Dixon-Woods Mary, Brown Hilary, Arthur Antony, Matthews Ruth, Jagger Carol
Department of Epidemiology and Public Health, University of Leicester, Leicester, UK.
J Health Serv Res Policy. 2004 Apr;9(2):85-90. doi: 10.1258/135581904322987490.
To follow up a trial of home-administered influenza vaccination of older people to explore reasons for their immunisation behaviour, including their views on the organisation of services.
Follow-up of original trial using analysis of records of 1865 older people and semi-structured interviews of 25 older people.
A once-off home visit does not appear to result in sustained changes in immunisation behaviour. Older people's behaviour appears to be largely explained by their beliefs about immunisation; the organisation of services may exert only small effects. Older people can be characterised as belonging to one of four groups in their orientation towards influenza vaccination: the 'faithful', who are keen to have vaccination; the 'converts', who have been persuaded of the benefits of vaccination and are likely to self-initiate appointments for vaccination; the 'easy-going', who require prompting for vaccination; and the 'sceptics', who perceive influenza vaccination to be ineffective or to be irrelevant for them because of their perceived inherent resistance to influenza. The last group sees vaccination as a form of interference and may be resistant to home visits to administer the vaccine.
Targets for immunising older people require more debate because of the delicate balance between achieving herd immunity and preserving autonomy and choice for older people.
对一项针对老年人家庭接种流感疫苗的试验进行随访，以探究其免疫行为的原因，包括他们对服务组织的看法。
通过分析1865名老年人的记录以及对25名老年人进行半结构化访谈，对原始试验进行随访。
一次性的家访似乎并未导致免疫行为的持续改变。老年人的行为很大程度上似乎由他们对免疫接种的信念所解释；服务组织可能仅产生微小影响。老年人在对待流感疫苗接种的态度上可分为四类：“忠实者”，热衷于接种疫苗；“转变者”，已被说服接种疫苗有益且可能自行预约接种；“随和者”，需要督促才会接种；“怀疑者”，认为流感疫苗接种无效或因自认为对流感有内在抵抗力而与己无关。最后一类将接种视为一种干扰形式，可能抵制上门接种疫苗。
由于在实现群体免疫与维护老年人的自主性和选择权之间存在微妙平衡，老年人免疫接种的目标需要更多讨论。
