This thesis explored the impact on whole blood donors of a six month deferral from giving
blood due to a low haemoglobin (Hb) concentration. The aims were two-fold: first, to
quantify the effect of a temporary deferral on donation patterns once eligible to return, and
second, to identify the processes contributing to the effect. The mixed methods design
utilised four distinct research phases: statistical analysis of donation patterns over a three
year period, surveys of whole blood donors three and twelve months after deferral, and
semi-structured interviews with 25 blood donors in the weeks immediately following
deferral.
Deferral for a low Hb increased the likelihood of non-return in both new and repeat donors,
and, amongst those who did return, delayed first return, reduced donation frequency and
increased the likelihood of drop-out in later years.
Qualitative interviews suggested that, predominantly, individuals give blood because it
represents an easy and convenient way to help others, and provides additional rewards, such
as enhancing positive self-concepts and a free health check. Returning promptly after
deferral appears to be related to three aspects of a person and his/her context: an
individual’s other obligations, especially parenting; the extent to which donation is
considered personally rewarding; and whether donation arrangements were facilitated by a
range of supports prior to deferral.
Over three quarters of surveyed deferred donors seek further advice and investigations from
their medical practitioner and nearly half of those are encouraged to change their donation
patterns. With the exception of having a low haemoglobin level confirmed at follow-up
testing, experiences seeking further investigations were not associated with either intentions
or return.
Triangulation of findings suggests that deferral disrupts the habit of regular donation, and
that this disruption makes donors more vulnerable to changes to their personal
circumstances or collection practices. Deferral may also increase the perceived
inconvenience of the activity, decrease self-perceptions of competence and good health, and
diminish the “blood donor” identity.
Practical implications of these findings are recommendations that may increase retention of
deferred donors, including encouraging donors to return promptly once eligible, enhancing
the convenience of blood donation, and improving aspects of the deferral event.Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 201