Abstract
Introduction:
A blood donation camp was organized in the institute which was a student initiative and a street play on blood donation awareness was carried out at different parts of the institute. For this reason, the study aimed at assessing the knowledge, attitude, and practises among the voluntary donors was carried out to bring out further awareness programs.
Materials and Methods:
The study is a Cross-sectional analysis to know about the knowledge, attitude, and practises among the donors as well as collect information regarding the rare blood groups. The idea to conduct a blood donation camp at a tertiary care hospital in Amritsar was initiated by the students of the 2nd, 3rd, and 4th professional year and was implemented on February 8, 2018. On this day, two awareness street plays were carried out, first at the outpatient department area and then near the college entrance to spread the message about the benefits and necessity of blood donation. The activity of blood donation was executed by a group of 15 team members and the staff posted in the blood bank of the institute. Each donor was taken care of by looking after any postdonation weakness or nausea plus were also provided with refreshments. At the end, feedback forms were handed over and 50 such filled forms were collected.
Results:
Out of the 50 donors, there were 21 male (42%) and 29 females (58%), with a mean age of 21.45 ± 1.35 years. It was recognized that, among 50 donors, 52% of the donors have not donated in the last 2 years while 58% of the donors would voluntarily like to donate blood again. It was seen that 52% of the donors had fear of needles acting as a hindrance for the blood donation.
Conclusion:
My experience during the whole journey of the initiative was quite enlightening. Looking at the enthusiasm of the donors and the organizing team, it also encouraged the patients' relatives and professors to come forward for the donation. The success of the event has further encouraged me to carry out such more awareness projects in the future.
KEYWORDS: Attitude, blood donation, knowledge, practises
INTRODUCTION
Blood can save millions of lives, and young people are the hope and future of a safe blood supply in the world.[1] Blood transfusion is crucial for health care systems, which contributes to rise in life expectancy and quality of life of people experiencing acute critical illness or chronic diseases.[1] Nowadays health care providers manage serious hemorrhagic complications after surgery, delivery or major accidents,[2,3,4,5] severe blood disorders,[6] and oncologic conditions[7,8] demanding blood transfusion. In these conditions, a huge volume of blood is required to meet a myriad of needs and numerous countries face the challenge of an increasing need of blood or its components. Health services should contribute adequate blood to meet needs. Procured blood from voluntary nonremunerated blood donors (VNRBD) is the most potent way to ensure safe and adequate blood supply.[1] Against an annual demand of 12 million units, in India, 9 million units were collected, of which 70% was from voluntary blood donors while the remaining 30% was from family or replacement donors. According to the protocol specified by the Government of India, 25% of all blood collected by a blood bank had to be kept aside as buffer stock to be used only in case of an emergency. However, out of India's 2433 blood banks, only 20% were able to maintain the buffer stock.[3] Blood scarcity is frequently encountered in health-care settings and is attributable to an imbalance between the increasing demand for safe blood and blood products on the one hand and failure to organize regular blood supply due to misconceptions, perceived harms and risks, and lack of motivation among potential donors. Medical college students can serve as a readily available pool of voluntary blood donors for the attached medical college hospitals and help tide away some of the scarcity of blood and blood products. However, different studies involving medical students have expressed concern on the low level of awareness and unsatisfactory voluntary blood donation practices among them. Some studies have also shown poor blood donation practice among the students despite relatively good knowledge and favorable attitude toward voluntary blood donation. To counter that, prosocial behavior which includes altruism and collectivism can be used as the main motivator,[9] while the other factors such as perceived need of blood,[9,10] self-esteem, and campaigns[9,10,11] can have an impact in blood donation. To mitigate the shortage of blood and blood products in the institute, we decided to organize a blood donation camp in our institute. We also decided to keep it to commemorate “The World Cancer Day” on 4th of February and try to decipher the attitude, knowledge, and hurdle to blood donation among college-going adults.
MATERIALS AND METHODS
Type of study
The study is a cross-sectional analysis to know about the knowledge, attitude, and practises among the donors as well as collect information regarding the rare blood groups.
Prepatory activities
Pamphlets, posters, banners, and dissemination of messages by word of mouth were used for generating awareness about the event. A pretested, structured questionnaire was used as a study tool. Information about the blood donation camp via posters, banners, class presentations was spread around some other institutes of Amritsar like Government medical college, Khalsa College, Guru Nanak Dev University. We designed and practiced a street play educating people on blood donation general practices and mitigating barriers. The approval was sought from the institutional ethical committee. The questionnaire was semi-structured consisting of 20 questions (both closed and open ended).
The idea to conduct a blood donation camp at a tertiary care hospital in Amritsar was initiated by the students of 2nd, 3rd, and 4th professional year and was implemented on February 8, 2018. The questionnaire was designed before the start of the study and was peer validated [Table 1].
Table 1.
Blood donation camp questionnaire
| Q1. Which of the following elements motivate you to donate blood? |
| a. My close family members might need it someday |
| b. Blood donation is being held near where I live |
| c. Gives me sense of pride |
| d. It helps to monitor my health |
| e. Tradition in my family |
| Q2. The experience of your latest blood donation |
| Q3. Any other social activity you ever did or you would like to do? |
| Q4. Did you feel any troublesome symptom immediately after donating blood |
| a. Weakness |
| b. Fainting |
| c. Vertigo |
| d. Bruising/bleeding |
| e. If any other |
| Q5. Are you a new donor/frequent donor? |
| a. If yes after how many months have you donated |
| b. Did not donate in last 2 years |
| c. Earlier used to donate but now stopped |
| d. If so then why? |
| Q6. Before this donation why did not you ever think of donating? |
| a. Fear of needles |
| b. Perceived inadequate health status |
| c. Perception that it is time-consuming |
| Q7. Do you think |
| a. Payment/monetary benefits should be given to those who donate blood (yes/no) |
| b. Benefits in attendance-If students (yes/no) |
| c. Any benefit in your job (yes/no) |
| d. Anything else |
| Q8. Do you feel self-confident/motivated after donating blood? (yes/no) |
| Q9. Are you encouraged/motivated to spread this blood donation awareness among your friend’s relatives? (yes/no) |
| Q10. Do you want to give blood again? If yes |
| a. Voluntarily |
| b After coming across some advertisement |
| c. Don’t want to donate blood |
| Q11. Did the staff managing the event satisfy any questions or concerns you might have had? |
| Q12. Would you like to donate blood again? (yes/no) |
| Q13. Why do think the patient is charged for the blood you donate for free? |
| Q14. Are you aware of any institute in your City/State/Country which holds blood donation camp? If yes then which institutes do you know? |
| Q15. Are you a member of any such group which organizes blood donation camps? |
| a. If yes, then which? |
| b. If no, then would you like to be a part of such group? |
| Q16. A healthy individual can donate blood after three months. Would you like to donate blood after 3 months? (yes/no) |
| Q17. If you do not want to donate blood after 3 months then what is the reason for it? |
| a. You had an unpleasant experience this time |
| b. You think it might harm your body and you will feel weak |
| c. Any other reason |
| Q18. How did you come to know about this blood donation camp? |
| a. Saw the poster at my college/any public place |
| b. Through friends |
| c. Through students |
| d. Through any social site |
| e. Any other reason |
| Q19. Did you face any problems while donating blood at the camp? Any suggestions you would like to give which could improve the experience of donating blood of the donors? |
| Q20. Have your views regarding blood donation changed from your views which you had before donating blood? If yes then what change has occurred? |
On the blood donation camp day, every donor's hemoglobin and blood group was checked. The criteria to donate blood was to at least have a hemoglobin of 13 gm% and 12 gm% for males and females, respectively. Out of these who full filled the criteria, the first 50 donors were taken in for the blood donation as decided by the faculty of the blood donation camp of our institute. Each donor was taken care of by looking after any postdonation weakness or nausea plus were also provided with refreshments. At the end, questionnaires were given to the donors in a separate room and 50 such filled forms were collected. Data were collected after obtaining informed consent. Ethical clearance from the institute was obtained before the study. The results were analyzed using Microsoft Corporation. (2018). Microsoft Excel. Retrieved from https://office.microsoft.com/ excel database sheet, and percentages were calculated.
RESULTS [Figures 1–11]
Figure 1.
Depicts 79% of the donors didn't feel any troublesome symptoms after blood donation
Figure 11.
Depicts that 60%, 14%, 16%, 6% and 4% got information about blood donation camp through poster displayed in college, through friends, students, social site or any other reason respectively
Figure 2.
Depicts 52% of the donors haven't donated in last 2 years
Figure 3.
Depicts 64% of the donors had a sense of pride as a motivation
Figure 4.
Depicts 52% of the donors had fear of needles acting as a hindrance for the blood donation
Figure 5.
Depicts 94 percent of the donors feel motivated and encouraged after donating blood
Figure 6.
Depicts 58% of the donors would voluntarily like to donate blood again
Figure 7.
Depicts that 33% of the donors think of having payment/monetary benefits after donation while 90% and 58% donors want benefits in attendance (if students) and benefit in the job respectively
Figure 8.
Depicts that 100% of the donors are encouraged/motivated to spread this blood donation awareness amongst your friend's relatives
Figure 9.
Depicts that 94% of the donors were satisfied with the staff management
Figure 10.
Depicts that 94% of the donors wish to donate again
Out of the 50 donors, there were 21 male (42%) and 29 females (58%), with a mean age of 21.45 ± 1.35 years.
The analysis of the feedback forms depicts the following results:
(12) When asked about the experience in the latest blood donation following common answers received were:
Amazing, good, great, awesome, excellent, proud, happiness
(13) When asked about any other social activity the donor ever did or would like to do, the following answers were received:
Blind school
Orphanage
Swachh bharat abhiyan
Pulse polio
eye donation
organ donation after death
organize cloth donations
awareness on issues about public health
plasma donation.
(14) When asked donor on why does the patient is charged for the blood he/she donate for free, the following answers were received:
Charged for the storage of blood
Preservatives added to the stored blood
Costs related to the tests done on the donor's blood
Equipment charges.
(15) When the donors were asked about any awareness of any institutes in the city/state/country/which holds blood donation camp, the following answers were received:
Khalsa College blood donation camp, Amritsar, India
Amandeep hospital blood donation camp, Amritsar, India
Dayanad Medical College and Hospital Blood Donation Camp, Amritsar, India
Derabassi blood camp camp, Punjab, India
Dera Baba Nanak blood donation camp, Punjab, India
Guru Nanak Dev University blood donation camp, Amritsar, Punjab, India
Guru Nanak Dev hospital blood donation camp, Amritsar, Punjab, India.
(16) When the donors asked about any change in their views which they had before donating blood, the following answers were received:
Never took the initiative but now motivated to donate again
Motivated to work for a noble cause
Encouraged to help the poor
Motivation to engage in social activities
Should donate blood more often
Fear of weakness after the blood donation has been conquered
False perception of time-consuming and tedious task cleared
gave a great feeling.
DISCUSSION
Targeting the beliefs associated with blood donation enhances the effectiveness of recruitment campaigns and the prevalence of blood donors annually. Prevalence (13.81%) of blood donors in this study was quite low similar to the study from Sikkim (12.7%).[8,9,10,11] Prevalence of female blood donors was also very less (9.65%) compared to male blood donors (19.53%). Low Voluntary Blood Donors (VBD) was an important indicator for us to modify and strengthen the recruitment and motivational strategies. Previous studies have shown that the path from attitude to intention was more strongly weighted in men than in women. Self-efficacy played a larger role in determining donation intention in females which can be a reason for high voluntary blood donation among men than in women.[12] Awareness on VBD was quite high (81.57%) which was similar to the KAP study of Thai students.[13,14] Awareness of the appropriate age for blood donation and the donor deferral criteria were very important factors. Lack of information on blood donation lowers the prevalence of voluntary blood donation.[15,16] Deferral of a donor is not only unpleasant for the donor, but it also leads to wastage of precious time and money of the transfusion center. Therefore, appropriate education of society regarding deferral factors of blood donation both temporary and permanent can lead to decrease in deferrals rate. Every individual should know their ABO and Rh D blood group so that they can donate blood whenever emergency requirement arises. Knowledge of ABO and Rh D blood groups is even more important in Jammu Region as it is prone to accidents and militancy-related incidents. Youngsters like college students must know their ABO and Rh D blood group so that they can donate blood easily whenever there is demand of their particular blood group. Especially, those with the rare blood groups should get their names enrolled as voluntary blood donors in rare blood group donor's records maintained by Regional Transfusion centers. About 61.18% of the students were aware of this fact that a healthy adult human being can donate blood after every 3 months. Knowledge of this fact can increase the frequency of repeat blood donations and can turn first-time blood donors into regular blood donors. Awareness of acquired immunodeficiency syndrome (AIDS) was not satisfactory in Indian society and for that more intensive public awareness campaigns by the government with the help of nongovernmental organizations are required.[17] Although all the students in our study were aware of AIDS/HIV still, 37.5% believed that blood donation causes HIV/AIDS to the donor.[18] More than 50% of the students gave the correct answers for the questions pertaining to Blood Donation. Frequent blood loss through voluntary blood donations is associated with reduced risk of acute myocardial infarction in middle-aged men.[2] High-frequency blood donors had evidence of decreased iron stores, decreased oxidative stress, and enhanced vascular function when compared with low-frequency donors and thus, there is a potential link between blood donation and reduced cardiovascular risk.[19] Blood donation is also associated with decreased risk of Type II diabetes and cardiovascular diseases.[3] The time to return for the next donation was associated with the total number of donations made.[20] Sex, Age, and other donor Demographic factors influence the probability of subsequent donations.[21] It also depends on the time since the index (first) donation. Social pressures and rewards were the factors that influence the decision for repeat blood donations at the early stages while self-originating factors influence the decision for blood donation in later stages.[22] Since our study involved a younger age group (18–26 years), in which most of the students (1350 students were in the age group of 18–20 years) just got eligible for blood donation, therefore, the number of blood donors who had donated only once or twice were more. Social causes were the major motivational factors for blood donation. “Altruism, doing good to others,” “Sense of social responsibility” and “For helping friends or relatives” were the major reasons for blood donation. In a study from Norway, 2.8% of respondents donated blood to be tested for HIV.[23] Younger donors donate blood for blood donor's credit cards and items of limited value while elder people donate for medical check-ups and blood tests.[24] The motivations to donate are altruism, humanitarian, social pressure, replacement, and rewards.[25] Altruism dominated the reasons for donating blood followed by social influence and ego enhancement.[26] Among students major determinants to become a blood donor were self-efficacy (for gaining experience), attitude, personal moral norm (personal responsibility, social obligation) and subjective norm (to help friends and relatives).[27,28,29,30]
In our study, the main reasons for not donating blood were Fear of needles, sight of blood, Fear of ill effects, objection from elder and never been asked for blood donation. The most common of them were fear of ill effects and never been asked for blood donation. Most of the students who were willing to donate, but they had not donated blood because of a lack of opportunity to do so. This finding showed that sufficient steps to involve students, to create opportunities for them to donate blood is something that needs to give due consideration. Among most first-time donors temporary deferral becomes the permanent excuse for not donating blood.[31,32,33]
Fear of contracting AIDS or other TTD's was also a major reason for not donating.[28] In our society parents have a wrong concept that blood donation causes weakness and hence they have a discouraging attitude toward the donation of blood by their children especially by girls. Experience of blood donation is an important factor for determining future blood donations, especially in first time Blood donors. Those blood donors who have a pleasant blood donation experience usually return for donating blood in future and turns into regular VNRBD while those who experience it unpleasant often do not return for repeat blood donation. In our study, 92.38% had pleasant experience of blood donation, while 7.61% felt it unpleasant. The percentage of nondonors who do not want to donate blood in future is more than the blood donors who do not want to donate blood in future.[34,35] Interactive awareness sessions on blood donation should be organized among students and opportunities for blood donation should be created, which can greatly enhance the movement for “voluntary nonremunerated blood donation,” to ensure good quality of blood and safe modern medical care.[36,37] All countries in SEAR are trying to phase out replacement systems and move towards 100% voluntary nonremunerated regular blood donation.[10] Lack of resources, lack of professional management, myths, and misconceptions arising from cultural and social differences forms a barrier to blood donation. As young people can be prospective regular blood donors, education in the fields of blood donation, need for safe blood and healthy lifestyles for young people are needed. Students are the most important target group and can easily be targeted in schools, colleges, and universities.
CONCLUSION
Being knowledgeable and having positive attitude regarding voluntary blood donation does not transform into the actual practice of blood donation, but this study shows a positive correlation between knowledge and donation practice. Therefore, specific recruitment and motivational campaigns are needed targeting the younger adults. Our efforts should be toward bringing the knowledge, awareness, and the positive attitude of the people in Amritsar into the application by motivating them and creating opportunities for them to become regular voluntary blood donor.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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