The principle of voluntarism and non-remuneration (VNR) of blood donation has long been advocated all over the world. The result is an increasing percentage and absolute number of VNR donors. However, the retention of many VNR donors is still a major concern, particularly in the economically restricted parts of the world, but also in the more advanced countries. This research focused on the retention behaviour of male and female donors in an advanced country following an adverse reaction to blood donation – vasovagal reaction (VVR) or needle reaction (NR). However, another frequently observed and personally embarrassing reaction, especially in young first-time blood donors, hyperventilation (HV), has not been included.



The analysis is based on the Theory of Planned Behaviour (TPB) and the effectiveness of coping planning (CP) through coping techniques. These two approaches from the behavioural sciences have so far only been applied in transfusion medicine in a limited way. However, the study illustrates the value of these approaches at the societal interface part of the transfusion medicine ‘vein-to-vein’ chain. 

Donor management is the art of communicating with people who, in principle, come to a blood centre of their own free will, whether fixed-site or mobile, to offer their blood for intended supportive haemotherapy. The common attitude of blood collection centres is usually driven by need, like catching fish, and not so much by establishing a sustainable relationship based on motivation, mutual understanding and respect, and proper information on what blood donation really is all about and how to cope with events that affect the emotional status and self-respect of the blood donor. The authors have undertaken a large (representative) study to understand how blood donors of either gender react to and cope with the effects of an adverse reaction, in order to develop changes in donor management that might prevent embarrassment and stimulate continuation of VNR blood donation. Particularly interesting is the approach, through the TPB, based on the assumption that intention is the most proximal determinant of a given behaviour. Intention per se, however, is influenced by three conceptually independent determinants – attitude, subjective norms and perceived behaviour control (PBC). In this approach a fourth determinant has been added – moral norms – which may widely differ from place to place.

The observations teach us that women experience adverse reactions more often than men, but that men seem to experience a greater effect on their self-esteem, and therefore tend to quit more easily than women. The authors postulate that proper and balanced planning for coping with the feelings of embarrassment might be of importance to improve the quality and efficacy of donor management.

For the large part of the world where VNR is not yet a common practice, and where culturally determined behaviour and feelings of self-respect and esteem, with distinct differences between the genders, are dominant, tailor-made coping strategies and techniques could help in the conversion of the mindset of the community towards regular VNR blood donation.

Prof. Dr. Cees Th. Smit Sibinga

ID Consulting for International Development of Transfusion Medicine (IDTM)

University of Groningen