Department of Ophthalmology, New York University School of Medicine, New York, NY 10021, USA.
Cornea. 2013 Jul;32(7):976-81. doi: 10.1097/ICO.0b013e318283453a.
To increase usage of the herpes zoster (HZ) vaccine at an academic medical center by studying physicians' knowledge, attitudes, practices, and perceived barriers and analyze the findings by practice setting.
A cross-sectional Internet-based survey administered to all 266 general internal medicine physicians in 4 clinical settings at an academic medical center between October 6 and December 12, 2011. Outcomes measures included knowledge questions regarding the disease and vaccine recommendations, Likert-type items about physician attitudes and practices, and questions about barriers and proposed interventions to improve utilization.
Response rate was 33.5% (89 of 266). Responders did not answer all questions. Only 66% (42 of 64) responded that HZ vaccination was an important clinical priority, and 48% (38 of 79) reported that less than 10% of their patients received the HZ vaccine. 95% responded that the influenza (61 of 64) and 92% that the pneumococcal (59 of 64) vaccines were important. Approximately 53% (42 of 79) and 51% (40 of 78) reported that more than 75% of their patients received these vaccines, respectively. Top barrier to vaccination was cost to patients (51 of 66; 77%). Lack of awareness of national recommendations (46 of 65, 71%) varied by setting. Physicians' preferred interventions included nurse-initiated prompting about vaccination (36 of 75, 48%) and chart reminders (34 of 74, 46%).
Not only increased knowledge but also a change in attitudes and practice are needed to enhance implementation of national recommendations. To improve use of this vaccine, physicians including ophthalmologists need to recommend it more strongly.
通过研究医师的知识、态度、实践以及对障碍的认知，提高学术医疗中心带状疱疹（HZ）疫苗的使用率，并按实践环境分析研究结果。
2011 年 10 月 6 日至 12 月 12 日，我们采用横断面互联网调查方式，向学术医疗中心 4 个临床科室的 266 名普通内科医师发放问卷。结果测量包括对疾病和疫苗推荐的知识问题、医师态度和实践的李克特量表项目以及对提高使用率的障碍和建议干预的问题。
应答率为 33.5%（266 名中的 89 名）。应答者并非回答了所有问题。只有 66%（64 名中的 42 名）的医师认为 HZ 疫苗接种是重要的临床重点，只有 48%（79 名中的 38 名）的医师报告其不到 10%的患者接种了 HZ 疫苗。95%（64 名中的 61 名）的医师认为流感疫苗重要，92%（64 名中的 59 名）的医师认为肺炎球菌疫苗重要。大约 53%（79 名中的 42 名）和 51%（78 名中的 40 名）的医师报告其分别有超过 75%的患者接种了这两种疫苗。接种的最大障碍是患者的费用（66 名中的 51 名；77%）。对国家推荐的认识不足（65 名中的 46 名；71%）存在科室差异。医师首选的干预措施包括护士主动提醒接种疫苗（75 名中的 36 名；48%）和图表提醒（74 名中的 34 名；46%）。
不仅需要增加知识，还需要改变态度和实践，以加强国家推荐的实施。为了提高这种疫苗的使用，包括眼科医生在内的医师需要更强烈地推荐这种疫苗。
