Masser BM, France CR, Himawan LK, Hyde MK, Smith G. The impact of the context and recruitment materials on nondonors' willingness to donate blood. Transfusion 2016; 56:2995-3003. [DOI: 10.1111/trf.13805] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/20/2016] [Accepted: 07/25/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Barbara M. Masser
- School of Psychology; The University of Queensland, St Lucia, Queensland, Australia
- Clinical Services and Research, The Australian Red Cross Service, Australia
| | | | | | - Melissa K. Hyde
- Menzies Health Institute Queensland, Griffith University; Gold Coast Campus Southport Queensland Australia
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14
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Disgust stimuli reduce heart rate but do not contribute to vasovagal symptoms. J Behav Ther Exp Psychiatry 2016; 51:116-22. [PMID: 26851836 DOI: 10.1016/j.jbtep.2016.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/09/2015] [Accepted: 01/27/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The vasovagal response demonstrates a unique form of stress response, common in medical settings yet provoked by a variety of blood-injury-injection stimuli. This study aimed to better understand the psychophysiological mechanisms of the vasovagal response.. METHODS 16 undergraduates with and 42 without a self-reported history of fainting watched five 3-5 min videos with different emotional content. One documentary clip (Neutral condition) described a campus environmental project while another (Blood/Injury) depicted portions of an open heart surgery. Three additional clips were also used, including Medical, Threat, and Contamination stimuli. Vasovagal symptoms and physiological variables were assessed during each video. RESULTS As predicted, while the disgust-related stimuli (Blood/Injury, Medical, Contamination) were associated with generally lower heart rate, the Blood/Injury video produced the highest symptoms and the only significant difference between previous fainters and non-fainters. The physiological measures also revealed that participants with a fainting history experienced higher stroke volume and lower systolic blood pressure throughout, as well as several main effects of video. LIMITATIONS An additional decrease in systolic blood pressure and respiration produced by watching the Blood/Injury video may have been sufficient to trigger symptoms in some, though results also suggest that systemic variables do not entirely explain susceptibility to symptoms. More careful evaluation of regional blood flow may be required. CONCLUSIONS Participants who had previously experienced strong vasovagal responses displayed what appeared to be an anticipatory response to the Blood/Injury video. Finally, disgust stimuli may reduce heart rate but do not appear to contribute to vasovagal symptoms.
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15
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Chell K, Waller D, Masser B. The Blood Donor Anxiety Scale: a six-item state anxiety measure based on the Spielberger State-Trait Anxiety Inventory. Transfusion 2016; 56:1645-53. [DOI: 10.1111/trf.13520] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Kathleen Chell
- Australian Red Cross Blood Service; Kelvin Grove Queensland, Australia
| | - Daniel Waller
- Australian Red Cross Blood Service; Sydney New South Wales, Australia
| | - Barbara Masser
- University of Queensland, Australian Red Cross Blood Service; Brisbane Queensland Australia
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16
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Jinguji M, Nakajo M, Nakajo M, Nakabeppu Y, Yoshiura T. Vasovagal-related stress immediately before FDG injection may increase bilateral adrenal FDG uptake. Br J Radiol 2016; 89:20150950. [PMID: 26943003 DOI: 10.1259/bjr.20150950] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between vasovagal-related stress on positron emission tomography (PET)/CT and adrenal fludeoxyglucose (FDG) uptake. METHODS We reviewed the medical records of 1358 consecutive patients who underwent FDG PET/CT examinations and selected those who presented with vasovagal-related symptoms and acute hypotension immediately before FDG injection (vasovagal reflex group). Patients who underwent FDG PET/CT examinations on the same days as the vasovagal reflex group without new complaints or any adrenal lesion were used as controls. We evaluated adrenal FDG uptake visually and by means of adrenal maximum standardized uptake value (SUV(max)) and adrenal/liver (A/L) SUV(max) ratio. Next, we reviewed the FDG PET/CT images of the same 1358 patients and selected the cases presenting with bilateral avid FDG uptake. RESULTS 4 patients were included in the vasovagal reflex group, and all of them showed bilateral avid adrenal FDG uptake visually, while 19 patients in the control group did not. The mean adrenal SUV(max) and the mean A/L SUV(max) ratio were significantly higher in the vasovagal reflex group than in the control group (p < 0.001). 10 (0.74%) patients, including 4 patients from the vasovagal reflex group, showed bilateral avid FDG uptake with normal adrenal configuration on CT. CONCLUSION Vasovagal-related stress immediately before FDG injection may increase bilateral adrenal FDG uptake. ADVANCES IN KNOWLEDGE Vasovagal-related stress may be included in the differential diagnosis of the cause of bilateral avid adrenal FDG uptake.
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Affiliation(s)
- Megumi Jinguji
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masatoyo Nakajo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masayuki Nakajo
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshiaki Nakabeppu
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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France CR, France JL, Frame-Brown TA, Venable GA, Menitove JE. Fear of blood draw and total draw time combine to predict vasovagal reactions among whole blood donors. Transfusion 2015; 56:179-85. [DOI: 10.1111/trf.13264] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/03/2015] [Accepted: 07/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Geri A. Venable
- Community Blood Center of Greater Kansas City; Kansas City Missouri
| | - Jay E. Menitove
- Community Blood Center of Greater Kansas City; Kansas City Missouri
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18
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Gilchrist PT, McGovern GE, Bekkouche N, Bacon SL, Ditto B. The vasovagal response during confrontation with blood-injury-injection stimuli: the role of perceived control. J Anxiety Disord 2015; 31:43-8. [PMID: 25728015 DOI: 10.1016/j.janxdis.2015.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 01/14/2015] [Accepted: 01/29/2015] [Indexed: 11/30/2022]
Abstract
The vasovagal response (VVR) is a common medical problem, complicating and deterring people from various procedures. It is an unusual stress response given the widespread decreases in physiological activity. Nevertheless, VVR involves processes similar to those observed during episodes of strong emotions and pain. We hypothesized that heightened perceived control would reduce symptoms of VVR. Eighty-two young adults were randomly assigned to perceived control or no perceived control conditions during exposure to a stimulus video of a mitral valve surgery, known to trigger VVR in non-medical personnel. Perceived control was manipulated by allowing some participants to specify a break time, though all received equivalent breaks. Outcomes included subjective symptoms of VVR, anxiety, blood pressure, heart rate, and other measures derived from impedance cardiography. Compared to participants with perceived control, participants with no perceived control reported significantly more vasovagal symptoms and anxiety, and experienced lower stroke volume, cardiac output, and diastolic blood pressure. Participants who were more fearful of blood were more likely to benefit from perceived control in several measures. Perceived control appears to reduce vasovagal symptoms. Results are discussed in terms of cognition and emotion in VVR.
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Affiliation(s)
- Philippe T Gilchrist
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Dr Penfield Avenue, Montreal, Quebec H3A 1B1, Canada.
| | - Gillian E McGovern
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Dr Penfield Avenue, Montreal, Quebec H3A 1B1, Canada
| | - Nadine Bekkouche
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Dr Penfield Avenue, Montreal, Quebec H3A 1B1, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre and Research Centre, Hôpital du Sacré-Coeur de Montréal - A University of Montreal Affiliated Hospital, Montreal H4J 1C5, Canada; Department of Exercise Science, Concordia University, 7141 Sherbrooke Street West, Montreal, Quebec H4B 1R6, Canada
| | - Blaine Ditto
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Dr Penfield Avenue, Montreal, Quebec H3A 1B1, Canada
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19
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Gilchrist PT, Ditto B. Sense of impending doom: Inhibitory activity in waiting blood donors who subsequently experience vasovagal symptoms. Biol Psychol 2015; 104:28-34. [DOI: 10.1016/j.biopsycho.2014.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/10/2014] [Accepted: 11/13/2014] [Indexed: 11/26/2022]
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20
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Blood donation fears inventory: development and validation of a measure of fear specific to the blood donation setting. Transfus Apher Sci 2014; 51:146-51. [DOI: 10.1016/j.transci.2014.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 04/04/2014] [Accepted: 07/25/2014] [Indexed: 11/22/2022]
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21
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France CR, France JL, Carlson BW, Himawan LK, Stephens KY, Frame-Brown TA, Venable GA, Menitove JE. Fear of blood draws, vasovagal reactions, and retention among high school donors. Transfusion 2013; 54:918-24. [DOI: 10.1111/trf.12368] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/24/2013] [Accepted: 06/29/2013] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | | | | | - Geri A. Venable
- Community Blood Center of Greater Kansas City; Kansas City Missouri
| | - Jay E. Menitove
- Community Blood Center of Greater Kansas City; Kansas City Missouri
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22
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Radvansky BM, Husain Q, Cherla DV, Choudhry OJ, Eloy JA. In-office vasovagal response after rhinologic manipulation. Int Forum Allergy Rhinol 2012. [PMID: 23193039 DOI: 10.1002/alr.21121] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Advances in endoscopic sinus surgery have led to a greater number of in-office procedures away from the traditional operating room setting. Rhinologists acting independently of anesthesiologists must be prepared for potential complications, such as vasovagal response (VVR), that may arise during in-office rhinologic manipulations. In this study, we review our experience with this condition and discuss risk factors and a management algorithm for in-office VVR. METHODS A retrospective analysis at a large tertiary referral center was performed on all patients undergoing in-office endoscopic procedures with rhinologic manipulation between July 2008 and June 2012. A total of 4973 patients underwent in-office endoscopic procedures and 8 patients with VVR were identified. Demographic data, diagnosis, procedure performed, and outcomes were reviewed. RESULTS Eight patients out of 4973 (0.16%) experienced VVR during in-office endoscopic procedures. Seven (87.5%) of these 8 patients recovered from the VVR within 30 minutes and subsequently completed their scheduled procedure. One (12.5%) of the 8 patients did not fully recover after 30 minutes and was sent to the Emergency Department, where he was stabilized and subsequently discharged. The most common comorbidities in these 8 patients with VVR were hypercholesterolemia in 3 patients (37.5%), and hypertension and benign prostatic hyperplasia, each found in 2 patients (25.0%). CONCLUSION Although the incidence of VVR during rhinologic procedures is low, rhinologists should be familiar with this condition and be prepared for its management.
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Affiliation(s)
- Brian M Radvansky
- Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07103, USA
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23
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Wong RKW, James JL, Sagar S, Wyatt G, Nguyen-Tân PF, Singh AK, Lukaszczyk B, Cardinale F, Yeh AM, Berk L. Phase 2 results from Radiation Therapy Oncology Group Study 0537: a phase 2/3 study comparing acupuncture-like transcutaneous electrical nerve stimulation versus pilocarpine in treating early radiation-induced xerostomia. Cancer 2012; 118:4244-52. [PMID: 22252927 DOI: 10.1002/cncr.27382] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/26/2011] [Accepted: 10/28/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND In this phase 2 component of a multi-institutional, phase 2/3, randomized trial, the authors assessed the feasibility and preliminary efficacy of acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) in reducing radiation-induced xerostomia. METHODS Patients with cancer of the head and neck who were 3 to 24 months from completing radiotherapy with or without chemotherapy (RT ± C) and who were experiencing xerostomia symptoms with basal whole saliva production ≥0.1 mL per minute and were without recurrence were eligible. Patients received twice weekly ALTENS sessions (24 sessions over 12 weeks) using a proprietary electrical stimulation unit. The primary study objective was to assess the feasibility of ALTENS treatment. Patients were considered compliant if 19 of 24 ALTENS sessions were delivered, and the targeted compliance rate was 85%. Secondary objectives measured treatment-related toxicities and the effect of ALTENS on overall radiation-induced xerostomia burden using the University of Michigan Xerostomia-Related Quality of Life Scale (XeQOLS). RESULTS Of 48 accrued patients, 47 were evaluable. The median age was 60 years, 84% of patients were men, 70% completed RT ± C for >12 months, and 21% had previously received pilocarpine. Thirty-four patients completed all 24 ALTENS sessions, 9 patients completed 20 to 23 sessions, and 1 patient completed 19 sessions, representing a 94% total compliance rate. Six-month XeQOLS scores were available for 35 patients and indicated that 30 patients (86%) achieved a positive treatment response with a mean ± standard deviation reduction of 35.9% ± 36.1%. Five patients developed grade 1 or 2 gastrointestinal toxicity, and 1 had a grade 1 pain event. CONCLUSIONS The current results indicated that ALTENS treatment for radiation-induced xerostomia can be delivered uniformly in a cooperative, multicenter setting and produces possible beneficial treatment response. Given these results, the phase 3 component of this study was initiated.
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Affiliation(s)
- Raimond K W Wong
- McMaster University, Department of Oncology, Juravinski Cancer Center, Hamilton, Ontario, Canada.
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Ditto B, Balegh S, Gilchrist PT, Holly CD. Relation between perceived blood loss and vasovagal symptoms in blood donors. Clin Auton Res 2011; 22:113-6. [PMID: 22045364 DOI: 10.1007/s10286-011-0147-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 05/25/2011] [Indexed: 11/28/2022]
Abstract
UNLABELLED INTRODUCTION/RESULTS: This study examined whether a belief of significant blood loss may be associated with vasovagal symptoms, irrespective of actual blood loss. Individual differences in vasovagal symptoms among blood donors who had an equivalent amount of blood withdrawn were significantly associated with their rating of perceived blood loss. CONCLUSION The anticipation or belief of blood loss, and perhaps more remotely associated ideas, may trigger processes similar to those induced by actual hemorrhage though further research is required to address other possibilities such as the inflation of ratings by vasovagal symptoms.
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Affiliation(s)
- Blaine Ditto
- Laboratory for Cardiovascular Psychophysiology, Department of Psychology, McGill University, 1205 Dr Penfield Ave, Montreal, QC, H3A 1B1, Canada.
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