Evaluation of pre-donation anxiety and attitude of blood donors and its e ect on blood pressure and pulse rate

Evaluation of pre-donation anxiety and attitude of blood donors and its e ect on blood pressure and pulse rate Bhuyan G.1*, Rabha A.2, Tirkey R.3, Ranga S.4 DOI: https://doi.org/10.17511/jopm.2020.i07.06 1* Geet Bhuyan, Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. 2 Anjumoni Rabha, Registrar, Department of Psychiatry, Jorhat Medical College, Assam, India. 3 Rekha Tirkey, Medical Officer, Department of Blood Bank, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. 4 Sunil Ranga, Professor and Head, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.


Introduction
A stable blood supply is essential to health care services but aging populations are likely to reduce donor numbers in many countries [1,2]. Blood donation is a voluntary activity associated with beneficial effects such as feeling satisfied or being more alert as well as feeling better in general [3]. But, donating blood may rarely result in adverse blood donation events like fainting, dizziness, bruising, which can even cause donors to withdraw permanently from future blood donation [4,5].
France et al showed that 64% of the donors who did not experience a vasovagal reaction returned for a next donation within 1 year, while among donors who experienced light vasovagal reactions, only 40% returned for a next donation4. Newman and colleagues found that donors experiencing a vasovagal reaction decreased return rates by 34% [5]. In a recent study, it was shown that previous adverse events, unfamiliarity with blood donation, and certain ways of coping are associated with a heightened state of anxiety [6].
Hoogerwerf et al in their study found that the predonation blood pressure of donors who had a negative donation experience (e.g. vasovagal reaction, deferral) when compared with that of donors without such an event, donors had a raised systolic and diastolic blood pressure at the subsequent donation attempt7. An exaggerated cardiovascular response to acute and chronic stresses may lead to an increase in the heart rate,  [13,14], whereas others present evidence of a negative influence on the intention to donate in the future [15].

Materials and methods
Donor registration and screening were done For each, a mean score was calculated.

Results
A total of 200 donors were included in the study, predominantly males (n=165, 82.5%). The mean age of the donors was 33.9 years. A total of 80 were first-time donors whereas 120 had a history of two or more donations in the past (Table 1). Summarising the above, no significant association between previous negative experience and predonation blood pressure on a later visit was noted.
However, the association between previous negative experience with pre-donation increased pulse rate was found to be statistically significant (p<0.05).

Bhuyan G. et al: Evaluation of pre-donation anxiety and attitude
Tropical Journal of Pathology and Microbiology 2020;6(7) Both affective and cognitive attitudes were negatively associated with anxiety and were found to be statistically significant. A significant interaction was found between donors with a previous negative experience and anxiety in the donors coming for future blood donation. Lastly, as a part of the study, anxiety and its relationship with increased blood pressure and increased pulse rate was assessed in first-time donors and it was seen that first-time donors especially showed raised blood pressure and pulse rate during their pre-donation assessment. The lower socio-economic and educational status may be negatively associated with the pre-donation anxiety of donors and this may be due to the lack of knowledge of the blood donation process and the benefits of it. This is the first article to study the level of education of donors and their relationship with pre-donation anxiety among them. However, a future study with a larger sample size may be required to verify the same.
The present study tried to find the effect of anxiety on the blood pressure and pulse rate in first-time donors and it was seen that a total of 36 donors experienced pre-donation anxiety in the present study and it was associated with a raised blood pressure in 22 of them. This was found to be statistically significant. Also, it was observed that the pulse rate was raised in 12 of these donors.
Therefore it was observed that 1st-time donors are more prone to pre-donation anxiety than experienced donors. This is in accordance with a previous study done by CR

Conclusion
In conclusion, no significant association was seen in a donor who experienced a negative experience in a previous visit with raised pre-donation blood pressure on a later visit. However, the association between a previous negative experience with predonation increased pulse rate was found to be statistically significant.
Both affective and cognitive attitudes were found to be negatively associated with anxiety and were found to be statistically significant. A significant interaction was found between donors with a previous negative experience and anxiety when they came for a future blood donation. What does the study add to the existing knowledge Anxiety and its relationship with increased blood pressure and increased pulse rate were assessed in first-time donors and it was seen that first-time donors especially showed raised blood pressure and pulse rate during their pre-donation assessment.
However, these findings should be explored in future studies taking into account various other stress parameters and also stress markers like serum cortisol levels to get a better insight of the basis of these findings to minimize negative donation experiences by targeting specific interventions. Tropical Journal of Pathology and Microbiology 2020;6(7)