Securing replacement donors: Patients’ perspectives

Of the twenty-four patients who took part in this study, seventeen were requested by hospital staff to find one or more replacement donors, 11/17 of whom were male. 5/17 were admitted to the Surgery unit, 4/17 to Medicine, 3/17 to A&E, 3/17 to O&G and 2/17 to Child Health (see Figure 8.2). Every patient interviewed in the Surgery unit was asked to find replacement donors. Note, in this study, none of the surgical patients were in for elective surgery. The number of transfusions these patients had received at the time of interview ranged from one to five, with the average being 2.6 blood transfusions. Highest level of education achieved by these participants ranged from primary to post-secondary.

Figure 8.2. Distribution of participants requested to find one or more replacement donors according to unit admitted in

At the time of interview, six patients had not been requested to secure a replacement donor, 4/6 of who were male. 5/6 of these patients were admitted in the Child Health unit and 1/6 in O&G. 4/6 of the patients had only received one transfusion while the remaining two patients had received two and three transfusions each. The average number of blood transfusion patients, who were not approached to find a replacement donor, received was

2 12%

4 23%

3 18%

3 18%

5 29%

Child Health Medicine A&E O&G Surgery

1.5. Education level among these participants ranged from nil to JHS.

One female patient from the oncology ward with primary school education and who had received five transfusions was unsure as information concerning her transfusion was given to her son.

Timing of replacement donors’ blood donation with regards to patients’ blood transfusions

Pre-Transfusion

Some patients were asked to secure replacement donors before their blood transfusion.

This was most common among surgical patients, particularly for scheduled surgeries. The time elapsed between donation and transfusion varied. For example, one donor with a scheduled surgery said:

“They donated one week before my operation” (Male, 38 years, Surgery, SHS)

In contrast, another donor received the blood one day after his replacement donor donated.

Between multiple transfusions

Patients receiving multiple units were often asked to find replacement donors as needed.

As patients received additional blood transfusions they were asked to find additional replacement donors. For example:

“After the first one my brother came, after the second my other brother came, after the 3^rd one my sister came and after the 4^th another sister came. Any time I was given blood I was told I have to find someone to come and replace.” (Female, 22 years, O&G, SHS)

“I was first asked a week ago. I brought someone before the first transfusion. Then asked

to bring two more people as needed.” (Male, 56 years, Surgery, JHS)

In one case, the patient received the first unit before finding a replacement donor but required additional transfusions and was told to find donors. According to this patient:

“I got the first unit in 30 minutes. But they told me to get two people to come and donate blood. No one has come. I am still waiting for donors.” (Female, 39, O&G, JHS).

Post-Transfusion

Patients were sometimes asked to find a replacement donor post-transfusion. This was the case for one of the patients admitted in the Child Health unit:

“My husband donated after my child’s transfusion” (Female [patient’s mother], unknown, Child Health, SHS)

Number of people patients approached to donate blood

The number of people that patients or their caregivers approached to act as replacement donors ranged from zero to six, whereas the number of people who successfully donated blood for a given patient ranged from zero to four. One patient was unable to find anyone to donate blood. Another patient was asked to find three replacement donors, but three had low Hb and could not donate therefore he approached three more individuals. In contrast, in some cases patients were able to find more replacement donors than requested.

Relationship between patients and replacement donors

Immediate Family

Most patients interviewed requested their immediate family members to act as their replacement donors. This included parents, siblings and children.

Extended Family

In some cases the replacement donors secured were more distantly related to the patient.

For example, nieces, nephews, in-laws and other relatives donated for some of the patients interviewed.

Other Friends

In rare cases, patients said their friends or family’s friends had donated blood for them

Tenants

In one case, the replacement donors for the patient were her tenants.

Difficulty securing replacement donors?

“No difficulties”

The majority of participants interviewed stated that they did not encounter any difficulties in finding the requested number of replacement donors. These patients relied on immediate family, extended family and friends to act as replacement donors. The number of donors these patients were requested to find varied from one to four.

“Some difficulty”

Some patients did express some difficulties in finding replacement donors. The number of transfusions these patients received and the number of replacement donors they were requested to find varied between one and four. Most common was that the patient did not know anyone available to ask. Below are examples of these patients’ responses:

“Yes. It is difficult. I live alone.” (Male, 26 years, A&E, SHS)

“My husband and two brothers are not around so I asked tenants. I don’t know when they will come.” (Female, 39 years, O&G, JHS)

In one case, the patient had successfully found three replacement donors, but struggling to secure a fourth, as requested:

“[No difficulties] to get the first three. My husband has now gone to our hometown in the Western region to find the fourth.” (Female, 35 years, Surgery, JHS).

In another isolated case the patient suggested that he was having difficulty finding replacement donors who possessed the same blood type as the patient.

“Yes. I have B+ and their blood is not B+. If they had B+ I could take their blood.” (Male, 50 years, A&E, Primary)

Gift/compensations provided by patients to replacement donors

Donors were asked whether they had or would consider giving any type of gift or compensation to their replacement donors. Below are the results:

None

Most patients said that they would not give their replacement donors any gifts or compensation. Generally this was due to the close relationship patients had with the donors, and thus patients did not feel obliged to provide any compensation. For example:

“No [I did not give them anything] because they are my brothers and sisters.” (Female, 22 years, O&G, SHS)

“Oh, they are my good friend. I don’t have to give.” (Male, 36 years, Medicine, post-secondary)

Other

Food – In some cases patients provided or planned to give their replacement donors with food items such as local food or soda drinks. In these cases, donors did not ask for any food items and patients provided this free willingly. For example:

“If they donate I will give them milo or malt […] no, [the donors] did not ask for anything.”

(Female, 39 years, O&G, JHS)

Money – There were cases where patients compensated (or were willing to compensate) their donors with money. In one case the donor was having difficulty finding replacement donors and said he would be willing to negotiate a price with potential donors, though he was unsure of what would be a fair price. In another case, the patient’s grandmother gave the patient 10 Ghana Cedis to give to the donor (the patient’s brother-in-law), though the donor had not requested anything. In an isolated case, the patient provided monetary compensation to the donor because the donors had asked for it. According to this patient: