Academic Collaborative Centre AMPHI, Dpt of Primary and Community Care, Radboud University Nijmegen Medical Centre, Geert Grooteplein 21, 6525, EZ Nijmegen, The Netherlands.
BMC Health Serv Res. 2012 Aug 1;12:231. doi: 10.1186/1472-6963-12-231.
In recent years healthcare professionals have faced increasing concerns about the value of childhood vaccination and many find it difficult to deal with parents who object to vaccination. In general, healthcare professionals are advised to listen respectfully to the objections of parents, provide honest information, and attempt to correct any misperceptions regarding vaccination. Religious objections are one of the possible reasons for refusing vaccination. Although religious objections have a long history, little is known about the way healthcare professionals deal with these specific objections. The aim of this study is to gain insight into the responding of healthcare professionals to parents with religious objections to the vaccination of their children.
A qualitative interview study was conducted with health care professionals (HCPs) in the Netherlands who had ample experience with religious objections to vaccination. Purposeful sampling was applied in order to include HCPs with different professional and religious backgrounds. Data saturation was reached after 22 interviews, with 7 child health clinic doctors, 5 child health clinic nurses and 10 general practitioners. The interviews were thematically analyzed. Two analysts coded, reviewed, discussed, and refined the coding of the transcripts until consensus was reached. Emerging concepts were assessed using the constant comparative method from grounded theory.
Three manners of responding to religious objections to vaccination were identified: providing medical information, discussion of the decision-making process, and adoption of an authoritarian stance. All of the HCPs provided the parents with medical information. In addition, some HCPs discussed the decision-making process. They verified how the decision was made and if possible consequences were realized. Sometimes they also discussed religious considerations. Whether the decision-making process was discussed depended on the willingness of the parents to engage in such a discussion and on the religious background, attitudes, and communication skills of the HCPs. Only in cases of tetanus post-exposure-prophylaxis, general practitioners reported adoption of an authoritarian stance.
Given that the provision of medical information is generally not decisive for parents with religious objections to vaccination, we recommend HCPs to discuss the vaccination decision-making process, rather than to provide them with extra medical information.
近年来，医疗保健专业人员越来越关注儿童疫苗接种的价值，许多人发现很难与反对接种疫苗的家长打交道。一般来说，医疗保健专业人员被建议尊重地倾听家长的反对意见，提供诚实的信息，并试图纠正任何关于疫苗接种的误解。宗教反对是拒绝接种疫苗的可能原因之一。尽管宗教反对有很长的历史，但人们对医疗保健专业人员如何处理这些具体反对意见知之甚少。本研究旨在深入了解医疗保健专业人员对父母因宗教原因反对为其子女接种疫苗的反应。
对荷兰有丰富疫苗接种宗教反对经验的医疗保健专业人员（HCP）进行了定性访谈研究。采用目的性抽样，纳入具有不同专业和宗教背景的 HCP。对 7 名儿童健康诊所医生、5 名儿童健康诊所护士和 10 名全科医生进行了 22 次访谈，达到了数据饱和。采用主题分析方法对访谈进行分析。两名分析师对记录进行编码、审查、讨论和完善，直到达成共识。使用扎根理论的恒定比较法评估新出现的概念。
确定了三种应对疫苗接种宗教反对的方式：提供医学信息、讨论决策过程和采取权威立场。所有 HCP 都向家长提供了医学信息。此外，一些 HCP 还讨论了决策过程。他们核实了决策是如何做出的，以及是否意识到可能的后果。有时他们还讨论了宗教方面的考虑因素。是否讨论决策过程取决于家长是否愿意进行这样的讨论，以及 HCP 的宗教背景、态度和沟通技巧。只有在破伤风暴露后预防的情况下，全科医生才会采取权威立场。
鉴于向有宗教反对意见的家长提供医学信息一般不能决定他们的态度，我们建议 HCP 讨论疫苗接种决策过程，而不是向他们提供额外的医学信息。
