School of Pharmacy, University College Cork, Cork, Ireland.
School of Pharmacy, University College Cork, Cork, Ireland; Department of Pharmacy, Mercy University Hospital, Cork, Ireland.
Res Social Adm Pharm. 2019 Apr;15(4):331-337. doi: 10.1016/j.sapharm.2018.05.013. Epub 2018 May 22.
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. Three prophylactic HPV vaccines are available for the prevention of HPV-related disease. Despite clinical success, immunisation rates remain sub-optimal. The purpose of this systematic review is to synthesise qualitative literature to achieve an understanding of the drivers and barriers to HPV vaccine acceptability and to determine targets for an intervention to improve vaccine uptake.
The seven-step model of meta-ethnography described by Noblit and Hare was used. The quality of the studies was assessed using the CASP (Critical Appraisal Skills Programme) for qualitative research. The ENTREQ (Enhancing transparency in reporting the synthesis of qualitative research) statement was used to guide reporting of results.
Thirty-three studies were included in the final analysis, compiling the opinions of 1280 parents/guardians from 14 countries. Five key concepts that reflected the principal findings of studies were determined: is prevention better than cure; the fear of the unknown; limited knowledge and understanding; complex vaccination decisions and; parental responsibility. Third-order interpretations were developed and linked using a 'line of argument' to develop a conceptual model.
The majority of parents are motivated to protect their children and prevent disease. The link to sexual intercourse associated with the HPV vaccine often complicates the vaccination decision. Vaccine manufacturers, national healthcare systems and healthcare providers can reinforce the importance of HPV immunisation and reiterate the rationale behind vaccination recommendations, by providing unambiguous information in a timely manner, transparently addressing parental concerns regarding vaccine safety and efficacy, whilst taking account of cultural and religious sensitivities and varying health literacy levels. In recent years, there has been a reduction in HPV vaccine uptake worldwide. Currently, there is a paucity of published qualitative studies addressing these new vaccine concerns. Therefore, such research is required to guide intervention development, to improve HPV vaccine uptake.
人乳头瘤病毒（HPV）是生殖道最常见的病毒感染。目前有三种预防性 HPV 疫苗可用于预防 HPV 相关疾病。尽管临床效果显著，但疫苗接种率仍不理想。本系统评价旨在综合定性文献，了解 HPV 疫苗可接受性的驱动因素和障碍，并确定提高疫苗接种率的干预目标。
采用 Noblit 和 Hare 描述的元分析七步模型。使用 CASP（定性研究的批判性评价技巧方案）评估研究质量。使用 ENTREQ（提高定性研究综合报告透明度的声明）来指导结果报告。
最终分析纳入了 33 项研究，共收集了来自 14 个国家的 1280 名家长/监护人的意见。确定了反映研究主要结果的五个关键概念：预防胜于治疗；对未知的恐惧；知识和理解有限；复杂的疫苗接种决策；和父母的责任。开发了第三级解释，并使用“论证线”将其链接起来，以开发一个概念模型。
大多数家长都有保护孩子和预防疾病的动机。与 HPV 疫苗相关的性行为联系常常使疫苗接种决策复杂化。疫苗制造商、国家医疗保健系统和医疗保健提供者可以通过及时提供明确的信息、透明地解决父母对疫苗安全性和有效性的担忧，同时考虑到文化和宗教敏感性以及不同的健康素养水平，来强调 HPV 免疫接种的重要性并重申疫苗接种建议的理由，从而增强 HPV 疫苗接种的重要性。最近，全球 HPV 疫苗接种率有所下降。目前，针对这些新的疫苗问题，发表的定性研究很少。因此，需要开展此类研究来指导干预措施的制定，以提高 HPV 疫苗接种率。
