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Lyu P, Shi J, Hu J, Wang J, He X, Shi H. Barriers and facilitators to using ophthalmic clinical health services following school vision screening: a mixed-methods study. BMJ Paediatr Open 2024; 8:e002459. [PMID: 38631844 PMCID: PMC11029195 DOI: 10.1136/bmjpo-2023-002459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To identify determinants of the utilisation of ophthalmic clinical health services among students who failed school vision screening. METHODS This study employed a sequential explanatory mixed methods design, underpinned by Andersen's Behavioural Model of Health Service Utilisation. Data were initially gathered through interviews with 27 stakeholders-comprising 5 ophthalmologists, 7 community doctors, 7 public health professionals and 8 teachers. The qualitative insights informed the construction of a questionnaire, which subsequently garnered responses from 6215 participants. Qualitative data underwent thematic analysis with NVivo V.12, while quantitative data were analysed using multivariable multinomial logistic regression in SAS V.9.4. Data integration was performed using the Pillar Integration Process for a deductive, evidence-based synthesis of findings. RESULTS The research revealed that students attending vision demonstration schools and receiving encouragement from schools or communities to access clinical ophthalmic services demonstrated higher adherence to referral (OR=1.66, 95% CI 1.30 to 2.12; OR=1.54, 95% CI 1.33 to 1.80). Conversely, older students and those from higher-income families exhibited lower adherence rates (OR=0.31, 95% CI 0.23 to 0.44; OR=0.34, 95% CI 0.25 to 0.46). Moreover, students with less urgent medical needs were more likely to adhere to referrals compared with those needing immediate referrals (OR=1.24, 95% CI 1.06 to 1.45).Four pillars emerged: (a) adherence decreased with age, (b) financial constraints did not pose an obstacle, (c) public health services played a critical role, (d) referral urgency did not linearly correlate with adherence. CONCLUSION The utilisation of ophthalmic clinical health services following vision screening failure in students is significantly influenced by public health services provided by schools or communities, such as prompting those with abnormal screening results to access ophthalmic clinical health services.
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Affiliation(s)
- Pingping Lyu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, Shanghai, China
| | - Jiaojiao Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, Shanghai, China
| | - Jingwen Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, Shanghai, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai, Shanghai, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai, Shanghai, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, Shanghai, China
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2
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Skelton E, Webb R, Malamateniou C, Rutherford M, Ayers S. The impact of antenatal imaging on parent experience and prenatal attachment: a systematic review. J Reprod Infant Psychol 2024; 42:22-44. [PMID: 35736666 DOI: 10.1080/02646838.2022.2088710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 06/04/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Medical imaging in pregnancy (antenatal imaging) is routine. However, the effect of seeing fetal images on the parent-fetal relationship is not well understood, particularly for fathers or partners, or when using advanced imaging technologies. This review aimed to explore how parent experience and prenatal attachment is impacted by antenatal imaging. METHOD Database searches were performed between September 2020 and April 2021 Inclusion criteria were English language primary research studies published since 2000, describing or reporting measures of attachment after antenatal imaging in expectant parents. The Pillar Integration Process was used for integrative synthesis. FINDINGS Twenty-three studies were included. Six pillar themes were developed: 1) the scan experience begins before the scan appointment; 2) the scan as a pregnancy ritual; 3) feeling actively involved in the scan; 4) parents' priorities for knowledge and understanding of the scan change during pregnancy; 5) the importance of the parent-sonographer partnership during scanning; and 6) scans help to create a social identity for the unborn baby. CONCLUSION Antenatal imaging can enhance prenatal attachment. Parents value working collaboratively with sonographers to be actively involved in the experience. Sonographers can help facilitate attachment by delivering parent-centred care tailored to parents' emotional and knowledge needs.
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Affiliation(s)
- Emily Skelton
- Division of Radiography and Midwifery, City University of London, London, UK
| | - Rebecca Webb
- Centre for Maternal and Child Health Research, City University of London, London, UK
| | | | | | - Susan Ayers
- Centre for Maternal and Child Health Research, City University of London, London, UK
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Prieto-Campo Á, Batista AD, Magalhães Silva T, Herdeiro MT, Roque F, Figueiras A, Zapata-Cachafeiro M. Understanding vaccination hesitation among health professionals: a systematic review of qualitative studies. Public Health 2024; 226:17-26. [PMID: 37980837 DOI: 10.1016/j.puhe.2023.10.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES In terms of vaccination, people trust healthcare professionals (HCPs) more than any other source of information. They are the cornerstone of vaccination as they can move undecided populations not only towards vaccination but also towards non-vaccination. The aim of this systematic review was to explore the knowledge, beliefs, attitudes, and barriers associated with own vaccination and patient recommendation in HCPs. STUDY DESIGN This study incorporated a systematic review. METHODS A systematic review of studies published from January 1, 2000, to June 1, 2020, was conducted by searching PubMed and EMBASE electronic databases. Qualitative studies reporting outcomes related to knowledge, attitudes, or barriers related to vaccination/recommendation by healthcare personnel were included. The guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. RESULTS From a total of 2916 studies identified, 36 articles met the inclusion criteria. Some of the factors cited by the HCP that may contribute to vaccine hesitancy were (a) concerns regarding safety or efficacy of vaccines (23 articles); (b) time constraints (21 articles); (c) lack of knowledge about the vaccination/vaccine (19 articles); (d) costs (13 articles); (e) distrust of pharmaceutical industry (8 articles); and (f) considering oneself insusceptible (7 articles), stock shortage (7 articles), lack of personnel (5 articles), and feelings of unnecessary vaccination (5 articles). CONCLUSIONS Our review suggests that interventions to combat vaccine hesitancy should increase HCP education on vaccine efficacy and safety, as well as intervene on health system factors such as cost and time per visit. In this way, we could tackle the problem of vaccine hesitancy, which seriously threatens global public health.
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Affiliation(s)
- Á Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - A D Batista
- Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal
| | - T Magalhães Silva
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - M T Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - F Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, no. ° 50, 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506, Covilhã, Portugal; Escola Superior de Saúde, Instituto Politécnico da Guarda Rua da Cadeia, 6300-035, Guarda, Portugal.
| | - A Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - M Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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4
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Flanagan P, Dowling M, Sezgin D, Mereckiene J, Murphy L, Giltenane M, Carr P, Gethin G. The effectiveness of interventions to improve the seasonal influenza vaccination uptake among nurses: A systematic review. J Infect Prev 2023; 24:268-277. [PMID: 37969468 PMCID: PMC10638950 DOI: 10.1177/17571774231208115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 09/30/2023] [Indexed: 11/17/2023] Open
Abstract
Background Seasonal influenza is a significant cause of mortality and morbidity worldwide. Despite annual recommendations, influenza vaccination uptake rates are disproportionately lower among nurses compared to other health care professionals, especially when compared to physicians. Nurses have an additional risk of exposure to influenza infection due to the nature of their work. Aim To determine the effectiveness of interventions in increasing seasonal influenza vaccination uptake among nurses. Methods Evidence on the effectiveness of interventions to improve seasonal influenza vaccination uptake among nurses was systematically reviewed. A comprehensive search of six electronic databases and grey literature was undertaken. A minimum of two reviewers completed study selection, data extraction and risk of bias assessment independently. Results One hundred and thirty-four studies were identified of which one cluster randomised trial met the inclusion criteria. The results of the included study found the implementation of an intervention with multiple components increased nurses' seasonal influenza vaccination rates during a single influenza season in geriatric healthcare settings in France. As the evidence in this review was very limited, it was not possible to make recommendations regarding which interventions were effective at increasing the seasonal influenza vaccination rate for nurses. Conclusion This systematic review highlights a lack of high-quality studies that assessed interventions to improve the seasonal influenza vaccination of nurses. In view of the likelihood of influenza and the coronavirus (COVID-19) pandemic occurring together, it is imperative to have evidence on effective interventions for the nursing workforce and for policy decision makers.
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Affiliation(s)
- Paula Flanagan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Duygu Sezgin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | | | - Louise Murphy
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Martina Giltenane
- School of Nursing and Midwifery, University of Limerick, Galway, Ireland
| | - Peter Carr
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Georgina Gethin
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
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Bellali T, Liamopoulou P, Karavasileiadou S, Almadani N, Galanis P, Kritsotakis G, Manomenidis G. Intention, Motivation, and Empowerment: Factors Associated with Seasonal Influenza Vaccination among Healthcare Workers (HCWs). Vaccines (Basel) 2023; 11:1508. [PMID: 37766184 PMCID: PMC10534342 DOI: 10.3390/vaccines11091508] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Vaccination against seasonal influenza has proven effective in preventing nosocomial influenza outbreaks among hospital patients and healthcare workers (HCWs). This study aims to explore the intention, motivation, and empowerment toward vaccination and vaccination advocacy as contributing factors for seasonal influenza vaccination in HCWs. METHODS A cross-sectional study in eight secondary hospitals in Greece was conducted from March to May 2022. An anonymous questionnaire was enclosed in an envelope and distributed to all participants, including questions on vaccine behavior and the MoVac-flu and MoVad scales. RESULTS A total of 296 participants completed the questionnaire. In multivariate logistic regression models adjusted for potential confounders, increased age, intention score, MoVac-flu scale score, and the presence of chronic diseases were significant predictors of influenza vaccination this year, while increased age, intention score, and presence of chronic diseases were predictors of vaccination every year. CONCLUSION Vaccination uptake is simultaneously affected by logical cognitive processes (intention), together with factors related to motivation and empowerment in distinct self-regulatory domains such as value, impact, knowledge, and autonomy. Interventions focused on these identified predictors may be used as a guide to increase HCWs' vaccination rates.
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Affiliation(s)
- Thalia Bellali
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus
- Faculty of Nursing, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Polyxeni Liamopoulou
- Faculty of Nursing, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Savvato Karavasileiadou
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (S.K.); (N.A.)
| | - Noura Almadani
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (S.K.); (N.A.)
| | - Petros Galanis
- Faculty of Nursing, National and Kapodistrian University of Athens, 11524 Athens, Greece;
| | - George Kritsotakis
- Department of Business Administration & Tourism, Hellenic Mediterranean University, 72300 Herakleion, Greece;
| | - Georgios Manomenidis
- Faculty of Nursing, International Hellenic University, Didimoteicho Branch, 57400 Thessaloniki, Greece;
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Tunisi GL, Ambrosi E, Zulianello G, Allegrini E, Provenzano D, Rizzello T, Canzan F. To Get Vaccinated or Not? The Vaccination Decision-Making by Healthcare Professionals Working in Haematology: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105901. [PMID: 37239627 DOI: 10.3390/ijerph20105901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Haematological patients are more susceptible to infections. Vaccination has always been the most effective primary prevention strategy, even during the COVID-19 pandemic. However, the efficacy of vaccines for some haematological patients is low. Although vaccination of Healthcare Workers (HCWs) could protect patients from vaccine-preventable diseases, there is evidence of a high level of hesitation among healthcare workers in Italy. The aim of this study was to explore the attitudes towards vaccination of HCWs caring for haematology patients. Qualitative descriptive design was conducted. Twenty-one HCWs were interviewed. Content analysis was applied to the qualitative data. The following themes were generated from the analysis: "Trust", "Decision-making process focusing on individual health", "Decision-making process focusing on community health", "Changing opinion", and "Two sides of vaccination commitment". The most hesitant HCWs were oriented towards individual health. They perceived a lack of benefit from vaccines, feared side effects, or were influenced by negative experiences of others. In contrast, community-health-oriented HCWs showed more positive attitudes towards vaccination. Some hesitant HCWs changed their opinion on vaccination because they began to reflect on the importance of vaccination for the community. The change in opinion of some HCWs interviewed provided insight into the importance of focusing organisational efforts on collective responsibility.
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Affiliation(s)
- Gian Luca Tunisi
- Servizio Professioni sanitarie Azienda Ospedaliera, Universitaria Integrata di Verona, 37100 Verona, Italy
| | - Elisa Ambrosi
- Dipartimento di Diagnostica e Sanità Pubblica, Università degli studi di Verona, 37100 Verona, Italy
| | - Giorgia Zulianello
- Department of General and Pancreatic Surgery, The Pancreas Institute, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy
| | - Elisabetta Allegrini
- Servizio Professioni sanitarie Azienda Ospedaliera, Universitaria Integrata di Verona, 37100 Verona, Italy
| | - Domenico Provenzano
- Servizio Professioni sanitarie Azienda Ospedaliera, Universitaria Integrata di Verona, 37100 Verona, Italy
| | - Tiziana Rizzello
- Unità di Ematologia, "Pia Fondazione Card G. Panico" Ospedale Tricase, 73100 Lecce, Italy
| | - Federica Canzan
- Dipartimento di Diagnostica e Sanità Pubblica, Università degli studi di Verona, 37100 Verona, Italy
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Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother 2022; 18:2041360. [PMID: 35290160 PMCID: PMC9009961 DOI: 10.1080/21645515.2022.2041360] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.
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Affiliation(s)
- D Pavlovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - P Sahoo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| | - E Karafillakis
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
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Alasmari A, Larson HJ, Karafillakis E. A mixed methods study of health care professionals’ attitudes towards vaccination in 15 countries. Vaccine X 2022; 12:100219. [PMID: 36193232 PMCID: PMC9526144 DOI: 10.1016/j.jvacx.2022.100219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/26/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background Health care professionals are widely considered to be the most trusted source of information on vaccine-related topics. However, several are reporting their own hesitancy around certain vaccines, influencing their intention to vaccinate themselves as well as influencing their recommendations to their patients and target population. Methods A mixed-methods approach was used including an online survey (n = 1,504) in 15 countries which aimed to determine drivers of HCPs vaccine confidence and examine how these drivers vary across nations. Thirty in-depth semi-structured interviews were conducted with 10 HCPs in a subset of three countries (France, Greece and Hungry) to explore barriers to HCPs vaccine uptake and their role in addressing vaccine hesitancy among patients. Findings. The survey’s regression analysis identified that nurses/midwives and HCPs from Hungary, Italy, Romania and Switzerland were less confident in the safety, importance or effectiveness of vaccines in general. Morocco (35%), Turkey (53%) and Greece (69%) reported the lowest influenza vaccination coverage among HCPs. Morocco also reported the lowest rates of HCPs who were “highly likely” to recommend MMR vaccine (34%), HPV vaccine (31%) and Covid-19 vaccines (29%). More than third of HCPs reported a lack of trust in health authorities and in the information they provide. Thematic analysis revealed that concerns over the risk of side-effects associated with vaccines, preference for natural immunity, whether it was necessary to be vaccinated against influenza every year, not having any chronic disease risk factors, and vaccines mandates as the key barriers to HCPs vaccination against influenza and Covid-19. Conclusion HCPs have an important role in vaccination and their confidence in vaccination and health authorities must be improved as this may affect their uptake of vaccines and influence their recommendations to their patients. Investigating the impact of political, socio-economic and cultural contexts on concerns about vaccination among HCPs is also necessary.
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Affiliation(s)
- Abrar Alasmari
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Corresponding author.
| | - Heidi J. Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Health Metrics Sciences, University of Washington, Seattle, United States
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Emilie Karafillakis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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9
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Barriers associated with seasonal influenza vaccination uptake among nurses: A cross-sectional study. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1185982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Aim: The aim of this study is to evaluate the barriers associated with seasonal influenza vaccination uptake among nurses
Material and Method: This web-based survey conducted in Turkey, from November to December 2021. A cross-sectional study included 390 nurses. The data were collected online by the researchers through a survey form that prepared in line with the literature. Descriptive statistics and chi-square analysis were used to evaluate the data (p
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Zhang E, Dai Z, Wang C, Hu J, Wang S, Zhang L, Fang Q. Targeting COVID-19 vaccine hesitancy among nurses in Shanghai: A latent profile analysis. Front Public Health 2022; 10:953850. [PMID: 36187664 PMCID: PMC9515966 DOI: 10.3389/fpubh.2022.953850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/23/2022] [Indexed: 01/24/2023] Open
Abstract
Objectives This study aims to clarify the profiles of the psychological antecedents of vaccine hesitancy among Shanghai nurses with a person-centered approach. Methods A population-based cross-sectional online survey was conducted on Shanghai nurses from July to August 2021 (N = 1,928). In the online survey, participants were asked to report their sociodemographic, the 5C vaccine hesitancy components, their knowledge level of COVID-19 vaccine and vaccination, and the COVID-19 vaccination uptake intention and attention to vaccine news. Latent profile analysis was used to reveal distinct profiles of vaccine hesitancy. Results The results revealed four profiles, including "believers" (68.9%; high confidence and collective responsibility), "free riders" (12.7%; similar characteristics to believers, except for a low collective responsibility), "middlemen" (14.6%; middle in all 5C constructs), and "contradictors" (3.7%; high in all 5C constructs). Compared to believers, middlemen were younger, more likely to be female, childless, less educated, held lower professional titles, had fewer years of nursing service, sometimes or never complied with recommended vaccinations, had satisfactory or poor self-assessed health status, had no work experience during the COVID-19 epidemic, and possessed greater levels of knowledge. Free riders were more likely to work in community health centers and have a lower degree than believers. Contradictors were more likely to work in community health centers, had junior college degrees or lower, and had no work experience during the COVID-19 epidemic than believers. From the highest to the lowest on vaccination intention and attention to vaccine news were believers, then free riders, contradictors, and finally middlemen. Conclusion This study could aid in the development of personalized vaccination strategies based on nurses' vaccine hesitancy profiles and predictors. In addition to vaccine believers, we identified other three profiles based on their 5C psychological antecedents, emphasizing the significance of establishing tailored vaccination campaigns. Further research into the prevalence of profile structure in other groups of healthcare workers is required.
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Affiliation(s)
- Enming Zhang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengyue Dai
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caifeng Wang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiale Hu
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Suxing Wang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Qiong Fang
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Barattucci M, Pagliaro S, Ballone C, Teresi M, Consoli C, Garofalo A, De Giorgio A, Ramaci T. Trust in Science as a Possible Mediator between Different Antecedents and COVID-19 Booster Vaccination Intention: An Integration of Health Belief Model (HBM) and Theory of Planned Behavior (TPB). Vaccines (Basel) 2022; 10:vaccines10071099. [PMID: 35891265 PMCID: PMC9320855 DOI: 10.3390/vaccines10071099] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 12/19/2022] Open
Abstract
As the literature highlights, many health behavior theories try to explain both social and psychological variables influencing an individual’s health behavior. This study integrates insights relative to the antecedents of getting vaccinated from health behavior theories, particularly including the health belief model (HBM), the theory of planned behavior (TPB), and the different socio-demographic factors. Furthermore, we considered the possible mechanism of impact of distrust in science on individuals’ hesitance and resistance to taking up SARS-CoV-2 vaccination in subjects living in Italy. A correlational study of 1095 subjects enrolled when the national vaccination campaign for the third dose was launched. A questionnaire was used to measure: Italian Risk Perception; subjective norm; trust in science, trust in the vaccine; fear of COVID-19; fear of the vaccine; perceived knowledge about SARS-CoV-2; booster vaccination intention. Principal results show that: (i) the positive relationship provided by HBM theory between perceptions of SARS-CoV-2 risk (vulnerability and severity) and intention to have the vaccine, through fear of COVID-19; (ii) the positive relationship between subjective norms and both trust in science and vaccination intention; (iii) that trust in science plays a crucial role in predicting vaccination intention. Finally, the results provided indications about a positive relationship between subjective norms and fear of COVID-19, and a full mediation role of trust in science in the relationships between determinants of both TPA and HBM, fear of COVID-19, and vaccination intention. In conclusion, an individual’s intention (not) to get vaccinated requires the consideration of a plethora of socio-psychological factors. However, overall, trust in science appears to be a key determinant of vaccination intention. Additional strategies promoting healthy behavior are needed.
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Affiliation(s)
- Massimiliano Barattucci
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
- Correspondence:
| | - Stefano Pagliaro
- Department of Neuroscience, Imaging and Clinical Sciences, University of Studies ‘Gabriele d’Annunzio’, 66100 Chieti, Italy; (S.P.); (C.B.); (M.T.)
| | - Chiara Ballone
- Department of Neuroscience, Imaging and Clinical Sciences, University of Studies ‘Gabriele d’Annunzio’, 66100 Chieti, Italy; (S.P.); (C.B.); (M.T.)
| | - Manuel Teresi
- Department of Neuroscience, Imaging and Clinical Sciences, University of Studies ‘Gabriele d’Annunzio’, 66100 Chieti, Italy; (S.P.); (C.B.); (M.T.)
| | - Carlo Consoli
- Koinè, Interdisciplinary Center for Psychology and Educational Sciences, 00185 Rome, Italy;
| | - Alice Garofalo
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (A.G.); (T.R.)
| | | | - Tiziana Ramaci
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (A.G.); (T.R.)
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Richards HL, Eustace J, O' Dwyer A, Wormald A, Curtin Y, Fortune DG. Healthcare workers use of psychological support resources during COVID-19; a mixed methods approach utilising Pillar Integration Analysis. PLoS One 2022; 17:e0267458. [PMID: 35476796 PMCID: PMC9045652 DOI: 10.1371/journal.pone.0267458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/08/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives We sought to examine healthcare workers (HCWs) utilisation of formal and informal psychological support resources in the workplace during the first and third waves of the COVID-19 pandemic in Ireland. Methods A convergent mixed methods approach was undertaken. Four hundred and thirty HCWs in the Mid West and South of Ireland responded to an online survey in terms of their use of psychological support resources during Wave 1 (April/May 2020) of COVID-19. Thirty-nine HCWs undertook in depth interviews at Wave 3 (January/February 2021), and a further quantitative survey was distributed and completed by 278 HCWs at this time. Quantitative data arising at Wave 1 and Wave 3, were synthesised with Qualitative data collected at Wave 3. A Pillar Integration Process (PIP) was utilised in the analysis of the quantitative and qualitative data. Results Five pillars were identified from the integration of results. These were: a) the primacy of peer support, b) the importance of psychologically informed management, c) a need to develop the organisational well-being ethos, d) support for all HCWs, and e) HCWs ideas for developing the well-being path. These pillars encapsulated a strong emphasis on collegial support, an emphasis on the need to support managers, a questioning of the current supports provided within the healthcare organisations and critical reflections on what HCWs viewed as most helpful for their future support needs. Conclusions HCWs who utilised supportive resources indicated ‘in house’ supports, primarily collegial resources, were the most frequently used and perceived as most helpful. While formal psychological supports were important, the mechanism by which such psychological support is made available, through utilising peer support structures and moving towards psychologically informed supervisors and workplaces is likely to be more sustainable and perceived more positively by HCWs.
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Affiliation(s)
- Helen L Richards
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Joseph Eustace
- Department of Nephrology, Cork University Hospital and HRB Clinical Research Facility at University College Cork, Cork, Ireland
| | - Amanda O' Dwyer
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Andrew Wormald
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Yvonne Curtin
- Department of Clinical Psychology, Mercy University Hospital, Cork, Ireland
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Dónal G Fortune
- Department of Psychology, University of Limerick, Limerick, Ireland
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Ahmad M, Akande A, Majid U. Health care provider trust in vaccination: a systematic review and qualitative meta-synthesis. Eur J Public Health 2022; 32:207-213. [PMID: 35021201 PMCID: PMC9090277 DOI: 10.1093/eurpub/ckab209] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing issue globally amongst various populations, including health care providers. This study explores the factors that influence vaccine hesitancy amongst nurses and physicians. METHODS We performed a qualitative meta-synthesis of 22 qualitative and mixed-method studies exploring the factors that may contribute to vaccine hesitancy amongst nurses and physicians. We included all articles that mentioned any aspect of trust concerning vaccination, including how trust may influence or contribute to vaccine hesitancy in nurses and physicians. RESULTS Our findings revealed that vaccine hesitancy amongst nurses stemmed predominantly from two factors: distrust in health authorities and their employers, and distrust in vaccine efficacy and safety. Both nurses and physicians had a precarious relationship with health authorities. Nurses felt that their employers and health authorities did not prioritize their health over patients' health, provided inaccurate and inconsistent vaccine information, and were mistrustful of pharmaceutical company motives. Like nurses, physicians were also skeptical of pharmaceutical company motives when it came to vaccination. Additionally, physicians also held doubts regarding vaccine efficacy and safety. CONCLUSIONS The relationship health care providers or their patients have with health authorities and other providers regarding vaccination serves as unsystematic clinical experiences that may bolster vaccine hesitancy. Providing accurate and tangible information to emphasize the safety and efficacy of vaccines to health care providers may help address their specific concerns that may ultimately increase vaccine uptake.
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Affiliation(s)
- Mobeen Ahmad
- Department of Internal Medicine, Abington Memorial Hospital/Abington-Jefferson Health, Abington, PA, USA
| | - Adebisi Akande
- Department of Biological Sciences, University of Toronto, Toronto, ON, Canada
| | - Umair Majid
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Akande A, Ahmad M, Majid U. A qualitative meta-synthesis on how autonomy promotes vaccine rejection or delay among health care providers. Health Promot Int 2022; 37:daab099. [PMID: 34171926 DOI: 10.1093/heapro/daab099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In spite of the overwhelming evidence that highlights the effectiveness of routine vaccination, an increasing number of people are refusing to follow recommended vaccination schedules. While the majority of research in this area has focussed on vaccine hesitancy in parents, there is little research on the factors that promote vaccine hesitancy in health care providers (HCPs). Identifying factors that promote vaccine hesitancy in HCPs is essential because it may help broaden our understanding of vaccine hesitancy in patients. Therefore, the goal of this investigation was to review 21 studies and examine how professional autonomy and risk perception may promote vaccine acceptance, rejection and delay in physicians and nurses. We found that vaccine hesitant nurses and physicians shared similar views towards vaccines; both groups believed that their decision to vaccinate was separate from their role as an HCP. This belief comprised of three themes: decisional autonomy, personal risk perception and alternatives to vaccination. Both groups believed that mandatory vaccine policies reduced their ability to decide whether vaccination was in their best interests. We argue that decisional autonomy may weaken risk perception of disease, which in turn may encourage beliefs and behaviours that reinforce a 'hero persona' that reduces appropriate preventive and hygiene measures. We employ the Health Belief Model to discuss the crucial role that risk perceptions may play in reinforcing autonomy in vaccine hesitant physician and nurses. We conclude this paper by providing a set of recommendations that aim to improve the decision-making process surrounding mandatory vaccinations for HCPs.
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Affiliation(s)
- Adebisi Akande
- Department of Biological Sciences, University of Toronto, Toronto, Canada
| | - Mobeen Ahmad
- Department of Internal Medicine, Abington Memorial Hospital/Abington-Jefferson Health, Abington, PA, USA
| | - Umair Majid
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Hall CM, Northam H, Webster A, Strickland K. Determinants of seasonal influenza vaccination hesitancy among healthcare personnel: An integrative review. J Clin Nurs 2021; 31:2112-2124. [PMID: 34716635 DOI: 10.1111/jocn.16103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore the determinants of and behaviour change models for seasonal influenza vaccination compliance among healthcare personnel. BACKGROUND COVID-19 vaccine hesitancy among healthcare personnel may be better understood by exploring determinants of seasonal influenza vaccine hesitancy. DESIGN Integrative literature review. METHODS A systematic search was conducted in accordance with PRISMA guidelines. Six thousand and forty-eight articles were screened. Seventy-eight met inclusion criteria. Due to the heterogeneity of included articles, a narrative synthesis was conducted utilising a conceptual matrix to identify thematic categories. RESULTS Six thematic categories were identified as influencing HCP SIV compliance: 'perceived vulnerability', 'trust', 'past behaviour', 'professional duty', 'access and convenience' and 'knowledge and experience'. The Health Belief Model (HBM) was the most commonly utilised health behaviour change model within the seasonal influenza vaccination context. Few studies have examined seasonal influenza vaccine acceptance and uptake within the Australian HCP context, particularly involving community care and aged care. CONCLUSIONS Factors that appear to relate to influenza vaccination compliance among HCP can be grouped according to several thematic categories, and they also appear influential in COVID-19 vaccine uptake. In particular, an emerging focus on 'trust' or the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic. Efforts to influence these domains to increase compliance, however, are likely to be impeded by a lack of a well-developed and tested behaviour change model. RELEVANCE TO CLINICAL PRACTICE Healthcare personnel (HCP) face high levels of occupational exposure to seasonal influenza every year. An emerging focus on 'trust' and the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic.
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Affiliation(s)
- Caroline M Hall
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Holly Northam
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Adrian Webster
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Health Systems Group, Australian Institute of Health and Welfare, Canberra, Australian Capital Territory, Australia
| | - Karen Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, Canberra, Australian Capital Territory, Australia.,Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT, Auckland, New Zealand.,Robert Gordon University, Aberdeen, Scotland
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Rosental H, Shmueli L. Integrating Health Behavior Theories to Predict COVID-19 Vaccine Acceptance: Differences between Medical Students and Nursing Students. Vaccines (Basel) 2021; 9:783. [PMID: 34358199 PMCID: PMC8310115 DOI: 10.3390/vaccines9070783] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/23/2021] [Accepted: 07/09/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to explore behavioral-related factors predicting the intention of getting a COVID-19 vaccine among medical and nursing students using an integrative model combining the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). METHODS A cross-sectional online survey was conducted among medical and nursing students aged > 18 years in their clinical years in Israel between 27 August and 28 September 2020. Hierarchical logistic regression was used to predict acceptance of a COVID-19 vaccine. RESULTS A total number of 628 participants completed the survey. Medical students expressed higher intentions of getting vaccinated against COVID-19 than nursing students (88.1% vs. 76.2%, p < 0.01). The integrated model based on HBM and TPB was able to explain 66% of the variance (adjusted R2 = 0.66). Participants were more likely to be willing to get vaccinated if they reported higher levels of perceived susceptibility, benefits, barriers, cues to action, attitude, self-efficacy and anticipated regret. Two interaction effects revealed that male nurses had a higher intention of getting vaccinated than did female nurses and that susceptibility is a predictor of the intention of getting vaccinated only among nurses. CONCLUSIONS This study demonstrates that both models considered (i.e., HBM and TPB) are important for predicting the intention of getting a COVID-19 vaccine among medical and nursing students, and can help better guide intervention programs, based on components from both models. Our findings also highlight the importance of paying attention to a targeted group of female nurses, who expressed low vaccine acceptance.
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Affiliation(s)
| | - Liora Shmueli
- Department of Management, Bar-Ilan University, Ramat Gan 52900, Israel;
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Flanagan P, Dowling M, Gethin G. Mandatory vaccination for seasonal influenza: what are nurses' views? ACTA ACUST UNITED AC 2020; 29:1186-1191. [PMID: 33180612 DOI: 10.12968/bjon.2020.29.20.1186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Preventing seasonal influenza is a public health priority but, although the benefits of vaccinating healthcare workers (HCWs) are emphasised, seasonal influenza vaccine uptake rates remain low. Voluntary vaccination policies have been less successful in achieving high vaccine uptake when compared to mandatory policies and the persistently low vaccine uptake among HCWs has fuelled debate on whether mandatory vaccination programmes should be implemented in the interest of patient safety. AIM This study explored nurses' views on mandatory vaccination policy for seasonal influenza. METHODS A self-selected sample (n=35) of qualified nurses working in two large hospital sites in Ireland participated in five focus groups. Data were analysed using Braun and Clarke's framework. FINDINGS Two themes were identified: (1) mixed views on mandatory vaccination and (2) leave nurses to make their own choice on vaccination. CONCLUSION This study provides an understanding of nurses' views regarding mandatory vaccination policy for seasonal influenza and highlights that individual choice and autonomy are crucial for vaccine acceptance.
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Affiliation(s)
- Paula Flanagan
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Republic of Ireland
| | - Maura Dowling
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, Republic of Ireland
| | - Georgina Gethin
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, Adjunct Associate Professor School of Nursing, Monash University, Australia, and Director, Alliance for Research and Innovation in Wounds, National University of Ireland, Galway, Republic of Ireland
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