Pless Anina, Shaw David, McLennan Stuart, Elger Bernice S
Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
Institute for History, Ethics and Philosophy of Medicine, Medizinische Hochschule Hannover, Hannover, Germany.
Influenza Other Respir Viruses. 2017 May;11(3):247-253. doi: 10.1111/irv.12441. Epub 2017 Jan 31.
Despite studies demonstrating that the annual influenza vaccination of healthcare workers reduces morbidity and mortality among vulnerable patients, vaccination rates remain very low, particularly in nursing staff. Educational programmes have failed to improve rates, which has led to a diverse range of enforced approaches being advocated and implemented.
To examine the attitudes of non-vaccinated nursing staff towards various enforced measures aimed at increasing rates of influenza vaccination.
Semi-structured qualitative interviews with a purposive sample of 18 non-vaccinated nurses, working in units with high-risk patients at two hospitals in Switzerland. Analysis of interviews was done using conventional content analysis.
Nurses were critical of enforced measures. However, measures that include an element of choice were perceived as more acceptable. Declination forms and mandatory vaccinations as part of the employment requirements were found to be the most accepted measures.
The perception of choice is crucial to the acceptance of a measure. Respect for choice and autonomy has a positive effect on behavioural change. Mandatory influenza vaccination as a condition of new (and perhaps ongoing) employment could be a feasible, effective and ethical measure to increase vaccination rates among nurses who oppose vaccination.
尽管有研究表明医护人员每年接种流感疫苗可降低脆弱患者的发病率和死亡率，但疫苗接种率仍然很低，尤其是在护理人员中。教育项目未能提高接种率，这导致人们提倡并实施了一系列不同的强制措施。
研究未接种疫苗的护理人员对旨在提高流感疫苗接种率的各种强制措施的态度。
对瑞士两家医院中在高危患者病房工作的18名未接种疫苗的护士进行了有目的抽样的半结构化定性访谈。采用常规内容分析法对访谈进行分析。
护士们对强制措施持批评态度。然而，包含一定选择因素的措施被认为更容易接受。发现作为就业要求一部分的拒绝接种表格和强制接种是最能被接受的措施。
对选择的认知对于措施的接受至关重要。尊重选择和自主权对行为改变有积极影响。将强制流感疫苗接种作为新（或许也是持续的）就业条件，可能是提高反对接种疫苗的护士接种率的一项可行、有效且符合伦理的措施。
