Distraction Technique Could Put Blood Donors at Ease

Written by Becky Orfinger, Staff Writer, RedCross.org

August 16, 2001 —  Although most people realize the importance of regular blood donation, fear of needles and misconceptions about the blood donation process keep much of the American population from actually rolling up their sleeves. But a new study by Ohio University scientists suggests that many donors will have a more comfortable donation experience if they are shown a 3-D movie as their blood is drawn. The researchers knew that distraction could successfully help relax patients undergoing invasive medical procedures and hypothesized that the same might be true for blood donation.

Many first-time blood donors worry that their donation will be painful, but most longtime donors claim that they feel "just a pinch."

In the study, the results of which were published this month in the journal Psychosomatic Medicine, 112 college students volunteered to give blood for the first time at an American Red Cross blood drive. Half of the participants were randomly assigned to the "distraction" group and watched a 3-D movie on individual screens and headsets during the donation, and the others had a more typical blood donation experience. The 3-D program showed different activities (one scene showed people skiing down a mountain) and was accompanied by relaxing but upbeat background music. All of the study participants answered the same set of questions about their physiological reactions during the blood donation experience.

Before giving blood, all of the study participants had answered a questionnaire about their style of dealing with stress. "Psychologists have determined that there are two distinct coping styles that people use in stressful situations: monitoring and blunting," said Christopher France, Ph.D, one of the Ohio University professors who co-authored the study. "Monitors try to get all the information they can about a situation that they are worried about, and blunters use distraction or denial strategies to cope." Monitors tend to ask a lot of questions before a medical procedure and seek out information on their own. Blunters would prefer not to know so many details.

France said that other studies have shown that the distraction technique is, predictably, more useful as a stress reliever for blunters than for monitors. "It appears that people who prefer to avoid information about their stressors do best when there's something to distract them from the situation that's causing stress," he said. The results of his group's study followed this trend also — the blood donors who were classified as blunters on the stress response questionnaire tended to be the ones who garnered the most benefit from the 3-D video during donation.

Many people deal with the stress of medical procedures by trying to get as much information as possible about the situation.

When asked about their blood donation experiences, the blunters who had watched the video were less likely to report what France calls "vasovagal reactions" — faintness, lightheadedness and dizziness. France said that while only about 2 percent of donors actually faint (briefly losing consciousness) during their donation, milder vasovagal reactions are more common. While these reactions do not seriously impair the long-term health of blood donors, they often prevent a first-time donor from coming back again, he said. Blood centers keep track of those donors who actually faint, but not those who report feeling faint, so there is limited data documenting how many people experience these uncomfortable reactions. First-time donors are more likely to feel faint during donation.

Having studied blood donors throughout his career, France hopes that his research will eventually increase the rate of donor retention across the country. "I want the experience of the individual donor to be as pleasant as possible so they are encouraged to return," he said. He and his colleagues will compile data on the rate of return for the donors in this study who reported the most benefit from the video distraction technique. "We are optimistic that since many of these people had such a positive donation experience, they will be likely to give blood again in the near future."

France said that his group's ultimate goal is to receive funding from the National Institutes of Health so that the effect of distraction techniques on blood donors can be looked at in a larger context. Although people who tend to employ the monitoring strategy in stressful situations do not experience the same benefits from distraction as blunters do, he and his colleagues believe that monitors may be put at ease during donation because they are given a lot of information about the donation process. "Because previous studies indicate that the provision of detailed information before a stressful medical procedure is helpful to monitors, the American Red Cross standard procedure of providing careful and thorough information before donation is effective at alleviating anxiety and minimizing vasovagal reactions in this subgroup," the study authors wrote.

The equipment used to show the 3-D movie to study participants is expensive (costing about $500 per donor), said France, but noted that there are other, less costly strategies that first-time donors can employ to relieve anxiety and prevent negative donation reactions. He said that using a Walkman and headphones to drown out sounds around you has been shown to be helpful, as well as alternately flexing and relaxing leg and arm muscles for five-second intervals during donation. The muscle contractions help to raise blood pressure and prevent the onset of lightheadedness and dizziness, he said.

The Ohio University group is currently conducting a study in Montreal, Canada, which will hopefully give the researchers a better idea of how much of an impact a negative donation can have on a donor's inclination to give blood again. Data from the 1,200-person study will be analyzed next year, according to France.