School of Social Science, University of Western Australia, 35 Stirling Hwy, Crawley, Australia; Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Western Australia, Australia.
School of Public Health, Edward Ford Building A27, University of Sydney, Australia; National Centre for Immunisation Research & Surveillance, cnr Hawkesbury Rd & Hainsworth St, Westmead 2415, Australia.
Vaccine. 2018 Oct 22;36(44):6531-6539. doi: 10.1016/j.vaccine.2018.02.028. Epub 2018 Feb 23.
Vaccine hesitancy in industrialised countries is an area of concern. Health professionals play a significant role in parental vaccination decisions, however, to date the role of midwives has not been widely explored. This review sought to describe the attitudes and communication practices of midwives in developed countries towards childhood vaccines. Medline, Cinahl, PsychInfo, Embase and the grey literature were searched. Inclusion criteria were qualitative and quantitative studies reporting midwives' beliefs, attitudes and communication practices toward childhood vaccination. The search returned 366 articles, of which 359 were excluded by abstract. Two additional articles were identified from the grey literature and references, resulting in nine studies from five countries included in the review. Across the studies, the majority of midwives supported vaccination, although a spectrum of beliefs and concerns emerged. A minority expressed reservations about the scientific justification for vaccination, which focussed on what is not yet known rather than mistrust of current evidence. Most midwives felt that vaccines were safe; a minority were unsure, or believed they were unsafe. The majority of midwives agreed that childhood vaccines are necessary. Among those who expressed doubt, a commonly held opinion was that vaccine preventable diseases such as measles are relatively benign and didn't warrant vaccination against them. Finally, the midwifery model of care was shown to focus on providing individualised care, with parental choice being placed at a premium. The midwifery model care appears to differ in approach from others, possibly due to a difference in the underpinning philosophies. Research is needed to understand how midwives see vaccination, and why there appears to be a spectrum of views on the subject. This information will inform the development of resources tailored to the midwifery model of care, supporting midwives in advocating for childhood vaccination.
在工业化国家，疫苗犹豫是一个令人关注的问题。卫生专业人员在父母的疫苗接种决策中发挥着重要作用，但迄今为止，助产士的作用尚未得到广泛探讨。本综述旨在描述发达国家助产士对儿童疫苗的态度和沟通实践。检索了 Medline、Cinahl、PsychInfo、Embase 和灰色文献。纳入标准为报告助产士对儿童疫苗接种的信念、态度和沟通实践的定性和定量研究。检索共返回 366 篇文章，其中 359 篇通过摘要被排除。从灰色文献和参考文献中又确定了另外 2 篇文章，最终有来自 5 个国家的 9 项研究纳入综述。在这些研究中，大多数助产士支持接种疫苗，尽管出现了一系列不同的信念和关注点。少数人对疫苗接种的科学依据表示保留意见，主要集中在尚未了解的方面，而不是对现有证据的不信任。大多数助产士认为疫苗是安全的；少数人不确定，或认为不安全。大多数助产士认为儿童疫苗是必要的。在那些表示怀疑的人中，一种普遍的观点是，麻疹等可通过疫苗预防的疾病相对良性，不需要接种疫苗来预防。最后，助产士的护理模式被证明侧重于提供个性化护理，将父母的选择放在首位。助产士的护理模式在方法上似乎与其他模式不同，这可能是由于其背后的理念不同。需要研究以了解助产士如何看待疫苗接种，以及为什么对这一主题似乎存在不同的看法。这些信息将有助于为助产士护理模式量身定制资源，支持助产士倡导儿童疫苗接种。
