目的:研究表明,医生们对疫苗接种犹豫不决的父母(VHP)数量正在增加。这项研究检查了医生的疫苗接种知识,与VHP的疫苗相关讨论,对疫苗犹豫的信念和反应,以及在讨论使用VHP进行免疫接种时面临的挑战。
方法:这个横截面,描述性研究在沙特国王大学医学城(KSUMC)进行,利雅得,沙特阿拉伯,2020年9月。数据是通过电子邮件分发的问卷收集的。样本包括90名医生,他们经常治疗儿童,并报告他们在遇到VHP时经常进行适当的疫苗讨论。
结果:90名参与者(59%为女性)填写了问卷。其中,37.8%来自家庭医学,7.8%来自初级保健,54.4%来自儿科。讨论最多的话题是疫苗的必要性,拒绝接种疫苗的原因,和疫苗安全。17名参与者(18.8%)报告非常有信心,(42.2%)对他们的疫苗特异性知识充满信心。关于沟通技巧的信心,22.2%的人表示非常有信心,45.6%的人表示有信心。知识和沟通技巧的信心较高的决定因素是医生年龄(分别为p=0.001和p=0.0001),多年的实践(p=0.002和(p=0.005),和每个工作日看到的患者(p=0.0001和p=0.024)。其他因素,如医生性别(p=0.062),实践领域(p=0.329),和每周工作时间(p=0.061)没有显着差异。四十六位(51%)医生有时发现进行适当的疫苗相关讨论具有挑战性,因为在咨询期间有太多其他问题需要讨论。此外,53(59%)参与者同意/强烈同意父母拒绝接种疫苗会引起疏忽的怀疑。另一方面,59(65%)不同意/强烈不同意父母拒绝疫苗是父母的权利。与会者表示有必要将VHP转至具有出色经验和谈判技巧的专业咨询诊所,以克服挑战。
结论:疫苗安全性和必要性是VHP最关心的话题,和一个知识渊博的医生有能力的沟通技巧是关键在应对这种情况。这项研究强调了成功的疫苗相关讨论的最多障碍。它提出了基本的道德原则,例如父母的自主权以及在VHP中培训医生的必要性。为VHP的成功疫苗顾问培训理疗师。
OBJECTIVE: Research has shown that physicians are encountering an increase in vaccine-hesitant parents (VHPs) numbers. This
study examined physicians\' vaccination knowledge, vaccine-related discussions with VHPs, beliefs about and responses to vaccine hesitancy, and challenges faced while discussing immunization with VHPs.
METHODS: This cross-sectional, descriptive
study was performed at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, in September 2020. The data were collected through a questionnaire distributed via email. The sample comprised 90 physicians who routinely treat children and reported they frequently have appropriate vaccine discussions when encountering VHPs.
RESULTS: Ninety participants (59% were females) completed the questionnaire. Of these, 37.8% were from family medicine, 7.8% from primary care, and 54.4% from paediatrics. The most discussed topics were vaccine necessity, reasons for vaccine refusal, and vaccine safety. Seventeen participants (18.8%) reported being extremely confident, and (42.2%) were confident in their vaccine-specific knowledge. Regarding confidence in communication skills, 22.2% reported being extremely confident and (45.6%) were confident. Determinants of higher confidence in the knowledge and communication skills were physician age (p = 0.001 and p = 0.0001, respectively), years of practice (p = 0.002 and (p = 0.005), and patients seen per workday (p = 0.0001 and p = 0.024). Other factors such as physician sex (p = 0.062), the field of practice (p = 0.329), and hours of work per week (p = 0.061) were not significantly different. Forty-six (51%) physicians sometimes find it challenging to conduct appropriate vaccine-related discussions because of having too many other issues to discuss during the consultation. Furthermore, 53 (59%) participants agreed/strongly agreed that parental refusal to vaccinate would raise suspicions of negligence. On the other hand, 59 (65%) disagreed/strongly disagreed that parental refusal of vaccines is a parental right. Participants expressed the need to refer VHPs to a specialised advisory clinic with excellent experience and negotiation skills to overcome the challenges.
CONCLUSIONS: Vaccine safety and necessity are the topics of most concern to VHPs, and a knowledgeable physician with competent communication skills is critical in responding to such situations. This
study highlights the most reported barriers to successful vaccine-related discussions. It raises underlying ethical principles such as parental autonomy and the need to train physicians in VHPs. To train physians for succucful vaccine counceling of VHPs.