Faculty of Nursing, Oslo University College, Norway.
J Adv Nurs. 2010 Nov;66(11):2421-30. doi: 10.1111/j.1365-2648.2010.05403.x. Epub 2010 Aug 16.
This paper is a report of a study conducted to identify parents' decision-making processes in relation to childhood vaccinations, including barriers and facilitators to searching for information.
Decision-making about childhood vaccinations is complex. Access to the best available evidence and the ability to obtain and understand such information are necessary for effective participation in decision-making.
A grounded theory approach was used, with semi-structured interviews and focus groups with parents (n = 10) and public health nurses (n = 16) conducted in 2008. Data were derived through incident-to-incident and axial coding.
Being positive towards vaccination and being decided were found to be main barriers to participation and obtaining information; other factors were perceptions about own abilities and capacity. Public health nurses were the parents' most important source of information, but tended to inform to facilitate vaccinations. Issues related to this and being inadequately informed were that some parents expressed low confidence about the decision they had made and uncertainty about their rights and responsibilities in decision-making.
Information delivered by public health nurses should not facilitate a specific choice but rather be balanced, explaining the benefits and harms, and accompanied by a qualified recommendation. Useful tools to improve practice may include checklists for shared decision-making and guidelines about trustworthy websites.
本研究旨在报告一项关于儿童疫苗接种决策的研究，包括父母获取信息的障碍和促进因素。
儿童疫苗接种决策是一个复杂的过程。为了有效参与决策，必须能够获得和理解最佳现有证据并获取相关信息。
2008 年采用扎根理论方法，对父母（n=10）和公共卫生护士（n=16）进行了半结构化访谈和焦点小组讨论。通过事件间和轴向编码获得数据。
对疫苗接种持积极态度和已做决定被认为是参与和获取信息的主要障碍；其他因素是对自身能力和能力的看法。公共卫生护士是父母最重要的信息来源，但往往是为了促进疫苗接种而提供信息。与这一点相关的问题以及信息不足的问题是，一些父母对自己做出的决定信心不足，对自己在决策中的权利和责任感到不确定。
公共卫生护士提供的信息不应促进特定的选择，而应保持平衡，解释利弊，并附有合格的建议。改善实践的有用工具可能包括共同决策检查表和关于可信赖网站的指南。
