Fear of blood draw is associated with inflated expectations of faint and prefaint reactions to blood donation

Blood Donation Fear, Perceived Rewards, Self-Efficacy, and Intention to Return Among Whole Blood Donors in China: A Social Cognitive Perspective

With the increasing demand from aging population and seasonal blood shortage, recruiting and retaining blood donors has become an urgent issue for the blood collection centers in China. This study aims to understand intention to donate again from a social cognitive perspective among whole blood donors in China through investigating the association between the blood donation fear, perceived rewards, self-efficacy, and intention to return. A cross-sectional survey was conducted in six cities, which are geographically and socioeconomically distinct areas in Jiangsu, China. Respondents completed a self-administrated questionnaire interviewed by two well-trained medical students. A total of 191 blood donors were included in the current study. Descriptive analysis, correlation analysis, and a generalized linear regression model were used to explore the association between demographic characteristics, psychological factors, and intention to donate again. After controlling other covariates, donors with higher fear scores reported lower intention to return (p = 0.008). Association between self-efficacy and intention to return was statistically significant (p < 0.001), whereas the association between intrinsic rewards (p = 0.387), extrinsic rewards (p = 0.939), and intention to return were statistically insignificant. This study found that either intrinsic rewards or extrinsic rewards are not significantly associated with intention to donate again among whole blood donors in China, and fear is negatively associated with intention to donate again. Therefore, purposive strategies could be enacted beyond appeals to rewards and focus on the management of donors’ fear.

Implementation of measures to reduce vasovagal reactions: Donor participation and results

BACKGROUND

There are several strategies to reduce donor reactions. We report donor participation and reaction rates before and after implementing multiple measures at Canadian Blood Services.

STUDY DESIGN AND METHODS

We introduced a structured program of 500 mL of water and a salty snack pre-donation and applied muscle tension (AMT) during donation. Donors were not deferred for out of range blood pressure (BP); however, BP was measured in first time donors. Time on the donation chair post-donation was decreased from 5 to 2 min for repeat donors. We assessed participation rates using our quarterly survey of 10,000 recent donors. We extracted vasovagal reactions with loss of consciousness (LOC) from our operational database and compared pre-implementation (Oct 12,018-March 31,2019) and post-implementation (Oct 12,019-March 31,2020) periods.

RESULTS

Survey response rates varied from 11% to 16%. The percentage of donors who drank the water and ate the salty snack increased from 58% to 82% and 44% to 70% over 4 quarters; those performing AMT increased from 24% to 41%. Reactions decreased from 19.07 per 10,000 (744 reactions in 390,123 donations) to 14.04 per 10,000 (537 in 382,382 donations) (p < .0001). No first-time donors with high BP (n = 684) but 5 with low BP (n = 718) had reactions, CI were very large.

CONCLUSIONS

Achieving optimal participation was challenging. After implementation of a donor wellness initiative based on best practice, rates of vasovagal reactions with LOC decreased by 25%. A larger dataset is necessary to assess the safety contribution of BP deferrals when other mitigation measures are in place.

Microneedles: a potential strategy in transdermal delivery and application in the management of psoriasis

Microneedles, as an updating approach delivering compounds through the skin, is potential in the management of psoriasis.

Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood

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.

Estimating the risk of blood donation fainting for self versus others: the moderating effect of fear

BACKGROUND

People overestimate the likelihood that blood donors will experience faint and prefaint reactions, particularly if they are themselves fearful of having blood drawn. This study investigated the influence of making a risk assessment for oneself versus others, and examined whether providing information about the low base rates of reactions affected donation attitude, anxiety, and intention.

STUDY DESIGN AND METHODS

An anonymous online survey was completed by 3702 individuals (53.9% female; mean age, 36.9 years; standard deviation, 12.1 years; range, 18-84) that included questions about fear of having blood drawn and estimation of the risk of donation-related faint and prefaint symptoms for themselves and others. A random one-half of the respondents received accurate information about the proportion of whole blood donors who experience such reactions before all participants completed questions concerning their donation attitude, anxiety, and intention.

RESULTS

Estimates of both faint and prefaint reactions revealed a pattern of lower perceived risk for self versus others among individuals with low fear, and higher perceived risk for self versus others among those with high fear. Provision of accurate information about risk of reactions was associated with more positive donation attitudes (F[1, 3692] = 8.182, p = 0.004) and intentions (F[1, 3692] = 10.137, p = 0.001) but did not significantly affect anxiety.

CONCLUSION

Donation-related fear is associated with inflated expectancies of adverse events, especially regarding oneself. Such fear may be particularly important to address, as it has both a direct and indirect negative effect on donor retention.