BMC Public Health | |
Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review | |
Ángel Gil2  José Manuel Estrada1  José Luis Del Barrio2  Camino Díaz3  Mª José Álvarez-Pasquin4  Raúl Herzog3  | |
[1] Virtual Library, Lain Entralgo Agency, Gran Vía 27, Madrid, Spain;Department of Preventive Medicine, Public Health, Medical Immunology and Microbiology, Rey Juan Carlos University, Avenida de Atenas s/n, Alcorcón, Spain;Primary Healthcare Service, Madrid Health Service, Santa Hortensia 14, Madrid, Spain;Spanish Association of Vaccinology, Madrid, Spain | |
关键词: Intentions; Coverage; Healthcare worker; Attitude; Belief; Knowledge; Vaccination; Immunization; | |
Others : 1162525 DOI : 10.1186/1471-2458-13-154 |
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received in 2012-03-23, accepted in 2013-01-31, 发布年份 2013 | |
【 摘 要 】
Background
The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers’ knowledge and beliefs about vaccines, and their attitudes towards them, to increase vaccination coverage. The aim of the study was to compile and analyze the areas of disagreement in the existing evidence about the relationship between healthcare workers’ knowledge, beliefs and attitudes about vaccines and their intentions to vaccinate the populations they serve.
Methods
We conducted a systematic search in four electronic databases for studies published in any of seven different languages between February 1998 and June 2009. We included studies conducted in developed countries that used statistical methods to relate or associate the variables included in our research question. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. The data were descriptively analyzed.
Results
Of the 2354 references identified in the initial search, 15 studies met the inclusion criteria. The diversity in the study designs and in the methods used to measure the variables made it impossible to integrate the results, and each study had to be assessed individually. All the studies found an association in the direction postulated by the SIEVE experts: among healthcare workers, higher awareness, beliefs that are more aligned with scientific evidence and more favorable attitudes toward vaccination were associated with greater intentions to vaccinate. All the studies included were cross-sectional; thus, no causal relationship between the variables was established.
Conclusion
The results suggest that interventions aimed at improving healthcare workers’ knowledge, beliefs and attitudes about vaccines should be encouraged, and their impact on vaccination coverage should be assessed.
【 授权许可】
2013 Herzog et al; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150413070838191.pdf | 665KB | download | |
Figure 1. | 70KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Centers for Disease Control and Prevention: Ten great public health achievements- United States 1900–1999. MMWR Morb Mortal Wkly Rep 1999, 48:1141-1147.
- [2]Barquet N, Domingo P, Smallpox: The triumph over the most terrible of the ministers of death. Ann Intern Med 1997, 127:635-642.
- [3]Muscat M, Bang H, Glismann S: Measles is still a cause for concern in Europe. Euro Surveill 2008, 13:pii=18837.
- [4]Van Treeck U: Measles outbreak in Germany: over 1000 cases now reported in Nordrhein Westfalen. Euro Surveill 2006, 11:pii=2955.
- [5]Mills EJ, Montori VM, Ross CP, Shea B, Wilson K, Guyatt GH: Systematically reviewing qualitative studies complements survey design: an exploratory study of barriers to pediatric immunisation. J Clin Epidemiol 2005, 58:1101-1108.
- [6]Mills E, Jadad A, Ross C, Wilson K: Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination. J Clin Epidemiol 2005, 58:1081-1088.
- [7]Nowalk MP, Zimmerman RK, Tabbarah M, Raymund M, Jewell IK: Determinants of adult vaccination at inner-city health centers: a descriptive study. BMC Fam Pract 2006, 7:2. BioMed Central Full Text
- [8]Schmitt HJ, Booy R, Weil-Olivier C, Van Damme P, Cohen R, Peltola H: Child vaccination policies in Europe: report from the Summits of independent European vaccination experts. Lancet Infect Dis 2003, 3:103-108.
- [9]Bedford H, Elliman D: Concerns about immunization. BMJ 2000, 320:240-243.
- [10]Llupià A, García-Basteiro AL, Mena G, Ríos J, Puig J, Bayas JM, Trilla A: Vaccination behaviour influences self-report of influenza vaccination status: a cross-sectional study among health care workers. PLoS One 2012, 7:e39496.
- [11]Prematunge C, Corace K, McCarthy A, Nair RC, Pugsley R, Garber G: Factors influencing pandemic influenza vaccination of healthcare workers-A systematic review. Vaccine 2012, 30:4733-4743.
- [12]European Vaccine Manufacturers: Survey regarding the Perception of Vaccines and Vaccinations. International Summary Report 2004. http://www.webcitation.org/query.php?url=http://www.evm-vaccines.org/pdfs/survey_perceptions.pdf&refdoi=10.1186/1741-7015-5-11 webcite
- [13]Navarro JA, Bernal PJ, Niguez JC: Analysis of factors influencing vaccine uptake:perspective from Spain. Vaccine 2001, 20(Suppl 1):13-15.
- [14]Bovier PA, Chamot E, Bouvier M, Loutan L: Importance of patients' perceptions and general practitioners' recommendations in understanding missed opportunities for immunisations in Swiss adults. Vaccine 2001, 19:4760-4767.
- [15]Centers for Disease Control and Prevention: Adult immunization: knowledge, attitudes and practices, DeKalb and Fulton Counties, Georgia, 1988. MMWR Morb Mortal Wkly Rep 1988, 37:657-661.
- [16]Gellin BG, Maibach EW, Marcuse EK: Do parents understand immunizations? A national telephone survey. Pediatrics 2000, 106:1097-1102.
- [17]Stefanoff P, Mamelund SE, Robinson M, Netterlid E, Tuells J, Bergsaker MA, Heijbel H, Yarwood J, VACSATC working group on standardization of attitudinal studies in Europe: Tracking parental attitudes on vaccination across European countries: The Vaccine Safety, Attitudes, Training and Communication Project (VACSATC). Vaccine 2010, 28:5731-5737.
- [18]Schmitt HJ, Booy R, Aston R, Van Damme P, Schumacher RF, Campins M, Rodrigo C, Heikkinen T, Weil-Oliver C, Finn A, Olcen P, Fedson D, Peltola H: How to optimise the coverage rates of infant and adult immunisation in Europe. BMC Med 2007, 5:11. BioMed Central Full Text
- [19]Gonik B, Jones T, Contreras D, Fasano N, Roberts C: The obstetrician-gynecologist’s role in vaccine-preventable diseases and immunization. Obstet Gynecol 2000, 96:81-84.
- [20]Schupfner R, Reimer B, Markuzzi A, Von Sonnenburg F: How do pediatricians in Munich perform vaccination?: a healthcare service research study. Soz Praventivmed 2002, 47:100-106.
- [21]Taylor JA, Darden PM, Brooks DA, Hendricks JW, Baker AE, Wasserman RC: Practitioner policies and beliefs and practice immunization rates: a study from Pediatric Research in Office Settings and the National Medical Association. Pediatrics 2002, 109:294-300.
- [22]Zimmerman RK, Mieczkowski TA, Mainzer HM, Medsger AR, Nowalk MP: Understanding physician agreement with varicella immunization guidelines. Prev Med 2002, 35:135-142.
- [23]Davis MM, Ndiaye SM, Freed GL, Clark SJ: One-year uptake of pneumococcal conjugate vaccine: a national survey of family physicians and pediatricians. J American Board of Fam Pract 2003, 16:363-371.
- [24]Milledge JT, Cooper CD, Woolfenden S: Barriers to immunization: attitudes of general practitioners to varicella, the disease and its vaccine. J Paediatr Child Health 2003, 39:368-371.
- [25]Jungbauer-Gans M, Kriwy P: Influence exercised by physicians on the vaccination rate. Gesundheitswesen 2003, 65:464-470.
- [26]Wilson K, Mills E, Boon H, Tomlinson G, Ritvo P: A survey of attitudes towards paediatric vaccinations amongst Canadian naturopathic students. Vaccine 2004, 22:329-334.
- [27]Russell ML, Injeyan HS, Verhoef MJ, Eliasziw M: Beliefs and behaviours: understanding chiropractors and immunization. Vaccine 2004, 23:372-379.
- [28]Petousis-Harris H, Goodyear-Smith F, Turner N, Soe B: Family practice nurse views on barriers to immunising children. Vaccine 2005, 23:2725-2730.
- [29]Clark SJ, Adolphe S, Davis MM, Cowan AE, Kretsinger K: Attitudes of US obstetricians toward a combined tetanus-diphtheria-acellular pertussis vaccine for adults. Infect Dis Obstet Gynecol 2006, 2006:87040.
- [30]Davis MM, Kretsinger K, Cowan AE, Stokley S, Clark SJ: New combined tetanus-diphtheria-acellular pertussis vaccines for adults: primary care physician attitudes and preferences. Hum Vaccin 2007, 3:130-134.
- [31]Gust D, Weber D, Weintraub E, Kennedy A, Soud F, Burns A: Physicians who do and do not recommend children get all vaccinations. J Health Commun 2008, 13:573-582.
- [32]Goodyear-Smith F, Grant C, Petoussis-Harris H, Turner N: Immunization champions: characteristics of general practitioners associated with better immunization delivery. Hum Vaccin 2009, 5:403-411.
- [33]Salmon DA, Pan WK, Omer SB, Navar AM, Orenstein W, Marcuse EK, Taylor J, deHart MP, Stokley S, Carter T, Halsey NA: Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children. Hum Vaccin 2008, 4:286-291.
- [34]Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson D, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB: Meta-analysis of observational studies in epidemiology. JAMA 2000, 283:2008-2012.
- [35]Gentile A, Bhutta Z, Bravo L, Samy AG, Garcia RD, Hoosen A, Islam T, Karimi A, Salem M, Simasathien S, Sohail A, Watanaveeradej V, Wiedenmayer K, Schmitt HJ: Pediatric disease burden and vaccination recommendations: understanding local differences. Int J Infect Dis 2010, 14:649-658.
- [36]Schaetti C, Ali SM, Chaignat CL, Khatib AM, Hutubessy R, Weiss MG: Improving community coverage of oral cholera mass vaccination campaigns: lessons learned in zanzibar. PLoS One 2012, 7:e41527.
- [37]Stang A: Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010, 25:603-605.
- [38]Yu IT, Tse SL: Workshop 6-sources of bias in cross-sectional studies; summary on sources of bias for different study designs. Hong Kong Med J 2012, 18:226-227.
- [39]Shaw JS, Samuels RC, Larusso EM, Bernstein HH: Impact of an encounter-based prompting system on resident vaccine administration performance and immunization knowledge. Pediatrics 2000, 105:978-983.
- [40]Boom JA, Nelson CS, Laufman LE, Kohrt AE, Kozinetz CA: Improvement in provider immunization knowledge and behaviors following a peer education intervention. Clin Pediatr (Phila) 2007, 46:706-717.
- [41]Sabnis SS, Pomeranz AJ, Amateau MM: The effect of education, feedback, and provider prompts on the rate of missed vaccine opportunities in a community health center. Clin Pediatr (Phila) 2003, 42:147-151.
- [42]Vorsters A, Tack S, Hendrickx G, Vladimirova N, Bonanni P, Pistol A, Metlicar T, Pasquin MJ, Mayer MA, Aronsson B, Heijbel H, Van Damme P: A summer school on vaccinology: responding to identified gaps in pre-service immunisation training of future health care workers. Vaccine 2010, 28:2053-2059.
- [43]Levi BH: Addressing parents’ concerns about childhood immunizations: a tutorial for primary care providers. Pediatrics 2007, 120:18-26.
- [44]Zimmerman RK, Barker WH, Strikas RA, Ahwesh ER, Mieczkowski TA, Janosky JE, Kanter SL: Developing curricula to promote preventive medicine skills: the teaching immunization for medical education (TIME) project. JAMA 1997, 278:705-711.
- [45]Franzini L, Boom J, Nelson C: Cost-effectiveness analysis of a practice based immunization education intervention. Ambul Pediatr 2007, 7:167-175.
- [46]Nicoll A, Elliman D, Begg NT: Immunisation: causes of failure and strategies and tactics for success. BMJ 1989, 299:808-812.
- [47]Rivera JA: Lo que Sócrates le diría a Woody Allen. Madrid: Espasa Calpe; 2008.
- [48]Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998, 351:637-641.
- [49]World economic and social survey 2006: Diverging Growth and Development. New York: United Nations Publications; 2006.
- [50]Injeyan HS, Russell ML, Verhoef MJ, Mutasingwa D: Canadian chiropractors' perception of educational preparation to counsel patients on immunization. J Manipulative Physiol Ther 2006, 29:643-650.
- [51]Davis MM, Broder KR, Cowan AE, Mijalski C, Katrina K, Stokley S, Clark SJ: Physician attitudes and preferences about combined Tdap vaccines for adolescents. Am J Prev Med 2006, 31:176-180.
- [52]Wilson K, Mills EJ, Norman G, Tomlinson G: Changing attitudes towards polio vaccination: a randomized trial of an evidence-based presentation versus a presentation from a polio survivor. Vaccine 2005, 23:3010-3015.
- [53]Salmon DA, Moulton LH, Omer SB, Chace LM, Klassen A, Talebian P, Halsey NA: Knowledge, attitudes, and beliefs of school nurses and personnel and associations with nonmedical immunization exemptions. Pediatrics 2004, 113:552-559.
- [54]Prislin R, Sawyer MH, Nader PR, Goerlitz M, De Guire M, Ho S: Provider-staff discrepancies in reported immunization knowledge and practices. Prev Med 2002, 34:554-561.
- [55]Prislin R, Sawyer MH, De Guire M, Brennan J, Holcomb K, Nader PR: Missed opportunities to immunize: psychosocial and practice correlates. Am J Prev Med 2002, 22:165-169.
- [56]Petrovic M, Roberts R, Ramsay M: Second dose of measles, mumps, and rubella vaccine: questionnaire survey of health professionals. BMJ 2001, 322:1120.
- [57]Zimmerman RK, Schlesselman JJ, Mieczkowski TA, Medsger AR, Raymund M: Physician concerns about vaccine adverse effects and potential litigation. Arch Pediatr Adolesc Med 1998, 152:7-10.
- [58]Mawn B, Pakkala K: Immunization update: a community-based nursing education program. J Contin Educ Nurs 2000, 31:101-110.
- [59]Petousis-Harris H, Goodyear-Smith F, Turner N, Soe B: Family physician perspectives on barriers to childhood immunisation. Vaccine 2004, 22:2340-2344.
- [60]Dionne M, Boulianne N, Duval B, Lavoie F, Laflamme N, Carsley J: Lack of conviction about vaccination in certain Quebec vaccinators. Can J Public Health 2001, 92:100-104.
- [61]Henderson R, Oates K, Macdonald H, Smith WC: General practitioners’ concerns about childhood immunisation and suggestions for improving professional support and vaccine uptake. Commun Dis Public Health 2004, 7:260-266.
- [62]Smith SW, Connery P, Knudsen K, Scott KL, Frintner MP, Outlaw G, Weingart S: Immunization practices and beliefs of physicians in suburban Cook County. Illinois. J Community Health 1999, 24:1-11.
- [63]Slora EJ, Steffes JM, Harris D, Clegg HW, Norton D, Darden PM, Sullivan SA, Wasserman RC: Improving pediatric practice immunization rates through distance-based quality improvement: a feasibility trial from PROS. Clin Pediatr (Phila) 2008, 47:25-36.
- [64]Cotter S, Ryan F, Hegarty H, McCabe TJ, Keane E: Immunisation: the views of parents and health professionals in Ireland. Euro Surveill 2003, 8:145-150.
- [65]Smith A, McCann R, McKinlay I: Second dose of MMR vaccine: health professionals’ level of confidence in the vaccine and attitudes towards the second dose. Commun Dis Public Health 2001, 4:273-277.
- [66]Lasserre A, Riviere M, Blanchon T, Alvarez F, Gaillat J, Romain O: Connaissance et application des recommandations vaccinales concernant la coqueluche par la médecine du travail des établissements de santé de Paris. Med Mal Infect 2009, 39:325-329.
- [67]Mahony A, Percival P, Condon R: Vaccine know-how. Kimberley immunisation study: community nurses immunisation education, knowledge and practice. Collegian 1999, 6:16-22.
- [68]Lehrke P, Nuebling M, Hofmann F, Stoessel U: Attitudes of homoeopathic physicians towards vaccination. Vaccine 2001, 19:4859-4864.
- [69]Ehresmann KR, Mills WA, Loewenson PR, Moore KA: Attitudes and practices regarding varicella vaccination among physicians in Minnesota: implications for public health and provider education. Am J Public Health 2000, 90:1917-1920.
- [70]Koepke CP, Vogel CA, Kohrt AE: Provider characteristics and behaviors as predictors of immunization coverage. Am J Prev Med 2001, 21:250-255.
- [71]Newman RD, Taylor JA: Reactions of pediatricians to the recommendation for universal varicella vaccination. Arch Pediatr Adolesc Med 1998, 152:792-796.
- [72]Sharkness CM, Goun BD, Davis LA, Sykes LE: Do we practice what we teach about childhood immunization in New Jersey? Fam Med 1998, 30:727-732.
- [73]Schaffer SJ, Bruno S: Varicella immunization practices and the factors that influence them. Arch Pediatr Adolesc Med 1999, 153:357.
- [74]Zucs AP, Crispin A, Eckl E, Weitkunat R, Schlipköter U: Risk factors for undervaccination against measles in a large sample of preschool children from rural Bavaria. Infection 2004, 32:127-133.