Negative experiences and pre‐donation blood pressure: the role of attitude and anxiety

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Excerpt

Blood donation is a voluntary activity and is associated with beneficial effects such as feeling satisfied or being more alert as well as feeling better in general (Nilsson Sojka and Sojka, 2003; van den Hurk et al., 2016). Unfortunately, donating blood sometimes results in adverse donation events (e.g., fainting, dizziness, bruising), which can even cause donors to withdraw permanently (France et al., 2005; Newman et al., 2006). In a recent systematic review, it was shown that adverse events, unfamiliarity with donating blood and certain ways of coping are associated with increased stress reactions such as a heightened state of anxiety (Hoogerwerf et al., 2015). Besides a positive correlation between pre‐donation (‘non‐acute’) fear and donor reactions (France et al.2013a), having had a negative donation experience has also been found to have more long‐term effects and was found to be associated with a higher pre‐donation blood pressure at the subsequent visit (Hoogerwerf et al.2016). When the pre‐donation blood pressure was studied in a large cohort of healthy blood donors (N = 248,118), and the pre‐donation blood pressure of donors with a negative donation experience (e.g. vasovagal reaction, deferral) was compared with that of donors without such an experience, Hoogerwerf et al. found that donors with a negative experience had a raised systolic and diastolic blood pressure at the subsequent donation attempt. This is in line with literature showing a prolonged increase in blood pressure following a mental stress test (Steptoe et al., 2003; Ginty et al., 2012). Moreover, anticipatory stress, i.e. worrying about the future, has also been shown to cause raised blood pressure (Ginty et al., 2012). Hoogerwerf et al. posited that the raised blood pressure at the subsequent visit could therefore indicate increased anticipatory stress as a response to the negative experience.
Several studies have explored the effects of interventions to reduce negative experiences during a donation, for instance, reducing the number of vasovagal reactions by water loading (Newman et al., 2007), using applied muscle tension to reduce vasovagal reactions (Holly et al., 2011) or the effect of distraction on self‐reported physiological reactions in first‐time donors (Bonk et al., 2001). However, the presence of a psychological or physiological anticipatory stress response at the following visit as a result of this negative experience has been mostly overlooked. In addition, the influence of the donor's attitude and anxiety towards a future donation after having experienced such an event is unclear. Attitude, both cognitive and affective, is a measure of how the donor rates the behaviour in terms of importance and pleasantness and has been found to be a predictor of the intention to donate in the future (Veldhuizen et al., 2011). The role of trait donation anxiety – how the donor rates the donation in advance in terms of fear – is still being debated; some studies show no difference in intention to donate (van Dongen et al., 2013a), whereas others present evidence of a negative influence on the intention to donate (France et al., 2013b).
Summarising the above, there is evidence indicating that donors with a negative donation experience might have anticipatory stress at their following donation visit, as expressed by a raised pre‐donation blood pressure. The actual impact of the negative event – how the donor handles and perceives the negative event – might also be influenced by the donor's attitude or anxiety. However, the relationships between the attitude and anxiety arising from previous negative donation experiences and future donation stress responses remain unclear.
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