Assessment of blood donation intention among medical students in Pakistan – An application of theory of planned behavior

Applying a modified and extended theory of planned behavior to predict blood donation intentions among Chinese university students: An empirical investigation

Background

The blood shortage in China has become a nationwide issue, which poses a threat to critical medical treatments and puts patients at risk. To address this problem, blood donation recruitment and retention campaigns have been launched, with university students being recognized as an important target audience. To recruit this particular population effectively, it is crucial to comprehend their motivations for donating blood.

Methods

This study used a modified and extended Ajzen's Theory of Planned Behavior to explain the determinants of blood donation intention among N = 1165 China's young adults through an online cross-sectional survey, utilizing a snowball sampling technique to recruit participants.

Results

In line with previous TPB-based studies, we found positive associations between attitude (β = 0.071, p < .01), subjective norms (β = 0.264, p < .001), and self-efficacy (β = 0.536, p < .001) with blood donation intention. Attitude and self-efficacy mediated the relationships between anxiety, altruism, and social norm with blood donation intention (β = 0.817, p < .01, 95%CI [0.737, 0.909]; β = 1.31, p < .01, 95%CI [1.203, 1.409]; β = 1.301, p < .01, 95%CI [1.209, 1.403]). Attitude also mediated the relationship between altruism and social norm with blood donation intention (β = .456, p < .01, 95%CI [0.38, 0.53]; β = 0.447, p < .01, 95%CI [0.374, 0.52]).

Conclusion

Our results highlight the significance of utilizing communication strategies, such as promoting altruism and reducing donation anxiety, as well as creating a supportive social environment. These strategies can improve attitudes and intentions toward blood donation, leading to an increase in blood donation rates.

Investigation and influencing factors of the behavioral intention of nurses voluntarily participating in the care of older adults with disabilities

Objectives

This study aimed to analyze nurses' intention and influencing factors to participate in voluntary care services for older adults with disabilities, and build a structural equation model to clarify the influence of behavioral attitude, subjective norms, and perceived behavioral control on the behavioral intention, to lay the foundation for establishing voluntary care teams for older adults with disabilities.

Methods

This cross-sectional study was conducted in 30 hospitals of different levels from August to November 2020. Participants were selected by convenience sampling. A self-designed questionnaire was used to survey nurses to investigate their intention to participate in voluntary care services for older adults with disabilities, including four dimensions: behavioral intention (three items), behavioral attitude (seven items), subjective norms (eight items), and perceived behavioral control (eight items), a total of 26 items. Logistic regression was used to analyze the influence of general information on behavioral intention. Smart PLS 3.0 software was used to build the structural equation model, and the influence of behavioral attitude, subjective norms, and perceived behavioral control on behavioral intention was analyzed.

Results

A total of 1,998 nurses were enrolled, 1,191 (59.6%) were willing to participate in volunteer care for older adults with disabilities, and the willingness of nurses to participate in volunteer care for older adults with disabilities was above the medium level. The scores of behavioral attitude, subjective norm, perceived behavioral control, and behavioral intention dimension were 26.31 ± 5.94, 30.93 ± 6.62, 27.58 ± 6.70, and 10.78 ± 2.50, respectively. Logistic regression analysis showed that the nurses who had urban household registration, held a management positions in the department, received free help from other volunteers, and was rewarded by hospitals or organizations for voluntary activities were more willing to participate (P < 0.05). The partial least squares analysis showed that behavioral attitudes (β = 0.456, P < 0.001), subjective norms (β = 0.167, P < 0.01), and perceived behavioral control (β = 0.123, P < 0.01) had a significant positive impact on behavioral intention. The more positive the attitude, the more support, the fewer the obstacles, and the greater the intention of the nurses to participate.

Conclusion

Mobilizing nurses to volunteer care for older adults with disabilities is feasible in the future. Therefore, policymakers and leaders need to improve relevant laws and regulations to ensure the safety of volunteers, reduce the external hindrance factors of volunteer activities, pay attention to the cultivation of nursing staff values, identify the internal needs of nursing staff and improve incentive measures, to improve the willingness of nursing staff to participate and transform it into practical action.

The Theory of Planned Behavior for the Improvement of the Delayed Blood Donation Cycle, Optimization of the Planning Behavior, and Donor Intention

The advances in the technology applied to the health field lead the medical system to be optimized and the medical equipment and drugs to be improved, and the benefits can be seen in the prolonged human lifetime. The increased age and the lifestyle, however, increase the demand of blood for medical procedures and to save lives. The average age of blood donors has gradually increased, the number of new blood donors has grown slowly, and the allocation of blood supply and inventory is complex and many times cannot be improved. The low increase in blood donor number is a concern that needs to be overcome. Here, the theory of planned behavior was used as a tool to analyze the motivation, intention, and behavior of blood donors. The theory of planned behavior was applied in the form of questionnaires to college students. The results indicated that participation on the research motivates and educates the participants to donate blood, encourages the behavior of relatives, and leads the participants to realize the altruistic and mutually beneficial outlook on blood donation. The results also indicated the awareness of the students with respect to the importance of blood donation and that it can be an important tool in order to educate and increase the young blood donor number.

Medical Student Attitudes Toward Blood Donation in Times of Increased Need

BACKGROUND

In situations of increased need, such as mass casualty incidents (MCIs) and COVID-19, donated blood products are in shortage across the United States. Medical students are a potential pool for blood donors. The aim of this study was to determine overall attitudes of medical students at a single academic institution toward blood donation during times of increased need.

METHODS

Three anonymous REDCap surveys were administered to all medical students at a rural academic institution. Surveys 1 and 2 were administered preceding and after an institution-wide MCI drill, in September and November 2019, respectively. Survey 3 was administered following a student-organized COVID-19 blood drive in June 2020. Multivariable analysis was performed to determine if factors, ie, experience with MCI drills and emergency medical services (EMS) training, were associated with willingness to donate blood. Furthermore, barriers to donation among those not willing to donate were assessed.

RESULTS

Overall response rate for MCI surveys (surveys 1 and 2) was 38% (mean age 25.2 years and 50% women). 91% (n = 210) of respondents were willing to donate blood. Previous participation in MCI drills and EMS training was not associated with higher willingness to donate blood. Response rate for survey 3 was 15.6% (59.4% women), and 30 (31.3%) respondents indicated they did not volunteer to donate blood during the COVID-19 drive. Most common reasons for not donating were "other," medical concerns, and being out-of-town.

CONCLUSIONS

Majority of medical students are willing to donate blood during times of increased need and offer a possible solution to increase blood donor pool.

Using Digital Platforms to Promote Blood Donation: Motivational and Preliminary Evidence from Latin America and Spain

The lack of blood donors is a global problem that prevents the demand for blood prompted by an ageing population and increased life expectancy from being met. The aim of this study was to conduct an initial exploration of the reasons for using digital platforms in blood donation. Using a Theory of Planned Behaviour (TPB) framework, microdata for 389 participants from Latin American countries and Spain, and Partial Least Square-Structural Equation Modelling (PLS-SEM), the study obtained three main prediction paths. The first two started from feelings of trust in the digital community and a positive mood state associated with a modern lifestyle, and they were linked to attitudes and behavioural control in the explanation of the intention to donate and actual blood donation. The third path started from modern lifestyles, and was linked to the subjective norm in the prediction of intention and actual donation. These paths represent one of the very first attempts to predict intentions of donation and collaborative donation by taking a PLS-SEM approach. By determining the paths underpinning collaborative blood donors' motives, the results of this study provide strong support for the usefulness of the TPB model within the context of digital platform use and blood donation.

Intention to donate blood and its predictors among adults of Gondar city: Using theory of planned behavior

Background

Blood transfusion is a lifesaving procedure when someone encounters severe anemia, accident or injury, surgery, heavy bleeding during childbirth and cancer chemotherapy. The average blood donation rate of Africa is 4.7/1000 inhabitants and Ethiopia is among one of the countries with the lowest annual donation rate which is 0.8/1000 population. This study assessed intention to donate blood on adults of Gondar city administration using the theory of planned behavior.

Methods

A community-based cross-sectional study was conducted. The study was conducted on two randomly selected Gondar sub-cities using systematic sampling on a sample size of 524 adults. Epi Data version 3.0 and STATA version 14 were used for entry and analysis of data respectively. Multiple linear regression was carried out to see the association between intention and sociodemographic variables, past donation experience, attitude, subjective norm and perceived behavioral control and with 95% confidence interval and a p-value of less than 0.05 was used to detect statistical significance.

Results

A total of 515 respondents participated in the study giving a response rate of 98%. Most of the participants were females (66.4%) and the participants’ age ranges from 18 to 65 years. The variance explained by the model was 49%. The mean intention to donate blood was 3.02±1.13. Direct perceived behavioural control (β = 0.14, CI (0.04, 0.23)), direct subjective norm (β = 0.11: CI (0.04, 0.17), direct attitude (β = 0.03; CI (0.01, 0.06)) and past behaviour of blood donation (β = 0.3; CI (0.07, 0.51) were significant predictor of intention.

Conclusion

Theory of planned behavior could be successfully applied in determining adult’s blood donation intention. Predictors of intention to donate blood were past experience of blood donation, direct subjective norm, direct perceived behavioural control and direct attitude. None of the external variables predict blood donation intention.

Knowing the Blood Nondonor to Activate Behaviour

This work is aimed at further developing the study of blood nondonor behaviour through a joint analysis of sociodemographic characteristics, psychological and physical barriers, impure altruism and anticipated emotions, as predictors of intention to donate. To that end, a step-by-step hierarchical regression analysis was applied on a sample of 2383 Spanish nondonors. The study’s results confirm the influence of traditional variables (sociodemographic characteristics, psychological and physical barriers and impure altruism), as well as the power of anticipated emotions, both positive and negative, of donation action and inaction as variables explaining the intention to donate. Another important contribution has been to develop the moderating role of psychological and physical barriers, in addition to impure altruism, on cause–effect relationships between anticipated emotions and intention to donate. A number of practical implications can be derived from this study for transfusion centres responsible for donation promotion.

Current approaches to increase blood donations in resource-limited countries

BACKGROUND

Low- and middle-income countries (LMIC) suffer from chronic or seasonal blood shortage. The first review was published in 2007.

METHODS

The review of literature since 2005 presented here uncovered a fairly large number of articles justifying the grouping of blood donation issues into five geographical areas sharing common background. These are Sub-Saharan Africa (SSA), Muslim countries, India, China/South East Asia and Latin America/Caribbean islands (LA&C).

RESULTS

SSA countries start collecting at 16-18 years of age in schools where female donors can be reached better than in other settings. Community-oriented culture favours family donors who need, similar to volunteer non-remunerated donors (VNRD), to be actively induced to repeat donation. Muslim countries share the contradiction of religion encouraging blood donation but restrain women from donating. The active involvement of religious leaders and the progressive easing of female participation are the keys to increasing blood donation. In India, 'social duty' is a major inducement to blood donation but also benefits and rewards. Ways of involving female donors by reducing the donation age to 16 years and providing donor education in schools need to be considered. In China and East Asia, the option of small-volume donation impairs blood collection without being justified by scientific evidence but is a concession to culture. Reducing the donation age would also help the supply. In LA&C, the concept of 'social capital' was developed as a complement or alternative to the theory of planned behaviour.

CONCLUSIONS

Strategies to improve blood donation and repeat donation should be innovative and adapted to local or regional culture and environment.