A Qualitative Study of Attitudes, Motivation and Perception of Blood Donors towards Blood Donation in a Tertiary Care Hospital

BACKGROUND: There are various barriers to donating blood that influence the behavior of people towards blood donation such as cultural beliefs in some ethnic groups, socio-economic factors, their knowledge or lack of knowledge with regards to blood donation and other issues AIM & OBJECTIVE: To establish motivational and socio-demographic factors for the development of a long-term commitment as a blood donor. METHODOLOGY: Questionnaire-based study collected from 310 participants containing 22 items, including socio-demographic information, donors' evaluation of blood bank service and 23 statements on motivation. Data on motivation was analyzed using factor analysis. RESULTS: Representation of males (85.4%) for donation was much higher compared to females (14.6%).Unemployed individuals were found to be under-represented. The single, most important, recruitment channel was the influence of active blood donors. CONCLUSION: Most donors were recruited by other donors. Their continued involvement as blood donors was primarily linked to altruistic and empathic reasons.


A Qualitative Study of Attitudes, Motivation and Perception of Blood Donors towards Blood Donation in a Tertiary Care Hospital
© The International Journal of Indian Psychology | 84 Against 8.5 million units/year requirement, the availability is only 4.4 million units/year of which only about 52% is through voluntary donations. It observed that all over the world including developing countries like India blood donors belong to a minority community. [4] "More blood, more life," this was the theme for World Blood Donor Day 2011 on the 14 of June to emphasize the critical need for more people all over the world to become lifesavers by donating blood regularly. Based on reports from 173 countries to WHO, around 93 million blood donors are donating annually. [5] Increase in the level of awareness and positive attitude towards blood donation is the highest priority of all blood transfusion centers. The initial step for achieving this goal is to perform comprehensive studies measuring the current situation of awareness, knowledge, beliefs, and both positive and negative attitudes of the population towards blood donation. [6] AIM: To explore the motivation and satisfaction towards blood donation among the blood donors in a tertiary care hospital.

OBJECTIVES: a)
To measure the level of satisfaction in blood donation bank b) To find out positive and negative attitudes towards blood donation c) To identify the obstacles and difficulties facing the individuals d) To suggest some motivational factors that can improve the donation process in the future.

METHODOLOGY: a) Subjects from the blood donor survey
Questionnaire-based samples were collected from 310 participants. Study periods lasted for 4 weeks1 month (Jan 2015) recruited from the Blood Bank of a tertiary care hospital. Blood bank staff distributed a four-page self-administered questionnaire to be filled in during donation and to be returned anonymously. Almost all donors returned the questionnaire, giving a response rate of about 100 percent.
The four-page questionnaire contained 22 items, including socio-demographic information (gender, age, social status, education, annual income, etc.), donation history, recruitment method, the donors' evaluation of the blood bank service and 23 statements on motives for donating. The questions on motivation targeted donors with previous donation experience, and first-time donors were therefore excluded from the motivational analysis. The statements on motives were primarily based on the volunteer functions inventory (VFI), elaborated by Misjeet.al. [7]. The VFI was designed with the dual purpose of providing researchers with a useful measurement of volunteerism and helping the administrators of voluntary organizations to manage human resources. Only four VFI factors of motivation ('value', 'social', 'esteem' and 'understanding') were included in the questionnaire.
(2) 'Social' reasons reflect the normative influence of friends, family, or a social group that motivates people to volunteer.
(3) 'Esteem' represents reasons for volunteering in order to feel better about oneself {e.g. feel better about myself, feel important) by helping others.
(4) 'Understanding' refers to positive experiences associated with volunteering {e.g. 'explore own strengths', 'learn from experience') [7] a) Statistical Analysis Factor analysis was performed for the data collected. Factors were extracted using a common factor (principal axis factoring) solution, because this factor model is recommended for the identification of latent factors. The number of factors to be extracted was decided using the latent root (eigen value) criterion on the unroasted factor matrix.
Only factors with latent roots higher than 1 were included in the analysis. A rotation of the factor matrix was performed in order to achieve a simple and meaningful factor pattern. An oblique rotational method (i.e. permitting factors to be correlated with each other) was selected because this method represents the clustering of variables more accurately than the alternative orthogonal method (i.e. each factor is computed to the independent of ail other factors). The statistical analyses were conducted using SPSS software.

RESULTS: a) Socio demographic
Men outnumbered women among the donors (85.4% vs. 14.6%). The age distribution among donors (26-35 years) was found with maximum percentage of blood donation. The youngest (18-25 years) and oldest (> 45 years) age groups were found to be underrepresented among blood donors shown in Graph 1 below.

Percentage of donors
The proportion of married persons among blood donors (64%). The proportion of unemployed individuals was considerably lower among blood donors (11%) than those they were employed (72.7%). The proportion of people working in health and social services was lower among blood donors (2.6%).

b) Recruitment
The single most important recruitment channel was the influence of relatives who were once blood donors. In total 32.9% of all donors reported that they had been influenced by relatives (graph 2). 25% of the donors were recruited by friends, but only 1.3% by a spouse or partner. A total of 3.9% of all donors reported to have been recruited by acquaintances and colleagues.
The second main recruitment channel was media advertising. In total 22.9% of donors indicated that they had been recruited via advertisements in newspapers, magazines, leaflets, posters. TV or radio Other types of recruitment represented only a small percentage of the reported influences to volunteer for blood donation. We notedthat only 1.3% started donating on the recommendation of healthcare professionals.

c) Employment
The large percentage of employed donors belonged to a private firm (47.7%) in which 26.6 % were associated with Technology, telecom and media (Figure 1 Long-term donors were defined as donors with a history of more than 10 donations. It was found that 9.4% of donors have donated more than 10 times. Media-recruited donors (newspaper, TV/radio, poster, leaflet) were found among recently recruited donors among the long-term donors. f) Donors evaluation of the Blood Bank service and facilities Overall, 89.2% of the Blood bank blood donors reported that they were satisfied (fully or partly agreed to a positive statement) with the professionalism of the collection staff. However, 9.8 % found donation fully or somewhat unpleasant. 86.2% of all donors gave a positive evaluation of blood bank facilities (

Motives for donating blood
Twelve of the 14motivation-related items in the questionnaire were adapted directly from the VFI. The statements A and G correspond to the "value factor' of the VFI; B, K and E to the 'esteem factor'; M and L to the 'social factor'; J and L to the 'understanding factor'. In addition Five items of our own design were included (statements C, D, E, F, I). These addressed a broad range of reasons for donating blood that were not covered by the VFI. a) Factor 1 The first factor that emerged was produced by the correlation between Variables J, K, F. Variables J correspond to the VFI-instrument's 'understanding' factor. Variables K correspond to the 'esteem' factor of the VFI and variables F and N address perceived health benefits from donation ('regular health control', and 'donating improves my own health). Factor 1 accounted for a large proportion (32%) of the total variance and hence labelled as 'understanding' factor. b) Factor 2 The second factor was composed of the responses to statements I, H andA, which cite altruistic and empathic reasons for giving blood. These statements Correspond to the VFI 'value' factor. c) Factor 3 The third variable was formed by correlation between variables B and E which address increased self-esteem associated with giving blood ( donating blood makes me feel better about myself). These variables correspond to the VFI 'esteem' factor. d) Factor 4 The fourth factor was composed of responses to statements M and C. The first variable emphasizes the importance of support from other people as reasons for donation, and corresponds to the VFI 'social' factor. Variable C addresses positive feelings when seeing the blood bank logo or advertisements for blood donation.

DISCUSSION:
Unemployed individuals were found to be under-represented among blood donors. This may reflect reduced health status among the unemployed, which would probably exclude from donation. Higher (40.6%) of donor had income level above 50,000/-annually. Surprisingly, the study also showed underrepresentation healthcare professionals who are expected to be more aware of the need for blood transfusion than others.
Generally, blood donorssocio-demographic characteristics showed some differences. Representation of males (85.4%) for donation was much higher than in the females. The small under-representation of women may be explained by screening of low-weight persons (there is a 45 kgweight limit for donation). The under-representation of women among long-time donors may partly be explained by the cessation of blood donation caused by pregnancy. The under representation of the youngest age group (18-25 years) among blood donors should be noted.