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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 7  |  Issue : 2  |  Page : 129-133

Knowledge, attitude, practice, and motivation toward blood donation among citizens of Albania


1 Department of Medical Laboratory Sciences, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
2 Department of Medical Laboratory Sciences, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia; Department of Medical Microbiology, University of Putra Malaysia, Seri Selangor, Malaysia

Date of Submission15-Mar-2022
Date of Decision09-Sep-2022
Date of Acceptance12-Sep-2022
Date of Web Publication5-Nov-2022

Correspondence Address:
Idris Sula
Department of Medical Laboratory Sciences, Sulaiman Al Rajhi University, Al Bukayriyah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/gjtm.gjtm_22_22

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  Abstract 


Background and Objectives: Blood donation is a remarkably safe medical procedure. However, it can easily be affected by attitudes, beliefs, and level of knowledge. A knowledgeable, attitudinal, and practical survey has been used in Albania, to understand and identify (1) The factors that influence blood donation, (2) the factors stopping people from blood donation, (3) the behavior and approach of the people toward blood donation in the future, (4) the knowledge level among donors and nondonors, and (5) misconceptions related to blood donation. Materials and Methods: This search was conducted on online surveys using Google Forms, which were shared through social media platforms such as Facebook, WhatsApp, and Gmail, and a self-administered questionnaire was shared to random people through social media platforms. Results: Of the 858 people answering the questionnaire from Albania, only 32% of the people were blood donors. The motifs that encouraged the people in Albania mostly to donate were to help others in need and save lives and donations for family members. The main reasons preventing people from donation were the fact that they were not asked for and medical reasons. In Albania, 88.6% would donate if called upon. Conclusion: Some of these results reflected an encouraging attitude toward blood donation. Further future planning with emphasis on educational programs and more organizations of donor recruitment campaigns could result in an increase of donations and thus fulfilling the needs of the patients in the country but not only.

Keywords: Albania, attitude, awareness, barriers, blood donation system, blood donation, blood transfusion, comparison, motivation, motivators, recruiting, survey, volunteering


How to cite this article:
Sula I, Alreshidi MA. Knowledge, attitude, practice, and motivation toward blood donation among citizens of Albania. Glob J Transfus Med 2022;7:129-33

How to cite this URL:
Sula I, Alreshidi MA. Knowledge, attitude, practice, and motivation toward blood donation among citizens of Albania. Glob J Transfus Med [serial online] 2022 [cited 2022 Dec 8];7:129-33. Available from: https://www.gjtmonline.com/text.asp?2022/7/2/129/360478




  Introduction Top


On World Blood Donor Day, June 14, 2017, the “Donate blood, Donate now, Donate often,” theme was used to emphasize the critical need for more people worldwide to become lifesavers by donating blood regularly. If just 1% of the population would donate, it would be sufficient for each country to fulfill their basic requirements for blood supply.

It is of the highest priority for all blood transfusion centers the incensement in the level of awareness and positive attitude toward blood donation. The initial step toward this goal is to perform comprehensive studies using knowledgeable, attitudinal, and practical (KAP) surveys to measure the levels of knowledge, beliefs, awareness, and attitudes of the population toward blood donation.[1] The leading cause of why people give blood is altruism, family support, and assurance, as well as social pressure. On the other hand, fear, lack of knowledge, and “not being asked to donate” have been described as the primary obstacles to donation.

The knowledge on the psychology and motivation of blood donors is important to establish a safe blood supply based on voluntary, nonremunerated donors in many countries worldwide.[2] On the other hand, more research surrounding the motivational factors affecting blood donations should be carried out. In Albania, according to the Ministry of Health and the Albanian Red Cross, recruiting safe and low-risk donors is still a challenge. In 2004, local donations fulfilled just 11% of the county's need, whereas in 2017 that number jumped as high as 45%. Despite this improvement, blood banks and recruiting institutions call on family, and in many cases, this becomes an important part of the blood supply system. The majority of volunteering recruitment is done by other nonprofit organizations, where the most active organization is the Albanian Red Cross. The Albanian Red Cross currently has more than 10,000 registered volunteers.

Over the past decades, there has been an increasing shift of reliance for blood, from imported blood and paid donations to local volunteering donations in Albania. It was during the COVID-19 pandemic that this trend changed and a big impact was given to the blood supply system worldwide. The most common misconception that hindered the access of donors to donation facilities were anxiety and fear of infections.[3] It was estimated by the WHO that the COVID-19 pandemic caused a 20%–30% reduction of blood supply.[4]

The purpose of this research was to find, understand, appraise, compare, and summarize the results of KAP surveys on blood donation in Albania. Such information is very crucial for planning the attainment of total voluntary blood donations. One of the main implementations of the World Assembly Resolution 28.72 of May 1975 is that member nations should work to establish a national blood transfusion services based on unremunerated donation of blood.


  Materials and Methods Top


A self-administered online questionnaire was prepared using Google Forms after a review of other similar studies that probed the attitudes toward blood donation in different countries then it was translated into the Albanian language.[5],[6],[7]

The questionnaire was distributed randomly among people. Basically, it was shared by social media, and receivers were encouraged and reminded to share it with other people, from March 2021 to April 2021. The participants were from both genders: males and females. The questionnaire analyses various aspects of the knowledge, beliefs, attitudes, and motivations toward blood donation. Respondents were asked to give an answer by a “Yes” or “NO” to some questions, whereas on other questions, they were asked to select or even write reasons for donating or not donating. There was a section where questions had to be answered by using a “Likert scale.” The questionnaire needed 5–10 min to be completed and was automatically collected by Google Forms.

Ethics

Ethical guidelines as per the Declaration of Helsinki were followed and confidentiality and consent were taken from all participants while administering the questionnaire and the anonymity of the participants was ensured.

Statistics

Data were collected by Google Forms and they were sorted and further analyzed using Microsoft Excel Worksheets (Headquartered at the Microsoft Redmond campus located in Redmond, Washington, United States).


  Results Top


There were a total of 858 responses received from random people. There was a close distribution between genders, 49.7% (427) were males and 50.3% (431) were female responders. Among the respondents, 31.8% (273) had donated blood at least once in their lifetime and 68.2% (585) were nonblood donors. To measure the frequency of donation, 5.2% (14) were regular donors donating 2–3 times a year, 38.4% (105) were regular donors donating once a year, and 56.4 (154) were donors donating every 2 or 3 years as represented in [Table 1].
Table 1: Frequency of Responses

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Knowledge

The knowledge assessment consisted of six items. Overall, as shown in [Table 2], general knowledge about the health benefits, required age, and blood group was high. Nondonors tended to have more general knowledge than donors, whereas nondonors knew more about health benefits and required age. The percentage of those who knew their blood group was higher among donors.
Table 2: Knowledge Level

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In the survey, there were some questions to evaluate the degree of misconception about the blood donation process. The most common misconceptions were two: the conditions that, to donate blood, “the donor should be fasting” and that “a smoker cannot donate.” Another misconception was that the donated blood is being sold to patients, thus fearing corruption and abuse. [Table 2] illustrates the percentage of each group expressing the stated misconception.

Attitude and motivation toward blood donation

In the current report, an overall positive attitude toward blood donation among people in the three countries was found. [Table 3] shows the percentages of people reporting a positive attitude for different scenarios. No negative attitude was found toward blood donation. In addition to these results, more than 80% of responders agreed or strongly agreed that every healthy person should donate blood. Almost 90% of all responders agreed or strongly agreed that their donation would encourage others to donate as well. More than 95% believed that blood donation can save lives. There is a positive attitude toward blood donation as shown in [Table 4]. More than 80% said that they would encourage others to donate and around 75% of the responders believed that blood donation is a duty of citizenship. More than 85% responded that they would donate if called on even for an unknown person, and 65% believe that they are fit to donate. More than 80% of all responders would not accept a monetary compensation for their donations.
Table 3: Beliefs for blood donation (n=858)

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Table 4: Attitude

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Reasons preventing nondonors from donating

As shown in [Table 5], in Albania, the top reasons for not donating were: fear, the fact that nobody had ever been asked and medical reasons. Fear of anemia, fear of sight of blood, and fear of injection were the most common deterrents among nondonors in Albania. Other reasons included medical reasons and the fact that they had never thought of it. Medical reasons included anemia, heart diseases, underweight, blood infection, cancer, etc.
Table 5: Reasons preventing nondonors from donating

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The main reason for donation was altruism (the desire to help those in need and save lives), where 81.3% of donor responders included altruism as a reason for donating, followed by the donation for family members. Social encouragement seemed to not play a significant role as a motivating factor. The consciousness of having to donate as a result of having a rare blood group was present among donors, as demonstrated in [Table 6].
Table 6: Motivating factors among blood donors

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Blood group distribution among responders

According to our study, the blood group distribution among people in Albania is similar to the values distributed by different sources.[8],[9] We can mention here that blood groups A positive and O positive were the most prevalent in Albania and B negative and AB negative were the least prevalent.


  Discussion Top


KAP surveys provide a context-specific evidence base for the development of communication strategies and interventions to encourage voluntary, nonremunerated blood donors, and crucial components of a safe and continuous blood supply in any health-care setting. There is no doubt that the problems surrounding donor recruitment differ in different countries, and are determined by cultural, social, educational, and other factors. Thus, in many developed countries, where the donations are mostly voluntary unremunerated, the main concern is a decline in blood supply, whereas, in most developing countries, where they are facing serious problems with the shortages of blood, blood donation is still predominantly involuntary in which family members, relatives, and friends of patients give a significant contribution in fulfilling the demands for blood, leaving a small proportion to voluntary unremunerated donors. In both situations, donor behavior and attitude are needed to be analyzed to make sure that the blood supply is sustained by recruiting new donors and maintaining those who have already donated, especially voluntary unremunerated donors.

Money compensation has remained out of favor in many studies. According to our data on money compensation, around 85% of the responders objected money as a compensation for their donation, leaving altruism as a main motivator. Nowadays, paid donations are being used widely for plasma donations in developed countries, where just in Canada, paid plasma donations account for nearly 70% of total donations.[10] According to the reports of the Ministry of Health of Albania in 2004, nearly 70% of the donations were paid donations, 25% were donations for family members, and only 5% were voluntary donations. In 2019, family replacement donations accounted for 73% of total donations and paid donations dropped as low as 1%.[11]

Recruiting a sufficient number of safe blood donors is an emerging challenge worldwide, especially during COVID-19 pandemics which led to a reduction of blood-related activities putting the safe blood supply and demand at risk.[3] COVID-19 pandemics had a negative impact on donor attendance.[4] It was estimated by the WHO that COVID-19 pandemics caused a 20%–30% reduction in blood supply.[12]

It is possible that with the decline in the number of voluntary donors, money compensation may be reconsidered as a way to attract more donors. However, there are serious potential disadvantages of paid donations such as the attraction of risky donors, especially drug users.

Albania has seen an increase of donations in the past years. In 2004, local donations fulfilled just 11% of the county's needs, whereas in 2017 that number jumped as high as 45%.[11]

The level of knowledge among responders is good. More than 90% of them know the health benefits of blood donation. Interestingly enough, in Albania, there is not a big difference between donors and nondonors, but nondonors scored higher 95.2% versus 92.4%. Even though the level of knowledge on health benefits of blood donation is high among Albanians, only 32% of responders were actual donors. By taking into consideration, the fact that the major reasons for not donating in Albania was fear and that nobody had ever been asked, means that more work is needed to be done in recruiting volunteering donors.

Although there are some misconceptions that might have been a factor to not donate, the most common misconceptions among all responders were the condition that a donor should be in a fasting state at the time of donation and that a smoker cannot donate. The levels of these misconceptions were almost double higher among nondonors than donors.

Among all surveys included, the most important motivating factor for blood donation was altruism, specified as “the desire to help others in need and save lives.” This trend is consistently overcoming the paid donation and increasing the rate of donations in many countries.[5],[14] Donation for family members is the second-leading motivating reason for donating blood. According to the WHO, the strong willingness to donate blood for friends or family is seen as a way for blood banks to recruit more donors. In Nigeria, around 67% of blood donations are made for family members; this is due to the policies of many hospitals which require donation of a blood unit as a condition for a family member to receive antenatal care[7] due to the fragmented blood supply system and an inadequate supply. Social encouragement seems to play a smaller role in recruiting donors where just 10%–16% of responders reported to be encouraged by their relatives and friends. Only 4%–6% of donations were as a result of the awareness of the rarity of their blood group.

In Albania, the most common deterrent of blood donation was fear and the fact of not being asked to donate. Several specific fears were reported such as fear of anemia, fear of the sight of blood, and fear of injection. Other reasons included medical reasons and the fact that they had never thought of it.

A common theme that emerged from survey results is the need for more work to convert positive attitudes toward blood donation into the practice of volunteering donations. In Albania, almost 90% were willing to donate even for someone that they did not know and 65% believed that they were fit enough to donate but only 32% had donated at least once.

There are different ways to recruit repeat donors and there are different reasons that affect their willingness to donate again. Donating for the first time plays a big role in the willingness to donate again.[13] Thus, future KAP studies might focus more on different strategies to convert first-time donors into repeating donors by trying to identify and eliminate the deterrent factors. Proper knowledge of blood donation plays an essential role for blood donation. In the present study, it was found that more knowledgeable participants tend to donate blood more than those with a lower level of knowledge.


  Conclusion Top


The collection of blood donation surveys undertaken in the three countries confirms that KAP surveys are an important source of information about blood donation that can be used to develop targeted strategies for encouraging voluntary unremunerated donors and building a safe blood system. Although the level of knowledge, beliefs, attitudes, and behaviors toward blood donation is relatively good, this review illustrates that new strategies are needed to recruit nondonors. Fear and the fact that nobody had ever been asked were the most common deterrent to blood donation, whereas altruism was the main motivating factor. There is a gap between positive attitude toward blood donation and the number of donors in Albania. New communication strategies should be designated to overcome these issues leading to the establishment of a safe blood supply based on voluntary and nonremunerated donors.

Acknowledgment

The author would like to thank his supervisor, Dr. Mateq Al Reshidi, and Dr. Abdullah Murhaf Al-Khani for their suggestions and their help in preparing the questionnaire.

The author would like to thank his father MSc. Telat Sula for the proofreadings in English and Albanian versions of the questionnaire and for supporting on every step of this research.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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Glauser W. Payment for plasma raises ethical issues. CMAJ 2014;186:E446.  Back to cited text no. 10
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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