Negative experiences and donor return: an examination of the role of asking for something different

The association between attitude towards facemasks, quality of donation experience and relationship with healthcare providers: A cross-sectional exploratory study

BACKGROUND AND OBJECTIVES

Facemasks represent an essential measure of prevention against the spread of infectious diseases; however, they lessen the ability to convey and understand emotions through facial expressions. In blood donation settings, facemask wearing could interfere with professionals' tasks, reduce the satisfaction of blood donors and affect their future blood donation behaviour. This preliminary cross-sectional study explored the association of mandatory facemask wearing with the quality of the blood donation process at the end of the coronavirus 2019 (COVID-19) pandemic.

MATERIALS AND METHODS

A sample of 615 voluntary unpaid Italian blood and plasma donors completed an online survey assessing their attitude towards facemask wearing, the perceived distress due to facemasks in the different steps of the donation process, self-reported vasovagal reactions after donation and the intention to donate again.

RESULTS

Nearly 24% of donors reported a worsened quality of the donation process due to facemask wearing, and 36% reported moderate to severe distress during the donation itself. Donors with a more negative attitude towards facemasks reported a worse donation experience, mainly related to the interactions and the communication with physicians and nurses, and a higher probability of experiencing vasovagal reactions at their last donation. No significant correlations were observed between negative facemask attitudes towards facemask wearing, distress or future intention to donate blood/plasma.

CONCLUSION

Facemasks have worsened the quality of blood and plasma donations for one fourth of donors, confirming the interference with the quality of communications and relationships with healthcare professionals.

What influences decisions to donate plasma? A rapid review of the literature

BACKGROUND AND OBJECTIVES

Plasma has become an essential ingredient for various medical treatments. Many blood collection agencies rely on voluntary non-remunerated donation when collecting plasma, but at present many do not collect sufficient plasma to meet domestic demands. This rapid review sought to explore the factors that have been found to influence people's decisions to donate plasma to inform future research.

METHODS

Searches were conducted in PubMed, PsycINFO, Social Sciences Citation Index and CINAHL for peer-reviewed journal articles that discussed plasma donation and the factors associated with donor behaviour. Pertinent information from included articles was extracted and arranged in themes.

RESULTS

In total, 33 articles were included in this review. Three main themes were identified by the authors. The first focused on site-level factors related to blood collection agencies' engagement with plasma donors and their influence on plasma donation experiences. The second theme considered how individual characteristics and experiences influence willingness to donate plasma. The third theme examined social and cultural-level factors, such as how social networks and community shape perceptions and experiences with donation.

CONCLUSION

Our findings suggest that the current understanding of plasma donation is focused mainly on converting whole blood donors and also centres on individual-level factors to donation. Further research must examine what factors attract non-whole blood donors to become plasma donors, focusing on broader social-level influences. This review will inform policies and interventions for blood collection agencies to increase plasma donors.

A review of whole-blood donors' willingness, motives, barriers and interventions related to donating another substance of human origin

Diversification of blood collection agencies' (BCAs) core business requires donors to donate substances of human origin (SoHO) beyond whole-blood. Whole-blood donors are assumed to be willing to convert to donate other SoHO as well as whole-blood. However, no reviews consider the evidence on conversion (i.e., willingness/intention, behaviour, retention, attrition). This rapid review provides a narrative synthesis of whole-blood donors' conversion to another SoHO, characteristics contributing to conversion, motives and deterrents, and interventions encouraging conversion. Sixty-five studies were reviewed. Most were cross-sectional and examined whole-blood donor conversion to organ (willingness/pledge for deceased donation), plasma or stem cell donation. Most examined conversion rather than characteristics contributing to conversion, motives, deterrents or interventions. Whole-blood donors appear willing to donate another SoHO, yet conversion rates are unclear. Besides self-efficacy, there is little consistency in reported characteristics of donors converting, and few theories applied to understand characteristics encouraging conversion. Intrinsic (altruism, self-esteem, curiosity) and extrinsic (perceived need, service experience, direct requests) motives and barriers (lifestyle, fearing reduced health) appear important and require further research. Interventions encouraging conversion need replication and may include in-person, in-centre approaches, raising awareness of the functional benefits of other SoHO (high need, usefulness), and developing promotional materials that pique donors' curiosity, invite questions, and encourage donor-initiated conversations about conversion. Centralising BCAs as a single business or partnering with other organisations appears mutually beneficial to encourage conversion and sustainable panels/resources. Research is needed to understand the impact of encouraging conversion on donors and organisations, and identify optimal management strategies for multi-SoHO donors.

An intervention study for the prevention of vasovagal reactions and evaluating donors' experience: Analysis of donors' return for subsequent donation

BACKGROUND AND OBJECTIVES

The EPISoDe (Experience Success in Donation) study investigated the effect of interventions on self-reported vasovagal reactions (VVRs) in first-time and novice (second to fourth donation) whole blood donors aged ≤30 years, demonstrating a 23% reduction of VVR from water drinking shortly before donation in the novice donors. Because donation experience and complications affect donor retention, we analysed intervention group donors' return for subsequent donation, a predefined secondary outcome.

MATERIALS AND METHODS

The interventions were as follows: 330 ml water, 500 ml water, ball squeezing before phlebotomy (placebo) and a control group. All donors received an online questionnaire about their experience within a week after donation. In the Netherlands, eligible donors are invited at least yearly depending on hospitals' needs. We analysed attendances within 421 days through return percentages and binomial logistic regression.

RESULTS

Of the 8300 EPISoDe participants, 6538 (78.8%) returned within 421 days. Return did not differ between the two water groups, whereas odds for return were significantly higher in both water and placebo intervention donors compared to the control group (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.00-1.29 and 1.22, 1.05-1.43, respectively) after adjustment for occurrence of VVR, unsuccessful collection, gender and donation history. Staff-recorded or self-reported VVR at index donation was associated with reduced odds for return (OR 0.47, 95% CI 0.37-0.60 and OR 0.53, 95% CI 0.46-0.61, respectively).

CONCLUSION

In this cohort of younger inexperienced blood donors, 78.8% returned for subsequent donation. Donors who received an active study intervention, either water or placebo, were more likely to return than control group donors.

Do deferred donors continue their donations? A large-scale register study on whole blood donor return in the Netherlands

BACKGROUND

Temporary deferral of whole blood donors is essential for a safe blood supply, yet deferral may impact donor return. Different deferral reasons may differently affect return, and donor experience may interfere with this. Therefore, we studied the joint effect of deferral reason and donor experience on return.

STUDY DESIGN AND METHODS

We used a large‐scale retrospective cohort design including all Dutch donors with a whole blood donation attempt in 2013 to 2015 (n = 343,825). We established details of the target donation (including deferral reason if applicable), details of attendances in the 2 years after the target donation, donor characteristics (blood type, sex, age), and donor experience (first‐time, novice, experienced, reactivated). Descriptive statistics as well as time‐to‐events methods were used.

RESULTS

Experienced donors were most likely to return, even after deferral (nondeferred 96% vs. deferred 92%). First‐time and reactivated donors were less likely to return after deferral (69 and 61%, respectively) compared to their nondeferred counterparts (82 and 76%, respectively). First‐time hemoglobin (Hb)‐deferred donors were less likely to return and slower to return than other donors. Similar results were found for reactivated donors deferred for short‐term medical reasons.

CONCLUSION

Deferral reason and donor experience individually as well as jointly impacted donor return. Particularly first‐time and reactivated donors were at risk of nonreturn, especially when deferred for Hb or short‐term medical reasons, respectively. Blood banks designing and implementing donor retention strategies should thus not only take successful but also unsuccessful donation experiences and different experience levels into account.

Psychosocial and cognitive engineering contributions to blood transfusion

Among the research developed in social psychology, there is a field of study questioning the mechanisms that explain prosocial behaviors. In 1956, the first links between transfusion medicine and social psychology were formed, with the study of underlying motivations to blood donation behavior. Sixty years later, the number of "fundamental" and "applied" research has widely increased, and we now have a theoretical understanding of blood donation engagement's levers, as well as experimental demonstrations of methods to activate these levers. Thus, the literature offers several strategies experimentally verified to improve the recruitment and retaining of blood donors. These methods can go from specific speeches when soliciting donors, to changes in the blood donation environment, etc. They aim either at impacting the donation experience, at obtaining a change in the donor's behavior, or at changing the determinants of blood donation. Yet, it is clear that the knowledge from the research in social psychology is not really deployed on the field by the organizations that could benefit from it. In this article, we will try to develop the difficulty regarding the application of fundamental and experimental knowledge, and to underline the implications for the blood transfusion establishments. We will then present the psychosocial and cognitive engineering method, and argue its relevance to answer this problematic.

Well-being and return rate of first-time whole blood donors

BACKGROUND AND OBJECTIVES

Previous studies observed a transient increase in well-being in about one-third of regular donors after blood donation. In addition, personal contact with donors after donation seems to increase return rates. We were interested whether changes in well-being and/or personal contact after the first donation impact return rates of first-time donors (FTDs).

MATERIALS AND METHODS

First-time donors were randomized to a questionnaire group (QG), in which questionnaires assessing the well-being had to be filled in, or a control group (CG), which was not contacted with a questionnaire. The QG had to complete the same questionnaire three times at the day of the first donation and then four times over an 8-week period with reminding calls by the study coordinator. Return rates of participants were followed for 12 months.

RESULTS

A total of 102 FTDs participated in the QG and 115 in the CG. Changes in well-being after the first donation had minimal impact on the return rates. In contrast, contacting FTDs after their first donation had a significant impact on the return rate of male donors (89·2% in the QG vs. 58·3% in the CG; P = 0·001). Females showed no significant difference in return rates between both groups (P = 0·32).

CONCLUSION

The well-being of FTDs had no influence on their return rate. The intervention of regular contacts during a research project follow-up resulted in an increased return rate of male but not of female FTDs. The pronounced difference of the impact of this intervention between male and female donors requires further studies.

[Commitment in plasmapheresis donation: A study of determinants among regular donors in plasmapheresis]

The purpose of this study, based on the Theory of planned behavior, is to identify and ultimately better understand what determines the fidelity and the regularity of donors committed in plasmapheresis donation. This qualitative study is a primary stage to establish a classification of donors in a French socio-cultural context. For this reason, we have carried out a survey among 16 regular plasmapheresis donors, by way of semi-structured individual interviews at the Établissement français du sang - Brittany. The level of commitment of these regular donors is considered as a level of appropriation. If subjective norms have initially influenced their decision to donate blood, no specific motivation has been highlighted for them to donate plasma except a generally favourable attitude towards the voluntary donation process. The perception of control over their environment is a variable which played a decisive role in the donor's intention to give, with little cost associated to plasmapheresis donation and recourse to internal causal explanations. A better comprehension of the plasmapheresis donors' determinants should lead us to a more efficient awareness of new potential donors, thereby enhancing recruitment and retention. Due to the increasing need for plasma-derived products, this study's ultimate issue is closely correlated both with ethical and socio-economic aspects. Following which, after analysing the results, a certain number of recommendations will be made.