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希腊医疗专业人员对人乳头瘤病毒(HPV)疫苗的看法、国家政策建议以及他们在传播相关健康信息方面自身所扮演的角色。

Greek health professionals' perceptions of the HPV vaccine, state policy recommendations and their own role with regards to communication of relevant health information.

作者信息

Karamanidou Christina, Dimopoulos Kostas

机构信息

Department of Social and Educational Policy, University of Peloponnese, Damaskinou & Kolokotroni Str, 20100, Corinth, Greece.

出版信息

BMC Public Health. 2016 Jun 3;16:467. doi: 10.1186/s12889-016-2831-5.

Abstract

BACKGROUND

Every year in Europe 60,000 women develop cervical cancer and 30,000 die from the disease. HPV vaccines are currently believed to constitute an important element of cervical cancer control strategy. Currently in Greece, the HPV vaccine is given on demand after prescription by a healthcare professional. Health care professionals' role is key as they are in a position to discuss HPV vaccination with parents, adolescents and young women. This study is aiming to explore health care professionals' perceptions of the HPV vaccine, state policy recommendations and their own role with regards to communication of relevant health information.

METHODS

This was an in-depth, qualitative study, employing a stratified, purposeful sampling. Fifteen face-to-face, semi-structured interviews were conducted with health care professionals from a variety of disciplines: pediatrics, obstetrics and gynecology, infectious diseases, pharmacy, dermatology, general practice. Thematic qualitative analysis was used to analyze participants' accounts.

RESULTS

Five major themes were identified: health care professionals' perceptions towards the HPV vaccine (recognition of importance, concerns about safety, effectiveness and impact of long-term use), animosity between medical specialties (territorial disputes among professional bodies, role advocacy, role limitations), health care professionals' perceptions of the public's attitudes (effects of cultural beliefs, health professionals' attitudes, media and family), the role of the state (health policy issues, lack of guidance, unmet expectations) and their own role (provision of health information, sex education).

CONCLUSIONS

Health professionals' concerns, lack of role definition and uniform information provision have led to territorial disputes among professional bodies and distrust among different medical specialties. Positive and negative judgements deriving from a multitude of sources have resulted in the confusion of the general public, as manifested by low vaccination rates. Due to the lack of clear regulation of vaccination prescription, administration and mode of delivery, factors such as lack of knowledge, cultural beliefs and personal attitudes have shaped the vaccination landscape. These factors have neither been explored nor addressed prior to the initiation of this public health effort and as such there is an evident less than efficient use of resources.

摘要

背景

在欧洲,每年有6万名女性患上宫颈癌,3万人死于该疾病。目前,人乳头瘤病毒(HPV)疫苗被认为是宫颈癌控制策略的重要组成部分。目前在希腊,HPV疫苗需凭医疗保健专业人员的处方按需接种。医疗保健专业人员的作用至关重要,因为他们能够与家长、青少年及年轻女性讨论HPV疫苗接种问题。本研究旨在探讨医疗保健专业人员对HPV疫苗的看法、国家政策建议以及他们在传播相关健康信息方面的自身作用。

方法

这是一项深入的定性研究,采用分层、目的抽样法。对来自儿科、妇产科、传染病科、药学、皮肤科、全科医学等多个学科的医疗保健专业人员进行了15次面对面的半结构化访谈。采用主题定性分析法对参与者的叙述进行分析。

结果

确定了五个主要主题:医疗保健专业人员对HPV疫苗的看法(认识到其重要性、对安全性、有效性及长期使用影响的担忧)、医学专科之间的敌意(专业机构之间的地盘之争、角色倡导、角色限制)、医疗保健专业人员对公众态度的看法(文化信仰的影响、卫生专业人员的态度、媒体和家庭)、国家的作用(卫生政策问题、缺乏指导、期望未得到满足)以及他们自身的作用(提供健康信息、性教育)。

结论

卫生专业人员的担忧、角色定义不明确以及信息提供不统一导致了专业机构之间的地盘之争和不同医学专科之间的不信任。来自多种来源的正面和负面判断导致了公众的困惑,表现为疫苗接种率较低。由于疫苗接种处方、管理和接种方式缺乏明确规定,知识缺乏、文化信仰和个人态度等因素塑造了疫苗接种的局面。在这项公共卫生工作启动之前,这些因素既未得到探讨也未得到解决,因此资源利用明显效率低下。

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