1
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Edwards ARA, Thorpe R, Masser BM, Barlow FK. 'Yeah, this is my donation': An application of psychological ownership in blood donation. J Health Psychol 2024:13591053241254581. [PMID: 38867414 DOI: 10.1177/13591053241254581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
To meet the priority healthcare needs of any population there must be a consistently available blood supply donated by willing donors. Due to this universal need for blood, retaining blood donors remains an ongoing challenge for blood services internationally. Encouraging psychological ownership, or the feeling of ownership one experiences over a possession, provides a potential novel solution to donor retention. This study, based on semi-structured interviews with blood donors, investigates how donors perceive and develop psychological ownership in the context of blood donation. Interviews were conducted in Australia with 20 current blood donors (10 men, 10 women; Mage = 41.95). Through thematic analysis, six themes were identified based primarily on the theoretical framework of psychological ownership. This research offers a novel perspective on donor retention, suggesting that donors' ownership over their individual donation practices, and not the blood service, may contribute to maintaining a stable blood supply.
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Affiliation(s)
- Abigail R-A Edwards
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Rachel Thorpe
- Research and Development, Australian Red Cross Lifeblood, Melbourne, VIC, Australia
| | - Barbara M Masser
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
- Research and Development, Australian Red Cross Lifeblood, Melbourne, VIC, 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
| | - Fiona Kate Barlow
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
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2
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Romón I, Domíguez-García J, Fernández C, Carretón M, Martínez N, Calzada L, Cortés MA, Mendez GA, Gorostidi I, Briz M, Ocio E. Adverse effects of therapeutic phlebotomies: Prospective study of 587 procedures. Transfusion 2024. [PMID: 38708765 DOI: 10.1111/trf.17862] [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: 02/14/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Therapeutic phlebotomy (TP), a widely used medical procedure, can be performed on diverse patients with iron overload or polyglobulia. However, its adverse events are not well known as most of the information on phlebotomy is derived from healthy blood donors (0.1%-5.3%). In contrast, TP is applicable to a broader, more complex population with comorbidities and old age. To ascertain the incidence of adverse events in phlebotomies, we conducted a prospective study on patients who attended our Unit. STUDY DESIGN AND METHODS We prospectively gathered data from patients referred to our Unit for TP. Data regarding demographics, health status, and adverse events within at least 24 h of phlebotomy were gathered via a structured questionnaire during each visit. RESULTS Between August 2021 and September 2022, 189 patients underwent 587 procedures. Most patients were men, over 60 (57.3%) had comorbidities, and 93% underwent at least two procedures during the study period. Twenty patients (10.8%) presented 25 adverse events (4.3% of phlebotomies), usually vasovagal reactions, none of which were clinically relevant, and all were managed by nursing staff on site, with full patient recovery. DISCUSSION The rate of adverse events (<5%) in patients undergoing TP was low and comparable to that seen in healthy blood donors. Consequently, even old patients and those with some comorbidities can safely undergo TP when the process is carefully managed.
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Affiliation(s)
- Iñigo Romón
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Juan Domíguez-García
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Carlos Fernández
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Marisa Carretón
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Noelia Martínez
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Laura Calzada
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Miguel A Cortés
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Gala A Mendez
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Irene Gorostidi
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Montserrat Briz
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
| | - Enrique Ocio
- Servicio de Hematología - IDIVAL, Pabellón 20, Planta Baja, Hospital Universitario Marqués de Valdecilla, Unidad de Aféresis, Santander, Spain
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3
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Meher R, Patidar GK, Chaurasia R, Pandey HC, Hazarika A. Prevention strategies for vasovagal reaction in whole blood donors: A quadri-armed randomised control trial. Transfus Med 2024; 34:20-29. [PMID: 38165089 DOI: 10.1111/tme.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/10/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Vasovagal reaction (VVR) is a frequently encountered generalised donor adverse reaction, associated with donor deterrence towards future donation. Several mitigation strategies for prevention of VVR were tried but still not standardised. This quadri-armed randomised study evaluated the utility of water ingestion, applied muscle tension (AMT) and combination of both in preventing the VVR among blood donors. METHODS A quadri-armed randomised controlled trial was performed on 4320 whole blood donors. Blood donors of 18-65 years of age were randomised into four groups based on the interventions performed i.e., control with no intervention (Group 1, n = 1081), water ingestion (Group 2, n = 1082), AMT (Group 3, n = 1070) and combined intervention (Group 4, n = 1087). VVR during and immediately after blood donation were observed along with assessment of risk factors in blood donors and the effectiveness of interventions were analysed. RESULTS The incidence of VVR observed 1.6% in our study, with the highest occurrence in the control group (2.5%) and the lowest in the combined intervention group (0.9%). Multivariable logistic regression revealed that the control group donors faced a 1.38-fold greater risk of VVR compared to those receiving interventions (OR: 1.38, 95% CI: 1.10-1.75). Other risk factors included younger age (OR: 1.5, 95% CI: 1.05-2.17), first-time donation (OR: 5.7, 95% CI: 1.66-5.74), prior history of VVR (OR: 2.5, 95% CI: 10.4-101.52). DISCUSSION/CONCLUSION The combined approach of water ingestion and AMT proved significantly more effective in VVR prevention compared to individual interventions.
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Affiliation(s)
- Radheshyam Meher
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Gopal Kumar Patidar
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Chaurasia
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Pandey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anjali Hazarika
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
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4
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Thijsen A, Williamson A, Davison TE, Masser B. Experiences of knowledge translation among researchers in transfusion medicine: Findings from an international survey study. Transfusion 2023; 63:1463-1471. [PMID: 37357984 DOI: 10.1111/trf.17466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Translation of research knowledge is critical to ensure transfusion medicine policies and practices reflect current evidence and so effectively support the health of blood donors and recipients, as well as ensuring ongoing blood supply. The aim of this study was to investigate the barriers and facilitators of knowledge translation (KT) among transfusion medicine researchers and determine what KT supports are needed. STUDY DESIGN AND METHODS An anonymous, cross-sectional survey was distributed by emailing corresponding authors of papers in four major blood journals, emailing grant recipients in the area of transfusion medicine, posting on social media, and through an international blood operator network. RESULTS The final sample included 105 researchers. Participants had a positive orientation toward KT, with few perceiving KT as not relevant to their research or beneficial for their careers. However, many reported facing difficulties practicing KT due to time constraints, competing priorities, or lack of funds or resources. Fostering relationships with stakeholders was seen as a key facilitator of KT but a number of researchers expressed difficulties engaging and communicating with them. Collaboration opportunities, protected time for KT, and access to KT resources were some of the supports researchers felt were required to help their KT efforts. CONCLUSION To minimize the knowledge to practice gap in transfusion medicine and ensure findings from research lead to improved outcomes, organizations need to support researchers in their KT efforts and facilitate interactions between researchers and research end-users.
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Affiliation(s)
- Amanda Thijsen
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Anna Williamson
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tanya E Davison
- Research & Innovation, Silverchain, Melbourne, Victoria, Australia
- Monash Art, Design and Architecture, Monash University, Melbourne, Victoria, Australia
| | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
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Wei WH, Smith M, Vera A, Meads K, Hessell J, Reid L, Scott L, Burge A, Kirwan S, Charlewood R, Sadani D, Walkden D, Chand A. Novel risk patterns of vasovagal reactions in NZ blood donations complicated by COVID-19 restrictions. Front Public Health 2023; 11:1180279. [PMID: 37304099 PMCID: PMC10248232 DOI: 10.3389/fpubh.2023.1180279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Vasovagal reactions (VVRs) are common but complex donor adverse reactions (DAEs) in blood donations. VVRs have been extensively studied with a multitude of risk factors identified including young age, female gender and first-time donor status. How they may interplay remains obscure. Methods A total of 1,984,116 blood donations and 27,952 immediate VVRs (iVVRs) and 1,365 delayed VVRs (dVVRs) reported between 2011 and 2021 in NZ were used in multivariate logistic regression analyses each concerning donations with iVVRs as cases and those free of DAEs as controls. For each analysis stepwise selection was used to identify the best model and risk factors carrying significant main effects and/or interactions. Identified interactions informed further in-depth regression analyses to dissect iVVR risk patterns. Results Over 95% of VVRs were iVVRs that had lower female preponderance and deferrals than dVVRs. iVVRs had a school seasonal pattern in whole blood donations driven by first-time donors from schools/colleges, and interactions between gender and age group differentiating the first-time from repeat donations. Subsequent regression analyses identified the known and novel risk factors of year and mobile collection sites and their interactions. iVVR rates were roundly elevated in 2020 and 2021 probably because of COVID-19 restrictions like facemask wearing. Exclusion of the 2020 and 2021 data removed the interactions with year, but confirmed interactions of gender with mobile collection sites (p = 6.2e-07) in first-time donations only and with age group in repeat donations only (p < 2.2e-16), together indicating young female donors at the highest risk of iVVRs. Our results also revealed that donation policy changes contributed to the year effects; donors had a lower iVVR risk at mobile sites than well-medicalized donation centers probably because of under-reporting. Conclusion Modeling statistical interactions is valuable in identifying odds and revealing novel iVVR risk patterns and insights into blood donations.
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Affiliation(s)
- Wen-Hua Wei
- New Zealand Blood Service, Auckland, New Zealand
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, The University of Manchester, Manchester, United Kingdom
| | | | - Amber Vera
- New Zealand Blood Service, Auckland, New Zealand
| | - Kelly Meads
- New Zealand Blood Service, Auckland, New Zealand
| | | | - Laura Reid
- New Zealand Blood Service, Auckland, New Zealand
| | - Lisa Scott
- New Zealand Blood Service, Auckland, New Zealand
| | - Asuka Burge
- New Zealand Blood Service, Auckland, New Zealand
| | - Susy Kirwan
- New Zealand Blood Service, Auckland, New Zealand
| | | | | | | | - Anup Chand
- New Zealand Blood Service, Auckland, New Zealand
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6
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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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7
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Lewin A, Deschênes J, Rabusseau I, Thibeault C, Renaud C, Germain M. Pre-donation water and salty snacks to prevent vasovagal reactions among blood donors. Transfusion 2023; 63:156-162. [PMID: 36345887 DOI: 10.1111/trf.17173] [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: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Minimizing the risk of vasovagal reactions (VVRs) can prevent donor harms and improve donor return. We report the results of a program to reduce VVR rates. STUDY DESIGN AND METHODS The program was implemented on June 11, 2017 and consisted in drinking water and eating a salty snack before donating blood, plasma, or platelets. All donations made during the "pre-program period" (October 11, 2015-June 10, 2017) and "post-program period" (June 11, 2017-May 11, 2019) were included. Study outcomes comprised VVRs (any severity) and syncopal VVRs, whether employee- or donor-reported. An interrupted time series (ITS) analysis proxied causality based on the "pre-program trend," the "immediate trend" (i.e., immediately before versus after the program), and the "post-program trend". The relative risk (RR) of VVR (along with confidence intervals [CIs]) was reported, overall and stratified by subgroups based on age, sex, donor type (i.e., first-time versus repeat), and donation type (i.e., whole blood versus apheresis). RESULTS The monthly VVR rate (any severity) dropped from 4.6% in the pre-program period to 4.3% in the post-program period, and never reached its pre-program level. The ITS analysis revealed a statistically significant and increasing pre-program trend (RR [95% CI] = 1.011 [1.002-1.020]), a statistically significant and decreasing immediate trend (RR [95% CI] = 0.848 [0.743-0.969]), and a non-statistically-significant and stable post-program trend (RR [95% CI] = 0.999 [0.993-1.006]). Similar trends were observed for nearly all high- and low-risk subgroups. No statistically significant trend was observed for syncopal VVRs. DISCUSSION These results suggest that the herein-described program durably reduced the incidence of VVRs (any severity) by ~15%.
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Affiliation(s)
- Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada.,Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jessyka Deschênes
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Isabelle Rabusseau
- Medical Affairs and Innovation, Héma-Québec, Québec City, Quebec, Canada
| | | | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
| | - Marc Germain
- Medical Affairs and Innovation, Héma-Québec, Québec City, Quebec, Canada
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8
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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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9
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Williams EL, Khan FM, Claydon VE. Counter pressure maneuvers for syncope prevention: A semi-systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:1016420. [PMID: 36312294 PMCID: PMC9606335 DOI: 10.3389/fcvm.2022.1016420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Physical counter pressure maneuvers (CPM) are movements that are recommended to delay or prevent syncope (fainting) by recruiting the skeletal muscle pump to augment cardiovascular control. However, these recommendations are largely based on theoretical benefit, with limited data evaluating the efficacy of CPM to prevent syncope in the real-world setting. We conducted a semi-systematic literature review and meta-analysis to assess CPM efficacy, identify literature gaps, and highlight future research needs. Articles were identified through a literature search (PubMed, April 2022) of peer-reviewed publications evaluating the use of counter pressure or other lower body maneuvers to prevent syncope. Two team members independently screened records for inclusion and extracted data. From 476 unique records identified by the search, 45 met inclusion criteria. Articles considered various syncopal conditions (vasovagal = 12, orthostatic hypotension = 8, postural orthostatic tachycardia syndrome = 1, familial dysautonomia = 2, spinal cord injury = 1, blood donation = 10, healthy controls = 11). Maneuvers assessed included hand gripping, leg fidgeting, stepping, tiptoeing, marching, calf raises, postural sway, tensing (upper, lower, whole body), leg crossing, squatting, “crash” position, and bending foreword. CPM were assessed in laboratory-based studies (N = 28), the community setting (N = 4), both laboratory and community settings (N = 3), and during blood donation (N = 10). CPM improved standing systolic blood pressure (+ 14.8 ± 0.6 mmHg, p < 0.001) and heart rate (+ 1.4 ± 0.5 bpm, p = 0.006), however, responses of total peripheral resistance, stroke volume, or cerebral blood flow were not widely documented. Most patients experienced symptom improvement following CPM use (laboratory: 60 ± 4%, community: 72 ± 9%). The most prominent barrier to employing CPM in daily living was the inability to recognize an impending faint. Patterns of postural sway may also recruit the skeletal muscle pump to enhance cardiovascular control, and its potential as a discrete, proactive CPM needs further evaluation. Physical CPM were successful in improving syncopal symptoms and producing cardiovascular responses that may bolster against syncope; however, practical limitations may restrict applicability for use in daily living.
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10
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Wang C, Chen L, Sun C, Zhang Y, Cao C, Ma Y, Shi W. Prevention of Blood Donation-related Vasovagal Response by Applied Muscle Tension: a Meta-analysis. J Int Med Res 2022; 50:3000605221121958. [PMID: 36127814 PMCID: PMC9500294 DOI: 10.1177/03000605221121958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Vasovagal reaction (VVR) is an adverse reaction to blood donation. Applied
muscle tension (AMT) has been reported to reduce the probability of VVR
during blood donation; however, the results have been controversial. We
therefore conducted a meta-analysis to systematically evaluate the effect of
AMT in reducing VVR. Methods We searched six major databases using “applied muscle tension” and “blood
donation-related vasovagal response” as keywords. Relevant articles
published in English or Chinese between 1 January 2000 and 30 June 2021 were
included in the analysis. The quality of the included articles was evaluated
and publication bias was assessed by forest and funnel plots and by Egger's
test. Results Fifty-one articles were identified, of which six were included according to
the pre-defined inclusion and exclusion criteria. A fixed-effects model was
adopted for effect size combination and revealed a relative risk of 0.52
(95% confidence interval 0.40 to 0.67). The AMT group was superior to the
control in terms of VVR prevention. A funnel plot and Egger's test suggested
that the findings were accurate and reliable with low publication bias. Conclusion AMT could effectively reduce VVR during blood donation. Further multicenter
studies with large sample sizes are needed to confirm these results.
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Affiliation(s)
- Cong Wang
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Li Chen
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago 60657, IL, USA
| | - Yan Zhang
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Can Cao
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Yuanyuan Ma
- Hebei Province Blood Center, Shijiazhuang 050011, China
| | - Wenwen Shi
- Hebei Province Blood Center, Shijiazhuang 050011, China
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11
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Thijsen A, Waller D, Masser B, Davison TE. Guiding the development and implementation of interventions in transfusion medicine: The intervention mapping protocol. Transfusion 2021; 61:2809-2812. [PMID: 34423449 DOI: 10.1111/trf.16632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Amanda Thijsen
- Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
| | - Daniel Waller
- Faculty of Health, University of Technology Sydney, 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
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12
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Rossmann SN, Hartwell BA. Would you like another pretzel? Water? We make progress in donor reactions. Transfusion 2021; 61:1665-1668. [PMID: 34142728 DOI: 10.1111/trf.16442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - Beth A Hartwell
- Gulf Coast Regional Blood Center, Houston, Texas, United States.,Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, United States
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13
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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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14
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Goldman M, Uzicanin S, Marquis-Boyle L, O'Brien SF. Implementation of measures to reduce vasovagal reactions: Donor participation and results. Transfusion 2021; 61:1764-1771. [PMID: 33880796 DOI: 10.1111/trf.16375] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Mindy Goldman
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Samra Uzicanin
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Lynne Marquis-Boyle
- Supply Chain Process Management, Canadian Blood Services, Saint John, New Brunswick, Canada
| | - Sheila F O'Brien
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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15
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Davies J, MacDonald L, Sivakumar B, Carty C, Whiting D, Graham D. Prospective analysis of syncope/pre-syncope in a tertiary paediatric orthopaedic fracture outpatient clinic. ANZ J Surg 2021; 91:668-672. [PMID: 33605034 DOI: 10.1111/ans.16664] [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: 08/24/2020] [Revised: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The incidence of vasovagal syncope (VVS) precipitated by medical procedures such as blood donation is quoted as between 0.13% and 4.17%. Vasovagal events have been observed to occur following cast removal at our paediatric orthopaedic clinic; however, there is no available information in the existing literature regarding incidence or risk factors. This study aims to identify the incidence and demographic traits of patients experiencing syncopal events following cast removal. METHODS Over a 12-month period, paediatric patients experiencing a syncopal or pre-syncopal event during an outpatient appointment for cast removal were prospectively enrolled into the study. Basic demographic data were recorded, as well as injury and procedure details and a description of the event. Statistical analysis as well as calculation of incidence of vasovagal events were performed. RESULTS A total of 6078 patients presented for cast removal in the 12-month period. Twenty syncopal or pre-syncopal events were recorded. Incidence was calculated as 0.32%. Mean patient age was 10.8 years. Male : female ratio was 2.3:1. Mean body mass index (BMI) was 20.08, with a trend for higher prevalence of males under the 50th BMI percentile-for-age. The mean time post-injury was 31.4 days. Ninety-five percent of patients were being treated for an upper limb injury and 30% had injuries that had been treated surgically. There were no associated secondary complications or injuries. CONCLUSIONS Incidence of VVS following cast removal is comparable to the values quoted in literature for other medical procedures. Demographic data of our cohort suggested that those who experienced VVS were predominantly young males of lower-than-average BMI.
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Affiliation(s)
- Jonathan Davies
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Leigh MacDonald
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Brahman Sivakumar
- Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Australian Research Collaboration on Hands, Gold Coast, Queensland, Australia
| | - Christopher Carty
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Donal Whiting
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - David Graham
- Department of Orthopaedic Surgery, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Australian Research Collaboration on Hands, Gold Coast, Queensland, Australia
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