Relation between perceived blood loss and vasovagal symptoms in blood donors

The Polish adaptation of the blood donation fears inventory

BACKGROUND AND OBJECTIVES

Given the decline in the number of voluntary blood donors in Poland and the lack of psychological research on blood donors and the donation system in the country, there is a need to develop a tool to measure barriers to recruiting new donors and retaining active donors. One significant barrier is the presence of specific fears associated with the blood donation process. Therefore, the main objective of this study was to perform the Polish adaptation of the Blood Donation Fears Inventory (the BDFI).

MATERIALS AND METHODS

The Polish adaptation of the BDFI was developed and tested on a sample of 409 individuals, consisting of 194 (47.5%) voluntary blood donors and 214 (52.5%) non-donors. The original tool comprises an 18-item scale that measures four different types of fears related to the blood donation process: (1) Fear of Syncopal Symptoms, (2) Fear of Blood and Needles, (3) Fear of Social Evaluation, and (4) Fear of Health Screen Results.

RESULTS

To determine the psychometric properties of the scale, exploratory factor analysis, confirmatory factor analysis (RMSEA =.098; CFI =.958; TLI =.935; SRMR =.035), second-order factor analysis (RMSEA =.097; CFI =.958; TLI =.936; SRMR =.036; NNFI =.936; NFI =.938), and bifactor analysis (RMSEA =.093; CFI =.969; TLI =.942; SRMR =.036; NNFI =.942; NFI =.952) were conducted. The reliability of the tool was assessed using Cronbach's Alpha and McDonald's Omega, resulting in high coefficients (ranging from.92 to.97) for each scale. Internal consistency was examined using the State-Trait Anxiety Inventory (STAI), while external consistency was examined using the Scale of Positive and Negative Experience (SPANE) and the Self-esteem Scale (SES).

CONCLUSION

Satisfactory results were obtained, establishing the Polish adaptation of the BDFI. This tool represents a novel contribution to the research on the blood donation system in Poland.

Analysis of vasovagal syncope in the blood collection room in patients undergoing phlebotomy

Vasovagal syncope (VVS) is well-known to occur in patients undergoing phlebotomy, however, there have been no large-scale studies of the incidence of VVS in the blood collection room. The aim of our present retrospective study was to investigate the conditions of phlebotomy and determine the incidence/factors predisposing to the development of VVS. We investigated 677,956 phlebotomies performed in outpatients in the blood collection room, to explore factors predisposing to the development of VVS. Our analysis revealed an overall incidence of VVS of 0.004% and suggested that use of more than 5 blood collection tubes and a waiting time of more than 15 min were associated with a higher risk of VVS. The odds ratios of these factors were 8.10 (95% CI 3.76-17.50) and 3.69 (95% CI 0.87-15.60), respectively. This is the large-scale study to analyze factors of the development of VVS in the blood collection room, and according to our results, use of a large number of blood collection tubes and a prolonged waiting time for phlebotomy may be risk factors for the development of VVS.

Psychological and hormonal stress response patterns during a blood donation

BACKGROUND AND OBJECTIVES

Donating blood has been associated with increased stress responses, with scarce evidence indicating that levels of psychological and hormonal stress are higher pre-donation than post-donation. We investigated whether a blood donation induces psychological and/or hormonal stress during the course of a blood donation, and whether responses differed between men and women, first-time and experienced donors and donors with high or low non-acute stress.

MATERIALS AND METHODS

In 363 donors, psychological (donation-stress and arousal) and hormonal (cortisol) stress were measured by questionnaire and salivary sample at seven key moments during a routine donation. Non-acute stress was assessed by a questionnaire. Repeated measurement analyses were performed, using the last measurement (leaving the donation center) as reference value.

RESULTS

Levels of donation-stress, arousal and cortisol were significantly higher during donation than when leaving the donation center. When compared with men, women reported higher levels of donation-stress and cortisol in the first part of the visit. When compared with first-time donors, experienced donors reported lower levels of donation-stress during the first part of the visit, and higher levels of arousal but less reactivity throughout the visit. When compared to donors high on non-acute stress, donors low on non-acute stress reported lower levels of donation-stress during the first part of the visit, and showed less cortisol reactivity throughout the visit.

CONCLUSION

Donating blood influences psychological and hormonal stress response patterns. The response patterns differ between women and men, first-time and experienced donors and between donors high and low on non-acute stress.

Phlebotomy, a bridge between laboratory and patient

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to "bridge" patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient's compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper.