Motivation, recruitment and retention of voluntary non-remunerated blood donors: a survey-based questionnaire study

BACKGROUND AND OBJECTIVES: The aim of this study was to establish which motivational and socio-demographic factors are important for the development of a long-term commitment as a voluntary, non-remunerated blood donor. STUDY DESIGN AND METHODS: A cross-sectional sample survey of active blood donors in Oslo, Norway, was conducted. Donors filled in a self-administered questionnaire during donation. Data on motivation were analysed using factor analysis. RESULTS: The blood donors' socio-demographic characteristics were found to be similar to those of the population as a whole. The single, most important, recruitment channel was the influence of active blood donors. Five dimensions of blood-donor motivation were identified with factor analysis. These were: altruism and empathy; social reasons (such as the influence of friends and family); strengthening of one's self-esteem; positive experiences associated with donation; and a moral obligation to donate. Support for statements on altruistic motives for donation was strong and similar in long-time and short-time donors. In contrast, short-time donors were more likely to be motivated by factors related to self-esteem than were long-term donors. CONCLUSION: The 'good habit' of continued blood donation seems not to be exclusively linked to a high degree of reported other-regarding ('altruistic') reasons, but also to a combination of motives, including some modestly self-regarding motives.     

The blood donation experience: self-reported motives and obstacles for donating blood

Background and Objectives The aim of the study was to investigate motives for donating blood as well as difficulties and obstacles associated with blood donation as perceived by the donors themselves. Materials and Methods Six hundred consecutive blood donors (i.e. all blood donors with a history of at least one previous whole blood donation attending, during nine working days, the Blood Centre of Umeå University Hospital) received a self‐administered questionnaire that contained questions aimed at elucidating motives for donating blood (general motives for donating blood, specific motives for the first donation and motives for continuing to be an active blood donor). Questions concerning difficulties and obstacles that had to be overcome in order to continue being a blood donor were also included in the questionnaire. Results Altogether 531 whole blood donors filled in the questionnaire (88·5%; 322 men and 209 women). No statistically significant differences were found between male and female blood donors concerning general reasons and motives related to donating blood. The most frequently reported reasons for giving blood the first time were ‘influence from a friend’ (47·2% of donors) and ‘request via media’ (23·5% of donors). Among general reasons/motives with highest ranking of importance, the most commonly reported motive for donating blood were ‘general altruism’ (40·3%), ‘social responsibility/obligation’ (19·7%) and ‘influence from friends’ (17·9%). General altruism’ and ‘social responsibility/obligation’ were also the most frequent reasons for continuing to donate blood (68·4 and 16·0%, respectively). The most commonly reported obstacle to becoming a regular blood donor was ‘laziness’ (19·1%) followed by ‘fear of needles’ (10·5%). Conclusions Altruism was the most common general motive for donating blood and also for continuing to be an active blood donor. Yet, for the first blood donation, direct ‘influence from friends/relatives’, ‘media appeal’ and other types of recruitment were more commonly reported as reasons or motives for donating blood than altruism. The findings support the notion that different strategies should be used/adopted to get people to donate blood the first time (e.g. recruitment through other blood donors using, for example, the ‘bring a friend along’ method) and to retain these subjects as active blood donors (e.g. by information and by strengthening their sense of being a blood donor or their self‐efficacy etc.).     

Factors associated with fainting: before, during and after whole blood donation

Background Whole blood (WB) donation encompasses several periods during which some donors faint. Identification of factors associated with fainting during each period should guide intervention strategies. Reducing faint reactions may reduce donor injuries and disability. Methods Blood donation was divided into three periods: Period 1 – registration; Period 2 – phlebotomy; and Period 3 – post‐phlebotomy. Period 3 consists of two sub‐periods (3A – on‐site and 3B – off‐site). For each Period, stratified rates of fainting in relation to various donor and donation characteristics were calculated and multivariable logistic regression analyses to identify factors associated with fainting were conducted. Donor injuries in each period were also analysed. Results Of the 956 766 donors registered in 2007, 554 534 (58%) donated WB. There were 43 fainting episodes and two injuries in Period 1 and 1520 faints and 73 injuries in Periods 2 and 3. Regression analyses showed that youth and donor first‐time status are associated with fainting in all periods; but most significantly in Period 1. Small estimated blood volume is notably not a factor in Period 1 but is significant in Periods 2 and 3. The highest injury rate is seen in Period 3A (0·07 and 0·09/1000 donations) for male and female donors, respectively. Conclusions Variability in factors associated with fainting across defined periods of the donation process suggest differing underlying mechanisms and the possibility that interventions for the reactions most associated with injury during each time period can be designed. The highest rate of injury per donation occurred in ambulating donors.     

Relationship between first-year blood donation, return rate for subsequent donation and demographic characteristics

Background

The aim of this study was to determine any relationships between return rates of first-time donors, number of donations in the first year and the donors’ demographic characteristics.

Materials and methods.

Data from 1,500 volunteer, first-time donors who donated blood at Shiraz Blood Transfusion Centre (Iran) were obtained from the donor database. The donors’ demographic characteristics (sex, age, educational status) and donation histories were obtained for a 3-year period and the number of donations and interval between the first donation and the following donation within a 1-year period were recorded. We searched for correlations between return rate and demographic characteristics and the number of donations in the first, second and third years. The data were analysed with the chi-squared test, multiple logistic regression and Spearman’s correlation tests. P values less than 0.05 were considered statistically significant.

Results

More than half of the first-time donors returned to donate again (n=776, 51.7%) during the 3 years after the first donation. The mean number of donations in the whole 3-year period was 0.69±0.49, while it was 1.33±0.62 (median 1) in the first year, 0.4±0.7 (median 0) in the second, and 0.3±0.65 (median 0) in the third year. The return rate was directly correlated with the number of donations in the first year (r=0.74, P<0.001). The return rate increased as the interval between the first and second donations decreased (P<0.05, OR=1.03). The return rate was higher for male donors and single donors (P<0.05), but was not related to age or educational level (P>0.05).

Discussion.

In this study 51.7% of first-time donors returned to donate again, a high figure indicating the success of our recruitment strategy. Understanding the importance of the number of donations in the first year for donors’ return rate and planning recruitment programs and more effective measures to encourage donors in the first year may help to increase return rates.     

The safety of blood donation by elderly blood donors

Background Due to the ageing population, blood donation by the elderly is necessary to maintain blood supply. We initiated a prospective study, to assess whether there is an increased risk of donor reactions in elderly donors. Study Design and Methods In this prospective study, regular donors aged from 66 to 68 and 69 to 71 years were invited to continue blood donation on mobile collection sites of the German Red Cross Blood Service West. A control group (50–52 years) was established. Admission of donors in all groups followed the German national guidelines for blood donation. Donor deferrals and all kinds of donor reactions during donation (on‐site) and in the 48 h following donation (off‐site) were monitored. Results A total of 64 260 valid cases were entered in the study. Donor deferrals increased with age from 1·12% in the control group up to 8·74 in female donors aged 69–71 years. Adverse reactions to blood donation were rare with an overall reaction rate of 0·63% (0·05% on‐site; 0·58% off‐site). Off‐site reactions significantly decreased with increasing age. The relative risk (RR) for adverse reactions in elderly donors compared to the control group (50–52 years) was slightly increased for on‐site reactions in the 69‐ to 71‐year‐old donors (RR 1·0309; 95% CI 1·0292–1·0325). In all other comparisons, the RR for adverse reactions was distinctively lower in elderly donors (RR 0·3785 – 0·7778). Conclusions Our data confirm that elderly regular blood donors may safely continue blood donation at least to the age of 71. Based on these data, we increased the upper age limit.     

Complications related to blood donation: a population-based study

BACKGROUND: Population-based data on the rate and outcome of complications related to blood donation are sparse. STUDY DESIGN AND METHODS: Data from a survey conducted in 2003 in Aarhus County, Denmark, were used to assess the overall rate of donor complications. Additional nationwide data on moderate and severe donor complications were obtained from the Danish Register of Complications Related to Blood Donation, with records of all moderate and severe donor complications in Denmark occurring during the period 1997-2003. RESULTS: In the regional survey, we identified 340 complications of any type among 41 274 donations, corresponding to a rate of 824/100,000 donations [95% confidence interval (CI): 741-916]. All complications were either needle injuries or vasovagal reactions. In the nationwide register, a total of 752 moderate and severe complications were recorded among 2,575,264 donations, corresponding to a rate of 29/100,000 donations (95% CI: 27-31). The rates of complications leading to long-term morbidity or disablement (> 5% loss of working capacity) were 5/100,000 donations (95% CI: 4.2-5.9) and 2.3/100,000 donations (95% CI: 1.8-2.9), respectively. CONCLUSION: The risk of complications related to blood donation is low. However, attention towards donor complications is warranted, given the non-negligible rate of complications resulting in long-term morbidity and disablement.     

Ethical aspects of blood and organ donation

Abstract
Ethics of blood and organ donation in Australia has been influenced by voluntarism and the Red Cross. The General Agreement on Trade in Services may threaten the principle of voluntary blood donation and self suf­ficiency of blood in Australia. However, a cooperative approach to managing the public good is more sustain­able than individual self interest and the author argues that voluntary blood and organ donation should be retained. (Intern Med J 2003; 33: 362−364)     

献血反应相关因素的分析

目的:了解献血反应的分布特点,为采取有针对性的干预措施,提供理论依据。方法:以2013年发生献血反应的全血献血者为研究对象,对该群体的年龄、性别、献血类型、发生献血反应的原因等进行回顾性分析。结果:2013年共有27 909人次参加了无偿献血,发生献血反应385人次(1.38%)。18~25岁年龄段献血反应发生率最高(2.14%),46岁以上年龄段献血反应发生率最低(0.57%);女性发生献血反应比例高于男性(P0.05);团体献血活动献血反应发生率高于街头采血(P0.05)。结论:小年龄组者、女性献血者和团体献血者,献血反应发生率较高,应重点加强对该人群的进行干预。     

南京地区街头流动献血人数与气温变化的关系

目的:分析南京地区气温对街头流动献血行为的影响。方法:筛选2012-01-2014-03每周双休街头流动献血人群,分析不同温度下献血人群数量。并以地理位置相近的流动献血车和固定献血屋各一处,进一步分析气温对献血人数的影响。结果:入组共计206d,献血22 329人次,日最高气温15~30℃时,流动献血人数各组间差异无统计学意义(P0.05)。当日最高气温低于15℃或高于30℃时,流动献血人数减少,差异有统计学意义(P0.05)。气温对固定献血屋影响较小,对流动献血车影响较大。结论:气温变化是影响街头流动献血人群数量的重要原因,针对温度变化,采血工作中应及时调整工作安排,减少气温变化对献血行为的影响。     

Knowledge, attitudes and practices surveys of blood donation in developing countries

Background and Objectives Knowledge, attitude and practice (KAP) surveys have been used in many countries to understand factors that influence blood donation and as the basis for communication and donor mobilization strategies. Materials and Methods A search was conducted of publically available databases, and studies with the following characteristics were selected: (1) the study was a knowledge, attitude and practice or KAP plus behaviour survey; (2) the subject of the survey was blood donation; (3) the survey was performed between 1995 and 2011; and (4) the survey was performed in countries classified as emerging and developing by the International Monetary Fund. Results Eighteen KAP studies conducted in seventeen developing countries were identified. There was considerable difference in the structure, population surveyed and conduct of the KAP studies. The common following themes emerged: misinformation about blood donation, fear of blood donation, willingness to donate for family and friends, concern about selling blood and a failure to transfer positive attitudes into actual blood donation. Conclusion Despite considerable differences in the culture and demographics of developing countries, several common themes emerged from different KAP surveys.     

Evaluation of the de-selection of men who have had sex with men from blood donation in England

BACKGROUND AND OBJECTIVES: The Blood Services of the UK permanently de-select men who have had sex with men (MSM) from donating blood. The rationale for this has been questioned. This article attempts to evaluate whether this selection criterion does contribute to blood safety. MATERIALS AND METHODS: Data about transfusion-transmissible infections, in particular about human immunodeficiency virus (HIV) infection, were used to evaluate whether de-selection of MSM meets the aims of donor selection. Models were constructed to estimate the risk of HIV-infectious donations entering the blood supply should this criterion be changed. RESULTS: Many assumptions were required to generate estimates of the risk of HIV infection entering the blood supply. The accuracy of the estimates is therefore uncertain and the probable ranges around the estimates were wide. However, by using the most probable assumptions, our models suggested that de-selection of MSM for 12 months since the last sexual contact, or complete removal of this selection criterion, would be expected to increase the risk of HIV-infectious donations entering the blood supply in England by approximately 60% (from the current risk of 0.45 per year to 0.75 per year) and 500% (to 2.5 per year), respectively. The increase in numbers of non-infected donations would be relatively small--less than 2% of donations. The probability of a relatively high frequency of other sexually transmissible blood-borne infections also currently favours maintaining permanent de-selection of MSM, irrespective of the risk of HIV-infectious donations. Current compliance with this selection criteria was estimated to be 95%. CONCLUSIONS: Based on current knowledge, accepting blood donations from MSM would probably increase the risk of transfusion-transmission of HIV and of other blood-borne infections. Good compliance with this criterion has contributed greatly to the safety of blood transfusions in England. Better communication about donor selection, to maintain and improve compliance with this and other selection criteria, is recommended. Other risk groups are gaining in relative importance for the risk of transfusion-transmitted HIV infection, and ongoing evaluation of all donor-selection criteria is also recommended.     

咀嚼口香糖对降低初次献血者献血反应的效果观察

目的:探讨咀嚼口香糖降低初次献血者献血反应的作用。方法:将2013年5至9月初次献血者2 041人按献血日期分为2组,即观察组1 086人、对照组955人,对照组按常规采血程序进行,观察组按常规采血程序的同时给予咀嚼口香糖,观察比较2组献血反应率。结果:观察组与对照组献血反应率分别为0.83%、6.07%,2组比较差异有统计学意义(χ2=44.02,P0.01)。结论:在初次献血者献血时给予口香糖咀嚼,能有效预防献血反应的发生,适合在预防无偿献血反应中应用。