Procedural Pain, Rather Than Donor-Perceived Needle Quality, Is Associated With Willingness to Donate Again: A Multicenter Cross-Sectional Study in Bangladesh

Background Retaining repeat blood donors is essential for maintaining a safe and sustainable blood supply. While pain during venepuncture has been linked to lower donor return, the influence of donor-perceived needle quality on future donation remains unclear, particularly in low- and middle-income countries. This study examined whether perceived needle quality was associated with willingness to donate again among blood donors in Bangladesh. Methods We conducted a cross-sectional analytical study among 100 consecutively recruited whole-blood donors from participating blood donation centres in Bangladesh. Participants completed a structured questionnaire assessing demographic characteristics, donation history, procedural pain using a 10-point Visual Analogue Scale (VAS), pre-donation fear, perceived needle quality, vasovagal symptoms, overall satisfaction, and willingness to donate again on a five-point ordinal scale. Univariable ordinal logistic regression was used for variable screening, followed by multivariable proportional-odds ordinal logistic regression with purposeful variable selection. Statistical significance was set at p < 0.05. Results The mean donor age was 35.8 +/- 11.8 years, and 88% of participants were male. High procedural pain (VAS >= 4) was reported by 73% of donors, whereas 48% expressed high willingness to donate again. After adjustment, procedural pain was the only independent predictor of future donation intention. Each one-point increase in pain score reduced the odds of greater willingness to donate again by 54% (adjusted OR 0.46, 95% CI 0.37-0.57; p < 0.001). Donor-perceived needle quality was not associated with willingness to donate again (adjusted OR 1.09, 95% CI 0.47-2.56; p = 0.840) and showed no association with procedural pain. Conclusions Procedural pain, rather than donor-perceived needle quality, was the principal determinant of willingness to donate again. Interventions that improve donor comfort and minimise venepuncture pain may strengthen donor retention. Larger prospective studies using actual donor return behaviour are warranted.