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全科医生实施国家人乳头瘤病毒疫苗接种计划的全国性调查。

National survey of general practitioners' experience of delivering the National Human Papillomavirus Vaccination Program.

作者信息

Brotherton Julia M L, Leask Julie, Jackson Cath, McCaffery Kirsten, Trevena Lyndal J

机构信息

Victorian Cytology Service, East Melbourne, Australia.

出版信息

Sex Health. 2010 Sep;7(3):291-8. doi: 10.1071/SH09135.

Abstract

BACKGROUND

Between 2007 and 2009, Australian general practitioners (GPs) were involved in implementing a population-based human papillomavirus (HPV) vaccination program. We investigated GPs' experiences of delivering the HPV vaccine to women aged 18-26.

METHODS

We posted a survey to 1000 GPs. The survey was informed by 12 domains incorporating constructs from psychological theories that focus on individual and environmental barriers and facilitators to effective implementation of evidence-based practice by health professionals.

RESULTS

The response rate was 32%. The 298 vaccinating GPs were positive about HPV vaccine implementation as part of their professional role as a worthwhile initiative within existing general practice infrastructure. They had more negative views about some aspects of program organisation, such as the timelines and potential adverse impacts on cervical screening rates. Vaccine safety was not a key concern. Actual levels of knowledge about HPV were moderate (mean score 3.41 out of 6 (s.d. 0.99)) and contrasted with self-rated knowledge, which was high (93% perceived their knowledge to be adequate). Notably, there were unrealistic expectations about the likely reduction in Pap abnormalities due to vaccination, which is important to clarify to avoid loss of confidence in the vaccine when this reduction does not eventuate.

CONCLUSIONS

Australian GPs viewed HPV vaccination of women aged 18-26 years as an integrated part of their routine practice, with positive attitudes regarding its benefits and achievability. GPs are well placed to implement mass immunisation programs as long as they are supported by effective and timely communication strategies and resources.

摘要

背景

2007年至2009年期间,澳大利亚全科医生参与实施了一项基于人群的人乳头瘤病毒(HPV)疫苗接种计划。我们调查了全科医生为18至26岁女性接种HPV疫苗的经历。

方法

我们向1000名全科医生发放了调查问卷。该调查由12个领域构成,这些领域纳入了心理学理论中的概念,重点关注个体和环境方面阻碍及促进健康专业人员有效实施循证实践的因素。

结果

回复率为32%。298名进行疫苗接种的全科医生对实施HPV疫苗接种持积极态度,认为这是其职业角色的一部分,是在现有全科医疗基础设施内一项有价值的举措。他们对计划组织的某些方面看法较为负面,比如时间安排以及对宫颈筛查率的潜在不利影响。疫苗安全性并非关键担忧因素。对HPV实际了解程度中等(平均得分3.41分,满分6分,标准差0.99),与自评知识水平形成对比,自评知识水平较高(93%认为自己知识充足)。值得注意的是,对于接种疫苗后巴氏涂片异常可能减少的情况存在不切实际的期望,澄清这一点很重要,以免在未出现这种减少情况时对疫苗失去信心。

结论

澳大利亚全科医生将为18至26岁女性接种HPV疫苗视为其日常工作的一部分,对其益处和可实现性持积极态度。只要有有效且及时的沟通策略和资源支持,全科医生很适合实施大规模免疫计划。

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