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采用团队协作方式推荐人乳头瘤病毒疫苗接种的重要性。

Importance of a team approach to recommending the human papillomavirus vaccination.

作者信息

Fontenot Holly B, Kornides Melanie L, McRee Annie-Laurie, Gilkey Melissa B

机构信息

WF Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.

Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts.

出版信息

J Am Assoc Nurse Pract. 2018 Jul;30(7):368-372. doi: 10.1097/JXX.0000000000000064.

Abstract

BACKGROUND AND PURPOSE

Few studies have examined human papillomavirus (HPV) vaccine communication in the context of the health care team.

METHODS

In 2016, the investigators conducted a national, online survey of U.S. parents who reported having discussed HPV vaccination with their adolescent's health care team. Multivariable logistic regression assessed associations between HPV vaccine initiation (≥1 dose) and having: 1) discussed HPV vaccination with multiple team members and 2) received congruent recommendations about HPV vaccination.

CONCLUSIONS

Of the 795 parents in the sample, about half (52%) reported discussing HPV vaccination with multiple team members, including nurse practitioners, nurses, and physicians. Most reported receiving congruent recommendations for (76%) or against (12%) HPV vaccination; few (12%) received mixed recommendations. Parents who discussed HPV vaccination with multiple team members had greater odds of series initiation (odds ratio [OR] = 2.34, 95% CI: 1.61-3.40), whereas those who received mixed versus congruent recommendations for HPV vaccination had lower odds of vaccination (OR = 0.56, 95% CI: 0.33-0.95).

IMPLICATIONS FOR PRACTICE

Findings suggest that a coordinated team approach to recommendations may encourage HPV vaccination. Nurse practitioners are well positioned to facilitate coordination efforts within their clinical practices.

摘要

背景与目的

很少有研究在医疗团队的背景下考察人乳头瘤病毒(HPV)疫苗的宣传情况。

方法

2016年,研究人员对美国那些报告称已与青少年的医疗团队讨论过HPV疫苗接种问题的父母进行了一项全国性在线调查。多变量逻辑回归分析评估了HPV疫苗起始接种(≥1剂)与以下情况之间的关联:1)与多名团队成员讨论过HPV疫苗接种;2)收到关于HPV疫苗接种的一致建议。

结论

在样本中的795名父母中,约一半(52%)报告称与包括执业护士、护士和医生在内的多名团队成员讨论过HPV疫苗接种。大多数人报告收到了关于接种HPV疫苗的一致建议(76%)或反对建议(12%);只有少数人(12%)收到了混合建议。与多名团队成员讨论过HPV疫苗接种的父母开始接种系列疫苗的几率更高(优势比[OR]=2.34,95%置信区间:1.61 - 3.40),而那些收到关于HPV疫苗接种的混合建议而非一致建议的父母接种疫苗的几率较低(OR = 0.56,95%置信区间:0.33 - 0.95)。

对实践的启示

研究结果表明,采用协调一致的团队方法提供建议可能会促进HPV疫苗接种。执业护士在其临床实践中很适合推动协调工作。

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