“I don’t see an added value for myself”: a qualitative study exploring the social cognitive variables associated with influenza vaccination of Belgian, Dutch and German healthcare personnel

BMC Public Health

Gerjo Kok³  Dick van Dam¹  Sabine Wicker²  Robert AC Ruiter³  Birthe A Lehmann³ 

[1] Microbiology, Orbis Medisch en Zorgconcern, Postbus 5500, 6130 MB Sittard, The Netherlands;Betriebsärztlicher Dienst, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany;Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands

关键词: Social cognitive determinants;    Qualitative research;    Hospital;    Healthcare personnel;    Influenza vaccination;   

Others  :  1131475
DOI  :  10.1186/1471-2458-14-407

 received in 2014-01-15, accepted in 2014-04-03,  发布年份 2014

【 摘 要 】

Background

Health Authorities recommend influenza vaccination of healthcare personnel (HCP) to decrease the transmission of influenza to vulnerable patients. Recent studies have almost exclusively used quantitative questionnaires in order to identify determinants of vaccination behaviour. Interviews enable HCP to express freely why they think they are (not) willing to get vaccinated against influenza.

Methods

By means of semi-structured one-on-one interviews with 123 Belgian, Dutch and German HCP, reasons for and against vaccination, experiences with influenza vaccination, intention to get vaccinated and possible barriers, as well as willingness to advice influenza vaccination to patients were investigated. Data were processed with QSR NVivo 8.0 and analysed using a combination of a deductive and a general inductive approach.

Results

Across countries, self-protection, patient protection, and protection of family members were reported as most important reasons to get vaccinated against influenza. Reasons to not get vaccinated against influenza were fear of side effects caused by the vaccine, a low risk-perception, the disbelief in the effectiveness of influenza vaccination, organizational barriers, misconceptions, and undefined negative emotions.

Conclusions

The social cognitive variables underlying the decision of HCP to get vaccinated against influenza (or not) seem to be similar in Belgium, Germany, and the Netherlands, even though some differences surfaced. A quantitative investigation of those social cognitive variables is needed in order to determine the importance of the social cognitive variables in explaining the intention to get vaccinated and the importance of the similarities and differences between countries that have been found in this study.

【 授权许可】

   
2014 Lehmann et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]WHO Fact Sheets: Influenza (Seasonal). Geneva: World Health Organization (Fact Sheet No. 211); 2009.
• [2]WHO Position Paper: Influenza Vaccines. Geneva: World Health Organization (Weekly Epidemiological Record No. 33); 2005.
• [3]Mertz D, Kim TH, Johnstone J, Lam P-P, Science M, Kuster SP, Fadel SA, Tran D, Fernandez E, Bhatnagar N, Loeb M: Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. BMJ 2013, 347:1-16.
• [4]CDC: Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011, 60(RR07):1-45.
• [5]Ahmed F, Lindley MC, Allred N, Weinbaum CM, Grohskopf L: Effect of influenza vaccination of healthcare personnel on morbidity and mortality among patients: systematic review and grading of evidence. Clin Infect Dis 2014, 58:50-57.
• [6]Burls A, Jordan R, Barton P, Olowokure B, Wake B, Albon E, Hawker J: Vaccinating healthcare workers against influenza to protect the vulnerable – Is it a good use of healthcare resources? A systematic review of the evidence and an economic evaluation. Vaccine 2006, 24:4212-4221.
• [7]Nichol KL, Lind A, Margolis KL, Murdoch M, McFadden R, Hauge M, Magnan S, Drake M: The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995, 333:889-893.
• [8]Couto CR, Pannuti CS, Paz JP, Fink MCD, Machado AA, de Marchi M, Machado CM: Fighting misconceptions to improve compliance with influenza vaccination among health care workers: an educational project. PLoS One 2012, 7:1-6.
• [9]Llupià A, García-Basteiro AL, Olivé V, Costas L, Ríos J, Quesada S, Varela P, Bayas JM, Trilla A: New interventions to increase influenza vaccination rates in health care workers. Am J Infect Control 2010, 38:476-481.
• [10]McLennan S, Wicker S: Reflections on the influenza vaccination of healthcare workers. Vaccine 2010, 28:8061-8064.
• [11]Doratotaj S, Macknin ML, Worley S: A novel approach to improve influenza vaccination rates among health care professionals: a prospective randomized controlled trial. Am J Infect Control 2008, 36:301-303.
• [12]Maltezou HC, Maragos A, Katerelos P, Paisi A, Karageorgou K, Papadimitriou T, Pierroutsakos IN: Influenza vaccination acceptance among health-care workers: a nationwide survey. Vaccine 2008, 26:1408-1410.
• [13]Van Essen GA, Palache AM, Forleo E, Fedson DS: Influenza vaccination in 2000: recommendations and vaccine use in 50 developed and rapidly developing countries. Vaccine 2003, 21:1780-1785.
• [14]Blank PR, Schwenkglenks M, Szucs TD: Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect 2009, 58:441-453.
• [15]Talbot TR: Update on immunizations for healthcare personnel in the United States. Vaccine 2013. in press
• [16]Zimmerman RK, Santibanez TA, Janosky JE, Fine MJ, Raymund M, Wilson SA, Bardella IJ, Medsger AR, Nowalk MP: What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and veterans affairs practices. Am J Med 2003, 114:31-38.
• [17]Aguilar-Díaz FC, Jiménez-Corona ME, Ponce-de-León-Rosales S: Influenza vaccine and healthcare workers. Arch Med Res 2011, 42:652-657.
• [18]Hollmeyer HG, Hayden F, Poland G, Buchholz U: Influenza vaccination of health care workers in hospitals: a review of studies on attitudes and predictors. Vaccine 2009, 27:3935-3944.
• [19]Cohen DL, Casken J: Why are healthcare workers so resistant to the acceptance of influenza vaccine? a review of the literature to examine factors that influence vaccine acceptance. Int J Caring Sci 2012, 5:26-35.
• [20]Hofmann F, Ferracin C, Marsh G, Dumas R: Influenza vaccination of healthcare workers: a literature review of attitudes and beliefs. Infection 2006, 34:142-147.
• [21]Fishbein M, Ajzen I: Predicting and Changing Behavior: The Reasoned Action Approach. New York, NY: Psychology Press; 2010.
• [22]Patton MQ: Qualitative Evaluation and Research Methods. 2nd edition. Newbury Park: Sage Publications; 1990.
• [23]Elo S, Kyngäs H: The qualitative content analysis process. J Adv Nurs 2008, 62:107-115.
• [24]Clark JP: How to Peer Review a Qualitative Manuscript. In Peer Review in Health Sciences. 2nd edition. Edited by Godlee F, Jefferson T. London: BMJ Books; 2003:219-235.
• [25]Hakim H, Gaur AH, McCullers JA: Motivating factors for high rates of influenza vaccination among healthcare workers. Vaccine 2011, 29:5963-5969.
• [26]Smedley J, Poole J, Waclawski E, Stevens A, Harrison J, Watson J, Hayward A, Coggon D: Influenza immunization: attitudes and beliefs of UK healthcare workers. Occup Environ Med 2007, 64:223-227.
• [27]Looijmans-Van Den Akker I, Van Delden JJM, Verheij TJM, Van Essen GA, Van der Sande MAB, Hulscher ME, Hak E: Which determinants should be targeted to increase influenza vaccination uptake among health care workers in nursing homes? Vaccine 2009, 27:4724-4730.
• [28]Van den Dool C, van Strien AM, Looijmans-Van Den Akker I, Bonten MJM, Sanders EA, Hak E: Attitude of Dutch hospital personnel towards influenza vaccination. Vaccine 2008, 26:1297-1302.
• [29]Gintis H, Bowles S, Boyd R, Fehr E: Explaining altruistic behavior in humans. Evol Hum Behav 2003, 24:153-172.
• [30]Jones R: Declining altruism in medicine. Understanding medical altruism is important in workforce planning. BMJ 2002, 324:624-625.
• [31]Bridges CB, Kuehnert MJ, Hall CB: Transmission of influenza: implications for control in health care settings. Healthc Epidemiol 2003, 37:1094-1101.
• [32]Baron J, Ritov I: Omission bias, individual differences, and normality. Organ Behav Hum Decis Process 2004, 94:74-85.
• [33]Asch DA, Baron J, Hershey JC, Kunreuther H, Meszaros J, Ritov I, Spranca M: Omission bias and pertussis vaccination. Med Decis Making 1994, 14:118-123.