Perceived hazards of transfusion: can a clinician tool help patients' understanding?

To evaluate the use of a tool prompting counselling behaviour for blood transfusion by assessing clinicians' self-reported counselling behaviours, and changes in patients' beliefs about transfusion.

Mixed quantitative and qualitative methodology undertaken in two phases. In phase 1, clinicians' responses (n = 12) to a semi-structured questionnaire were analysed to identify the content of discussions with patients about different aspects of receiving a blood transfusion. The content of discussions was coded using illness representation concepts from the Common Sense Self-Regulation Model. Phase 2 included patients (n = 14) scheduled for elective surgery who completed a questionnaire on their beliefs about transfusion before and after counselling.

The most frequently coded illness representations targeted by clinicians using the tool were 'consequence of treatment' (32%) and 'cure/control' (30.5%). Two patient beliefs showed significant change following counselling using the checklist. After counselling, patients were more likely to disagree/strongly disagree with the statement that doctors relied too much on transfusion (P = 0.034) and more likely to agree/strongly agree that blood transfusion can result in new health problems (P = 0.041).

This pilot study provides insight into how clinicians use a tool for blood transfusion counselling and shows the potential to influence patients' beliefs about transfusion. Whilst the checklist has a role in standardising practice, this pilot study highlights the need for optimising its use before undertaking a fully randomised evaluation of the tool.