Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Fam Pract. 2011 Dec;28(6):632-7. doi: 10.1093/fampra/cmr038. Epub 2011 Jul 10.
Influenza and pneumococcal diseases are responsible for more deaths than all other vaccine-preventable diseases combined. Despite all efforts, the vaccination rate is below target.
To assess knowledge and beliefs of family physicians in Lebanon regarding influenza and pneumococcal vaccines, to identify adult immunization barriers, to assess physicians' use of evidence-based strategies to improve adult immunization and identify barriers to implementation of such strategies.
All 52 Lebanese family physicians attending the annual family medicine conference in Beirut in November 2009 were asked to fill a self-administered questionnaire that included items inquiring about knowledge, beliefs, attitudes, barriers to these vaccines and their opinions regarding strategies to improve immunization rate.
Response rate was 82.7%. Accurate knowledge of influenza and pneumococcal vaccination guidelines was 58.1% and 53.5%, respectively. Thirty-eight physicians (88.4%) believe that influenza and pneumococcal vaccines are important, while 36 (83.7%) recommend influenza vaccine and 33 (76.7%) pneumococcal vaccine. Barriers for recommending vaccines were reported by 14 participants (32.5%). Concerning the influenza vaccine, the most commonly reported barriers were patient's refusal and non-availability of the vaccine, followed by physicians' concerns about efficacy and safety. As for the pneumococcal vaccine, the most frequently reported barriers were patient's refusal, cost and physicians concerns about efficacy. Insufficient time and unknown immunization status were reported to be barriers of lesser importance. Twenty-six physicians (61%) reported physicians' reminders as the most important intervention to promote adult immunization, followed by patient education (48%). Lack of time and availability of electronic medical record were cited as important strategies to increase adult immunization rate.
Education and intervention efforts are needed to overcome barriers faced by practitioners and to define the most effective strategies to overcoming these barriers.
流感和肺炎球菌疾病导致的死亡人数超过所有可通过疫苗预防的疾病死亡人数的总和。尽管已经做出了种种努力，但疫苗接种率仍未达到目标。
评估黎巴嫩家庭医生对流感和肺炎球菌疫苗的认知和信念，确定成人免疫接种的障碍，评估医生使用循证策略来提高成人免疫接种率并确定实施这些策略的障碍。
2009 年 11 月，在贝鲁特举行的年度家庭医学会议上，邀请所有 52 名黎巴嫩家庭医生填写一份自我管理问卷，其中包括询问他们对流感和肺炎球菌疫苗的知识、信念、态度、疫苗接种障碍以及对提高疫苗接种率的策略的看法。
应答率为 82.7%。对流感和肺炎球菌疫苗接种指南的准确了解率分别为 58.1%和 53.5%。38 名医生（88.4%）认为流感和肺炎球菌疫苗很重要，而 36 名（83.7%）推荐流感疫苗，33 名（76.7%）推荐肺炎球菌疫苗。有 14 名参与者（32.5%）报告了推荐疫苗的障碍。在流感疫苗方面，报告最多的障碍是患者拒绝和疫苗不可用，其次是医生对疗效和安全性的担忧。在肺炎球菌疫苗方面，报告最多的障碍是患者拒绝、费用和医生对疗效的担忧。报告时间不足和免疫接种状况未知被认为是不太重要的障碍。26 名医生（61%）报告医生提醒是促进成人免疫接种的最重要干预措施，其次是患者教育（48%）。缺乏时间和电子病历的可用性被认为是增加成人免疫接种率的重要策略。
需要开展教育和干预措施，以克服从业者面临的障碍，并确定克服这些障碍的最有效策略。
