Costantino C, Restivo V, Gaglio V, Lanza G L M, Marotta C, Maida C M, Mazzucco W, Casuccio A, Torregrossa M V, Vitale F
Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, Italy.
Ann Ig. 2019 Jan-Feb;31(1):35-44. doi: 10.7416/ai.2019.2256.
Healthcare workers are continuously exposed to the risk of being infected by influenza viruses during their work, thus representing a threat especially for fragile patients. Although the Italian Ministry of Health strongly recommends influenza vaccination for all HCWs, coverage levels in Italy are still far from the expected. Several studies report that one of the preferred strategies to improve vaccination coverage among Healthcare Workers is improving vaccination knowledge through specific multidisciplinary courses. To assess the effectiveness of an educational intervention on influenza vaccination coverage among Healthcare Workers a study was conducted at "Paolo Giaccone" University Hospital of Palermo, in the occasion of the 2016/2017 seasonal influenza vaccination campaign.
Educational interventions on influenza infection and vaccination were organized involving personnel of the hospital units in which patients were more fragile. The Healthcare Workers who volunteered attend the course were considered as the intervention group, while two controls for each case, composed by Healthcare Workers not attending it, were randomly selected from the same unit. For both groups, a questionnaire was used to investigate attitude and behaviors toward influenza vaccination, while vaccination coverage data were obtained throughout the Hospital informational data system.
Overall, out of the 125 participants, 38 (30.4%) followed the course (intervention group) and 87 (69.6%), not attending the course, represented the control group; later, only 43 Healthcare Workers out of 125 (34.4%) underwent vaccination during the season considered. In particular, after the educational intervention, 42% of the attending Healthcare Workers got vaccinated, while vaccination prevalence in the control group was 31%. The Healthcare Workers who underwent vaccination reported, before the intervention, a higher risk perception for contracting (transmitting) influenza compared to those not vaccinated (p<0.05), while no significant difference in risk perception of transmitting influenza to their patients was reported between the two groups.
Despite the training provided, and an improvement in vaccination adherence by the Healthcare Workers involved, coverage obtained was lower than recommended to reduce influenza spread in hospital contexts. In conclusion, our data suggest that specific training alone may play a role in the improvement of influenza vaccination adherence, but it should be integrated by a wider range of public health measures, including mandatory vaccination.
医护人员在工作期间持续面临感染流感病毒的风险,因此对脆弱患者构成尤其严重的威胁。尽管意大利卫生部强烈建议所有医护人员接种流感疫苗,但意大利的接种覆盖率仍远低于预期。多项研究报告称,提高医护人员疫苗接种覆盖率的首选策略之一是通过特定的多学科课程提升接种知识。为评估一项教育干预措施对医护人员流感疫苗接种覆盖率的效果,在巴勒莫“保罗·贾科内”大学医院开展了一项研究,时间为2016/2017季节性流感疫苗接种活动期间。
针对患者较为脆弱的医院科室人员组织了关于流感感染和疫苗接种的教育干预活动。自愿参加课程的医护人员被视为干预组,而从同一科室中随机挑选出不参加课程的两名医护人员作为每个干预组病例的对照。对两组人员均使用问卷来调查其对流感疫苗接种的态度和行为,同时通过医院信息数据系统获取疫苗接种覆盖率数据。
总体而言,在125名参与者中,38人(30.4%)参加了课程(干预组),87人(69.6%)未参加课程,构成对照组;之后,在所考虑季节期间,125名医护人员中仅有43人(34.4%)接种了疫苗。具体而言,经过教育干预后,42%的参加课程的医护人员接种了疫苗,而对照组的接种率为31%。接种疫苗的医护人员在干预前报告的感染(传播)流感的风险认知高于未接种疫苗者(p<0.05),而两组在将流感传播给患者的风险认知方面未报告有显著差异。
尽管提供了培训,且参与的医护人员的疫苗接种依从性有所提高,但所获得的覆盖率仍低于在医院环境中减少流感传播所建议的水平。总之,我们的数据表明,仅特定培训可能在提高流感疫苗接种依从性方面发挥作用,但应通过包括强制接种在内的更广泛的公共卫生措施加以补充。