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新加坡父母对儿童季节性流感疫苗接种的看法:一项横断面调查。

Parental perceptions of childhood seasonal influenza vaccination in Singapore: A cross-sectional survey.

作者信息

Low Mabel S F, Tan Hweeyong, Hartman Mikael, Tam Clarence C, Hoo Cheehow, Lim Jiaqing, Chiow Simin, Lee Simin, Thng Renzhi, Cai Mingzhe, Tan Yanru, Lock Jingzhan

机构信息

Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore.

Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore.

出版信息

Vaccine. 2017 Oct 27;35(45):6096-6102. doi: 10.1016/j.vaccine.2017.09.060. Epub 2017 Sep 27.

Abstract

PURPOSE

Seasonal influenza vaccination is recommended in children aged 6-59months, but little is known about child vaccination coverage and determinants in Asian settings. We report the results of a survey of knowledge, attitudes, practices, and determinants of child influenza vaccination in Singapore.

METHODS

In December 2015-March 2016, we conducted a survey of 332 parents of children aged 6months to 5years attending pre-schools. We assessed child influenza vaccine coverage and parental knowledge, attitudes, and practices of child influenza vaccination. We used multivariable regression and structural equation models to identify factors associated with child influenza vaccination.

RESULTS

Knowledge about influenza, perceived benefit of vaccination, and willingness to vaccinate were high. However, only 32% of children had ever received influenza vaccine, and only 15% in the past year. Factors independently associated with child influenza vaccination included: being recommended influenza vaccine by a child's doctor (prevalence ratio (PR)=2.47, 95% CI: 1.75-3.48); receiving influenza vaccine information from a private general practitioner (PR=1.47, 95% CI: 1.05-2.04); regularly receiving pre-travel influenza vaccine (PR=1.64, 95% CI: 1.19-2.25); higher willingness to vaccinate (PR=1.58, 95% CI:1.24-2.04 per unit increase in willingness score); and feeling well-informed about influenza vaccine (PR=1.44, 95% CI: 1.04-1.99). Parents who obtained influenza vaccine information from television were less likely to have vaccinated their child (PR=0.44, 95% CI: 0.23-0.85). Path analysis indicated that being recommended vaccination by a child's doctor increased willingness to vaccinate and self-efficacy (feeling well-informed about influenza vaccine). Median willingness-to-pay for a dose of influenza vaccine was SGD30 (interquartile range: SGD20-SGD50), and was higher in parents of vaccinated compared with unvaccinated children (SGD45vs SGD30, p=0.0012).

CONCLUSION

Knowledge and willingness to vaccinate was high in this parent population, but influenza vaccine uptake in children was low. Encouraging medical professionals to recommend vaccination of eligible children is key to improving uptake.

摘要

目的

建议6至59个月大的儿童接种季节性流感疫苗,但在亚洲地区,对于儿童疫苗接种覆盖率及其决定因素知之甚少。我们报告了一项关于新加坡儿童流感疫苗接种的知识、态度、行为及决定因素的调查结果。

方法

2015年12月至2016年3月,我们对332名就读于幼儿园的6个月至5岁儿童的家长进行了一项调查。我们评估了儿童流感疫苗接种覆盖率以及家长对儿童流感疫苗接种的知识、态度和行为。我们使用多变量回归和结构方程模型来确定与儿童流感疫苗接种相关的因素。

结果

对流感的了解、对疫苗接种益处的认知以及接种意愿都很高。然而,只有32%的儿童曾经接种过流感疫苗,过去一年中只有15%。与儿童流感疫苗接种独立相关的因素包括:孩子的医生推荐流感疫苗(患病率比(PR)=2.47,95%置信区间:1.75 - 3.48);从私人全科医生处获得流感疫苗信息(PR = 1.47,95%置信区间:1.05 - 2.04);定期接种旅行前流感疫苗(PR = 1.64,95%置信区间:1.19 - 2.25);更高的接种意愿(PR = 1.58,接种意愿得分每增加一个单位,95%置信区间:1.24 - 2.04);以及自认为对流感疫苗充分了解(PR = 1.44,95%置信区间:1.04 - 1.99)。从电视获取流感疫苗信息的家长给孩子接种疫苗的可能性较小(PR = 0.44,95%置信区间:0.23 - 0.85)。路径分析表明,孩子的医生推荐接种疫苗会增加接种意愿和自我效能感(自认为对流感疫苗充分了解)。一剂流感疫苗的支付意愿中位数为30新元(四分位间距:20新元 - 50新元),接种孩子的家长比未接种孩子的家长支付意愿更高(45新元对30新元,p = 0.0012)。

结论

在这一家长群体中,对疫苗接种的知识和意愿较高,但儿童流感疫苗接种率较低。鼓励医疗专业人员推荐符合条件的儿童接种疫苗是提高接种率的关键。

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