Donor satisfaction with a new german blood donor questionnaire and intention of the donor to return for further donations

Undisclosed Sexual Risk Exposures: Results of a Nationwide Compliance Study among Whole Blood Donors in Germany

Background

Undisclosed sexual infection risks are the main reasons for transfusion transmissible infections in German blood donors that have qualified for donation by donor health interviews and questionnaires. Until now, data about compliance with deferral criteria were only available from post-donation interviews with infected donors, and information about the proportion of donors which did not disclose (sexual) risks at the donor health questionnaire was not available.

Methods

A prospective nationwide anonymous online survey was conducted to investigate compliance of whole blood donors with deferral criteria for sexual infection risks. Twenty-one blood establishments which represent 80% of the regular whole blood-donor population invited all donors which donated blood during an 8-week period between January and March 2020.

Results

14,882 participants completed the questionnaire. A relevant proportion of non-compliance was shown (3.0%, 95% CI: 2.7-3.3%) - with male donors being non-compliant significantly more frequently than females (3.5% vs. 2.2%, p < 0.001). A quarter of the non-compliant men were MSM (0.9%, 95% CI: 0.7-1.1%). Non-compliance was strongly associated with the perception that questions about sexual risk exposures are too private. This is in line with the finding that a large proportion of donors (21%) refused to answer at least one question about sexual infection risks.

Conclusion

The presented data, collected for the first time, is suitable for assessing the impact of changes in the donor selection process. Donor's limited willingness to provide detailed information about sexual risk behaviour has to be kept in mind when further strategies for fair appraisal of individual sexual infection risks will be discussed.

Motivation, blood donor satisfaction and intention to return during the COVID-19 pandemic

Background and Objectives

This study aimed to describe motives as well as donation experiences and the intention to return for further donations of German whole blood donors who donated at the beginning of the COVID‐19 pandemic.

Materials and Methods

To describe motives and donor experiences, a retrospective survey was conducted among whole blood donors that had a donation appointment at the German Red Cross Blood Donation Service in the first 4 weeks of the pandemic. A donor questionnaire including 17 retrospective questions was sent to 7500 donors. Donor motivation and donor experiences were compared for different donor groups using chi‐square statistics. Finally, in an ordinal logistic regression model predictors for the intention to return were identified.

Results

More than half of the participating donors (56.9%) wanted to contribute to the fight against the pandemic by donating blood. Most of the donors were satisfied with their last donation experience and felt safe during the blood donor appointment. However, some donors would have liked more information on how to deal with the pandemic (20.3%). Intention to return for further donations was strongly associated with overall satisfaction (OR: 1.67, CI: 1.47–1.90) and the feeling of being safe during blood donation (OR: 1.33, CI: 1.05–1.68).

Conclusion

Donor satisfaction with the last donation was high and the vast majority of donors felt very safe. However, those donors who felt unsafe expressed a low intention to return and blood donation services should therefore carefully monitor donor satisfaction.

Motivation zur Vollblutspende während pandemischer Ereignisse

Auch während Pandemien müssen die Blutspendedienste kontinuierlich BlutspenderInnen rekrutieren, um die Versorgung mit Blutprodukten zu gewährleisten. Während im Anschluss an andere Katastrophen wie Erdbeben oder Terroranschlägen die Spendebereitschaft meist sprunghaft ansteigt, zeigte sich in der Vergangenheit bei beginnenden Pandemien zunächst ein Rückgang des Spendenaufkommens. Viele SpenderInnen fürchten eine Infektion oder eine Schwächung ihres Immunsystems und bleiben zu Hause. Auch fällt es den Blutspendediensten zunächst schwer, die gewohnte Anzahl an mobilen Spendeterminen zu organisieren, wodurch das Spendenaufkommen zurückgeht. In der aktuellen SARS-CoV-2-Pandemie betrug dieser Rückgang in vielen Ländern mehr als 10%. SpenderInnen, die auch während einer Pandemie spenden, sind in der Regel erfahrener und besitzen bereits eine ausgebildete Spenderidentiät. Viele dieser SpenderInnen berichten, dass sie gezielt einen Beitrag zur Überwindung der Krise leisten möchten. Auch während einer Pandemie ist demnach eine hohe Solidarität unter BlutspenderInnen zu finden. Potenzielle ErstspenderInnen lassen sich durch die unsicheren Rahmenbedingungen dagegen von einer Spende eher abhalten und es bedarf gezielter Rekrutierungsstrategien unter Einsatz von Social-Media-Kanälen, um neue SpenderInnen zu gewinnen. Erste Befunde unter deutschen BlutspenderInnen lassen hierbei eine hohe Rückkehrintention der ErstspenderInnen erwarten. Um die Blutversorgung auch während einer Pandemie aufrechterhalten zu können, sollten die Blutspendedienste neben der Rekrutierung von ErstspenderInnen versuchen, schnell die Anzahl ihrer Spendetermine zu erhöhen. Die Ansprache bestehender SpenderInnen sollte vor allem die Verunsicherung reduzieren und das Vertrauen in die Blutspendedienste stärken. Je größer das Vertrauen in die Spendeeinrichtung ausfällt, desto geringer ist die Risikowahrnehmung der SpenderInnen. Auch sollten alternative Kontaktwege etwa über Messengerdienste getestet werden, da diese eine schnelle Ansprache erlauben.

Validation of a standardized donor health questionnaire across substances of human origin

BACKGROUND AND OBJECTIVES

A donor health questionnaire (DHQ) aims to ensure the safety of donors and recipients of transfusions or transplantations with blood components, plasma-derived medicinal products, tissues, haematopoietic stem cells and medically assisted reproduction (in short substances of human origin; SoHO). Currently, many different DHQs exist across countries and SoHO. TRANSPOSE (TRANSfusion and transplantation PrOtection and SElection of donors) developed and validated a standardized DHQ to use across countries and SoHO. We tested whether participants understand the questions and provide honest answers.

METHODS

For the validation of the standardized DHQ, two demographically representative online surveys were conducted in Germany (N = 3329) and Austria (N = 3432). We surveyed whether participants understood each DHQ question and would answer the questions truthfully. We used experimental settings to test whether there is a difference between mode of administration (print vs. online), the order of the questions (subject vs. chronological order), and the positioning of the general state of health question (beginning vs. end) in the DHQ. Using regression models, we tested the DHQ's impact on participant mood after completion and on socially desirable response behaviour.

RESULTS

Participants understood the DHQ questions well and would answer them honestly. Nevertheless, the data show different levels of understanding and honesty when responding. Administration mode was the only characteristic that had a significant influence on mood, with the online version resulting in a more favourable mood in comparison to the printed version.

CONCLUSION

The DHQ was well understood and had a low dishonest tendency. Our findings can serve as an impulse for further research on DHQ criteria across other SoHO and countries.

Recommendations for application and interpretation of the Blood Donor Satisfaction Questionnaire (BDSQ)

Background

The level of satisfaction of donors with the blood donation system is an important factor which influences their intent to return for future donation. A 25-item questionnaire on the satisfaction of blood donors has been recently proposed to assess the donor satisfaction with the service provided by a blood bank. The objective of this study was to present a proposal for application and interpretation of a BDSQ considering a sample of blood donors of a Brazilian blood bank.

Methods

A sample of 1019 blood donors at the Regional Hemotherapy Center of Franca, Brazil, answered the BDSQ. A top-box analysis was used to assess the associations between the variables characterizing the profiles of blood donors and their overall satisfaction with the service provided by the blood bank. We proposed the use of a performance-importance plot (PIP) for the interpretation of the 25 items of the BDSQ.

Results

Older donors are more likely to report lower overall satisfaction with the service provided by the blood bank. PIP allows us to classify the items of BDSQ into long- and short-term improvement opportunities as well as into motivational and hygiene factors. Motivational factors (i.e. attributes that promote overall satisfaction when present) tend to be associated with the treatment offered by the blood bank staff. Donors seem to give more importance to the interpersonal aspects than to the physical structure of the service and other aspects of convenience.

Conclusions

Top-box analysis and PIP proved to be efficient strategies to interpret the results of the BDSQ.

Which Infectious Blood Donors Could Be Identified by the Donor History Questionnaire? - Comparison of Blood Donors Infected with HIV or HCV with Notified Cases from General Population in Germany

Background

Potential risks for transfusion-transmissible infections are identified by donor history questionnaires (DHQs), and donors with higher risks are deferred from donation. We assessed to which extent the currently used DHQs support the identification of infections among blood donors.

Methods

Between 2006 and 2013, we analyzed data from notified HIV and HCV cases in the general population and positive blood donors in Germany. Logistic regressions were used to identify relevant infection risks. We estimated the possible effect of improved capture of risk factors for donor selection by calculation of population attributable fractions (PAF).

Results

Risky sexual contacts - MSM as well as heterosexual contacts - were the most prominent infection risks among HIV-infected donors. Whereas MSM contacts were significantly less reported by donors than by cases from the general population, 58% of donors disclosed heterosexual risks compared to 26% of notified cases. The complete identification of heterosexual risk contacts might prevent acceptance of 53% of HIV-infected donors. HCV-infected donors were more likely to report heterosexual exposure, imprisonment, and piercing/tattoo than notified HCV cases. Improved recording of piercing/tattoo could prevent acceptance of 16% of HCV-infected donors.

Conclusion

Donor selection should be improved with special attention to the identification of (hetero)sexual risk factors, invasive procedures (piercing/tattoo and imprisonment) applying well-designed DHQs, effective donor education, and confidential environment in all steps of the selection process.

Selecting the Right Donors - Still a Challenge: Development of a Uniform Donor Questionnaire in Germany

The selection of blood donors includes the assessment of the individual's health and medical history by using a donor questionnaire (DQ) in order to identify persons whose donation could present a health risk to recipients or to themselves. This way, DQs provide one layer of blood safety and contribute to the high safety profile of blood components currently available in Germany. This review reports the development of a new uniform questionnaire in Germany and its first evaluation using a field test approach. This development is set in context with the international experiences regarding donor selection and prospective challenges.