Barriers and facilitators to seasonal influenza vaccination uptake among nurses: A mixed methods study. (15th April 2020) - Flanagan, Paula
Abstract: Aim: To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses. Background: Seasonal influenza causes significant mortality and morbidity among older people and high‐risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low. Design: An explanatory sequential mixed methods study design. Data Sources: Qualified nurses attending mandatory training in two large acute hospitals in Ireland. Methods: A paper‐based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses ( N = 462) between September 2017 – February 2018. A self‐selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 – October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process. Results: Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure. Conclusion: Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi‐faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence‐based knowledge, accessibility, and external cues to action. Impact: Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses. Abstract : 目的: 探讨护士接种季节性流感疫苗的助力及阻力因素。 背景信息: 季节性流感对于老年群体和高危群体具有极高的病死率和发病率。为护士接种流感疫苗是减轻疾病负担的重要公共卫生举措。然而, 尽管这个意见年年被提及, 但护士的流感疫苗接种率仍偏低。 设计: 解释性与顺序性的混合法研究设计。 数据来源: 在爱尔兰两所大型急症医院接受强制性培训的合格护士。 方法: 将调查护士医学知识、风险认知、健康信念和流感疫苗接种实践的纸质问卷分发给2017年9月至2018年2月间随机抽取的合格护士样本( N = 462)。在2018年9月至2018年10月期间, 邀请35名完成问卷调查的自选护士样本参加五个焦点小组, 深入探讨其疫苗接种实践相关的助力和阻力因素。然后对问卷数据进行统计分析, 在这些定性数据中采用主题分析的方法。利用支柱一体化流程整合定量和定性研究结果。 结果: 提出七大主题:(a)护士的医学知识对疫苗接种的影响;(b)信息的传播;(c)对疫苗的恐惧和担忧;(d)保护、风险和脆弱性:自我和他人;(e)影响者;(f)可获取性;(g)组织压力。 结论: 通过自愿疫苗接种方案在护士中实现高疫苗接种率仍存在挑战。应优先考虑基于健康信念模式的多方面流感活动, 以传播循证知识、可获取性和外部的行动线索。 影响: 护士偏低的流感疫苗接种率会危及患者的安全, 并对医疗卫生服务造成严重的负担。本研究确定了与护士接种疫苗相关的各类因素, 并将通报有关针对护士的具体介入治疗的进展。