PSYCHOLOGICAL, BIOETHICAL, AND CARE-RELATED ASPECTS OF BLOOD TRANSFUSION: AN INTEGRATIVE LITERATURE REVIEW

Resumo

This integrative literature review examines the interdependent psychological, bioethical, and care-related dimensions that shape transfusion experiences and influence patient adherence, perceived safety, and clinical effectiveness. The analysis highlights emotional responses such as fear, hopelessness, and cumulative distress, demonstrating how these factors modulate threat appraisal, coping strategies, and willingness to engage with transfusion procedures. It further explores ethical tensions arising from compromised autonomy, treatment refusal, and conflicts between personal values and clinical recommendations, emphasizing that transfusion decisions unfold within morally complex settings that require continuous ethical mediation and clear communication between healthcare teams and patients. Within the care dimension, the study identifies strengths and weaknesses in hemovigilance systems, risk-management practices, and institutional protocols, showing how these elements affect both objective safety and subjective patient experience. The findings reveal that transfusion effectiveness cannot be reduced to technical execution, as it emerges from dynamic interactions between emotional regulation, ethical deliberation, and structured care environments. By integrating these perspectives, the study demonstrates that transfusion is a multidimensional process where subjective experiences, normative frameworks, and organizational structures intersect, creating conditions that either support or hinder treatment adherence and perceived security. The review concludes that comprehensive and interdisciplinary approaches are necessary to address these interconnected dimensions, advocating for emotionally attuned communication, ethically grounded decision-making, and systematically reinforced care practices that together enhance the quality and safety of transfusion therapy. These insights contribute to strengthening clinical protocols and guiding future research on the interface between psychology, bioethics, and healthcare delivery.