|Year : 2019 | Volume
| Issue : 7 | Page : 2322-2327
Knowledge, attitude and practice of blood donation among health professions students in Saudi Arabia; A cross-sectional study
Mohammed A Alsalmi1, Hani M Almalki1, Abdulrahman A Alghamdi1, Badr A Aljasir2
1 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
2 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center; Department of Community and Preventive Medicine, King Abdulaziz Medical City, Ministry of the National Guard – Health Affairs, Jeddah, Saudi Arabia
|Date of Submission||23-May-2019|
|Date of Decision||26-May-2019|
|Date of Acceptance||10-Jun-2019|
|Date of Web Publication||31-Jul-2019|
Dr. Mohammed A Alsalmi
King Abdulaziz Medical City, Makkah - Jeddah Hwy, Jeddah 22384
Source of Support: None, Conflict of Interest: None
Introduction: World Health Organization advocates that 3-5% of the population should donate blood yearly. However, the donors in Saudi Arabia (SA) in 2011 represented 1.46% of the population. This study aimed to assess knowledge, attitude and practice concerning voluntary blood donation among health professions students in Saudi Arabia and to determine the associated factors. Methods: This is a cross sectional study on 598 students. Chi-square and Fisher tests were used to analyze the significant association of blood donation and influencing factors. Results: Majority of respondents (360; 60.2%) showed sufficient knowledge regrading blood donation. A total of 593 participants (99.2%) believed that blood donation is important for the community. Around 180 (30.1%) of the respondents have donated blood before. Out of the participants, 422 students (70.6%) reported that they did not take any courses concerning blood donation in their colleges. However, 502 (83.9%) showed a high willingness to donate blood if their colleges organize a blood donation camp within campus. There was a significant association between knowledge level, current academic level and gender with practice of blood donation. Conclusion: Saudi health professions colleges' role in promoting blood donation was notably missed. Students showed high willingness to donate blood if a blood camp was organized within the campus. The implementation of encouragement campaigns and educational sessions within the campus will have a great effect on blood donation.
Keywords: Blood donation, knowledge, perception, Saudi Arabia
|How to cite this article:|
Alsalmi MA, Almalki HM, Alghamdi AA, Aljasir BA. Knowledge, attitude and practice of blood donation among health professions students in Saudi Arabia; A cross-sectional study. J Family Med Prim Care 2019;8:2322-7
|How to cite this URL:|
Alsalmi MA, Almalki HM, Alghamdi AA, Aljasir BA. Knowledge, attitude and practice of blood donation among health professions students in Saudi Arabia; A cross-sectional study. J Family Med Prim Care [serial online] 2019 [cited 2020 Jul 4];8:2322-7. Available from: http://www.jfmpc.com/text.asp?2019/8/7/2322/263808
| Introduction|| |
Blood is an essential part of human life and blood donation has become a necessity that every society must take into consideration., Nowadays, both developing and developed countries are facing difficulties to find regulars donors. The number of blood banks in Saudi Arabia is 251. World Health Organization (WHO) advocates that 3-5% of the population should donate blood every year. Applying this recommendation in Saudi Arabia, in 2010, the whole population was 27,136,977, so the ideal number of donors would range from 814,109 to 1,356,849. However, the number of donations according to the central statistics in 2011: 341,688 blood units.
In Saudi Arabia, youths comprise high percent of its population. Out of them, healthcare professions students are one of the most that have knowledge of the importance of donation. Assessing awareness in them gives an insight to the level of awareness and the misbeliefs they may have.
The present study assessed the knowledge, attitude and practice concerning voluntary blood donation among health professions students in Saudi Arabia, and to determine the factors affecting blood donation.
| Methods|| |
Study design, sampling and sample size
A cross sectional study was conducted during the period between 2014 and 2015 on Saudi health professions students from 40 Saudi universities registered at Ministry of Education., This study has been approved by the Institutional Review Board of King Abdullah International Medical Research Center.
A quota sampling technique was used to ensure that the sample was representative. This was done based on the percentage that each major's students represent to the population, according to the latest statistics by the Saudi Ministry of Education in 2013., With 95% confidence level and 4% margin of error, the sample size was 598 participants. If the participants of one university did not respond, reminders were sent to them.
A new questionnaire, consisting of 3 sections and a total of 40 questions, was developed. The first section targeted sociodemographic characteristics. The second tested knowledge and attitude toward blood donation. The third investigated practice and barriers along with universities' role. Then it was translated into Arabic.
The questionnaire had been reviewed for face and content validation by preventive medicine and epidemiology experts in King Abdul-Aziz Medical City, Jeddah. A pilot study was conducted on 55 students at King Saud bin Abdul-Aziz University for Health Sciences in Jeddah. Finally, to check for the internal consistency, Cronbach's alpha was calculated for the 2 sections of the questionnaire to be 0.61 (knowledge and attitude) and 0.64 (practice and universities roles). The Cronbach's alpha for the study questionnaire was found to be 0.68.
Data management and analysis were done using Microsoft Office Excel 2013 and Statistical Package for Social Sciences (SPSS) version 23. Descriptive statistical analyses were used to report frequencies with percentages for categorical variables and means with standard deviations for continuous variables. The Chi-square test was used to assess for significant associations between practice of blood donation, knowledge level and demographic characteristics. Significant variables were further analyzed using multivariate regression analysis with results being reported as odds ratio (OR) and 95% confidence interval (CI). P value < 0.05 was considered of statistical significance.
| Results|| |
A total of 598 participants were included in the study (58% males and 42% females). The mean age of all participants was 21 ± 2. Most of the participants were students in public universities 91%. Details of demographic characteristics are summarized in [Table 1].
Knowledge and attitude toward blood donation
Out of 12 questions assessing the knowledge, the mean of right answers number by participants was 8 answers. The majority of respondents (360; 60.2%) showed sufficient knowledge (≥ 8 right answers to questions assessing knowledge), while (238; 39.8%) showed below average knowledge regrading blood donation. In terms of attitude towards blood donation, most of the sample delivered a positive attitude regarding blood donation. A total of 593 participants (99.2%) believed that blood donation is important for the community and 265 (44%) of them had a positive feeling about blood donation procedure followed in blood banks. Moreover, the majority reported willingness to donate blood upon request from relatives (586; 98%) or non-relatives in need (538; 90%). Details of answers to specific questions about knowledge and attitude toward blood donations are shown in [Table 2] and [Table 3], respectively.
Practice of blood donation and universities role in promotion
Patterns of blood donation practice and the barriers from regular blood donation are illustrated in [Table 4]. Around 180 (30.1%) of the respondents have donated blood before. Of them, 138 (76.6%) were males and 76 (42.2%) donated blood for once only. There was 429 (71.7%) participants who did not know that Saudi government offers awards for those who donate blood regularly. Around 65% of the participants believed that blood donation is a religious duty. Public media had a role in promotion of blood donation as 353 (59.0%) participants had come across calls for donation in public media.
|Table 4: Practice of blood donation among the participants and universities role in promotion (n=598)|
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Regarding the role of colleges in encouraging students to donate blood, 422 students (70.6%) reported that they did not take any courses or lectures concerning blood donation in their colleges. However, colleges of 337 (56.4%) participants had organized blood donation campaigns. Out of the students, 502 (83.9%) showed a high willingness to donate blood if their colleges organize a blood donation camp within campus.
Barriers and motivations for blood donation
The most common reported barrier from blood donation by donors was various fears from donation (67; 16%), in contrast to health reasons (85; 47.2%) according to non-donors. Around 286 (47.8%) students expressed that appreciation certificates are the best motivations for them to donate blood, while, while 226 (37.8%) preferred academic support such as bonus marks in the courses they take. Details of barriers and motivations for blood donation are shown in [Table 5].
|Table 5: Barriers and motivators to donate blood among the study sample (n=598)|
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Association between demographics, knowledge level and practice of blood donation
There was a significant association between knowledge level and practice of blood donation c 2 (1) =49.5, P value <0.001, between current academic level and the practice of blood donation c 2 (1) =10.95, P value = 0.001, and between gender and the practice of blood donation c 2 (1) =38.62, P value <0.001. On binary logistic regression, we found that students with sufficient knowledge were more likely to have donated blood before (OR = 4.94, 95% CI = 3.14-7.77), along with those in senior years (OR = 1.6, 95% CI = 1.06-2.41) and male students (OR = 4.61, 95% CI = 3.00-7.06). Details about association between demographics, knowledge level and practice of blood donation are shown in [Table 6].
|Table 6: Association between blood donation practice and multiple predictive variables (n=598)|
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| Discussion|| |
Blood donation is a life-saving procedure that necessitates counselling as an essential component of care for all individuals who present themselves for it. Counselling in primary health care limits the loss of donors, assist in the informed consent and detects risky donors. Understanding people's knowledge and attitude towards this procedure may aid family physicians in their interaction with such group.
The provision of enough storage of blood in Saudi Arabia represents a challenge to health service providers. Various causes contribute to this challenge such as the increase in population size as well as the number of medical facilities in Saudi Arabia. The present study has been conducted on all health profession students all over the Kingdom, to assess the various factors contributing to knowledge, attitude, and practice of blood donation.
In the current study, 30.1% of students reported a history of previous donation. Among males, 40.1% have donated blood, whereas only 16.5% of female students donated. Similarly, in another study in Saudi Arabia, 66% of males and 13% of females were previous donors. Also, percentage of donors in this study was higher than the number of donors in all-professions students in a previous study conducted on university students in Jeddah, where the donors' percentage was 19%. In the present study, the distribution of 180 donors (30%) according to their academic year in all health majors showed an increase in the donation process over progression in the academic years, which is similar to what was observed among medical students in Puducherry, India where increased of donation practice according to students' progression of academic year (1st year 10%, 2nd year 13% and 3rd year 24%).
This study results show an acceptable level of knowledge about blood donation. All of participants knew the common blood groups. Moreover, they expressed good knowledge in regards to who can donate blood and whether or not blood is required blood, which was found in 585 (97.8%) and 590 (98.7%), respectively. On the other hand, 361 (60.4%) expressed poor knowledge by thinking that a donor can be infected through blood donation. Also, it is interesting to notice that 50 out of the 598 do not know their blood group, which indicated a deficit personal knowledge, even though they have the basic knowledge about blood. Despite being of the same age group and living in the same country, non-health profession students exhibited lower level of knowledge, which was indicated in another study carried out in the Kingdom, where university students of different major exhibited a level of knowledge that was not up to the mark.
A significant proportion of the participants showed a strong willingness to donate blood to anonymous patients (90%). This can be interpreted as that altruism is a major factor for blood donation, which was similar to a study in which (83.3%) of students were voluntary blood donors  There are other factors that participants said they would be good motivators for them. Surprisingly, getting money compensation/gifts was not one of them. The best motivator was getting approved certificates (47.8%). Out of all participants, 85.6% rejected the idea of money compensation and gifts. The same was seen in another study in the Kingdom in 2008 where (75%) objected to money compensation.
Furthermore, the religious aspect plays an important role in motivating Saudis to donate blood. In the current study, 65% believed that blood donation is a religious duty. Higher rates have been reported in other studies in Saudi Arabia, (71%), (91%), respectively. This considerable response rate may partially be based on the Fatwa (religious ruling) that is placed in most donor centers in Saudi Arabia from the General Presidency of Scholarity Research and Ifta'a that advocates donating blood to save the life of patients.
Fear has been considered as the most commonly reported negative attitude on blood donation.,, In the current study, however, non-donor students reported that fear was one of the lowest reasons for not donating (10%). In contrast, donors believed that the main cause that discouraged non-donors from donating was fear (37%).
Saudi health professions colleges' role in promotion of donating blood was notably missed. Most of respondents reported that their colleges had never offer lectures regarding blood donation (70%), neither had they organized blood donation campaigns (56%). However, most of the participants showed willingness to donate blood if blood donation camps arranged within the campus (84%), and this finding is higher than another Saudi study conducted on university students (70%). So, blood campaigns can be conducted within universities campuses to provide comfortable access for students.
| Conclusion|| |
Both academic level and knowledge of blood donation were significantly associated with the practice. Also, colleges' role in promoting blood donation was notably missed. The implementation of encouragement campaigns that also address some of the false believes, may have a great effect.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Safizadeh H, Pourdamghan N, Mohamadi B. University student awareness and attitude toward blood donation in Kerman City. IJBC 2009;1:107-11.
Karim MR, Alam M, Farazi MMR, Labone RJ. Factors influencing blood donation behavior of university level student in Bangladesh. JIT 2012;1:35-40.
The General Population and Housing Census | General Authority for Statistics [Internet]. General Authority for Statistics. 2016 [cited 2019 May 10]. Available from: http://www.stats.gov.sa/en/13
Abolfotouh MA, Al-Assiri MH, Al-Omani M, Al Johar A, Al hakbani A, Alaskar AS. Public awareness of blood donation in Central Saudi Arabia. Int J Gen Med 2014;7:401-10.
Blood Donor Counselling. Geneva: World Health Organization; 2014.
Baig M, Habib H, Haji AH, Alsharief FT, Noor AM, Makki RG. Knowledge, misconceptions and motivations towards blood donation among university students in KSA. Pak J Med Sci 2013;29:1295-9.
Kowsalya V, Vijayakumar R, Chidambaram R. A study on knowledge, attitude and practice regarding voluntary blood donation among medical students in Puducherry, India. Pak J Biol Sci 2013;16:439-42.
Chauhan R, Kumar R, Thakur S. A study to assess the knowledge, attitude, and practices about blood donation among medical students of a medical college in North India. J Family Med Prim Care 2018;7:693-7.
] [Full text]
Abdel Gader A, Al Gahtani F, Ramadan A, Osman A, Farghali M, Al-Momen A. Attitude to blood donation in Saudi Arabia. Asian J Transfus Sci 2011;5:121-6.
Javadzadeh Shahshahani H, Yavari MT, Attar M, Ahmadiyeh MH. Knowledge, attitude and practice study about blood donation in the urban population of Yazd, Iran, 2004. Transfus Med 2006;16:403-9.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]