Freedman Tamlyn, Taddio Anna, McMurtry C Meghan, Wong Horace, MacDonald Noni, McDowall Tori, deVlaming-Kot Christene, Alderman Leslie
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.
University of Guelph, Guelph, Ontario.
Paediatr Child Health. 2019 Apr;24(Suppl 1):S19-S28. doi: 10.1093/pch/pxz017. Epub 2019 Mar 29.
Pain, fear, and fainting management during school-based vaccinations is suboptimal. The objective was to examine stakeholder perceptions of barriers and facilitators to better practices. Method: Six semi-structured focus groups were conducted in Niagara Region, Ontario: two parent groups (n=7); one grade 7 to 8 student group (n=9); two nurse groups (n=12); and one school staff group (n=6). Participants shared perceptions about school vaccination clinics and the implementation of specific strategies and tools. Focus groups were audio recorded and transcribed. The Consolidated Framework for Implementation Research (CFIR) was used as the framework for analysis.
Feedback from stakeholders was categorized into four domains of CFIR: intervention characteristics, inner setting, outer setting, and characteristics of individuals. Intervention characteristics included: vaccine educational materials, vaccination accommodations, distraction techniques, topical anaesthetics, and food. Inner setting factors included: school vaccination procedures, relationships between school staff and nurses, assessment and documentation of student fear, and factors that contribute to a chaotic vaccination clinic. Outer setting factors were: the social environment and addressing parent and student needs. Stakeholder roles were discussed in characteristics of individuals.
This study identified elements that can facilitate and challenge pain and fear mitigation tools and strategies; these elements should be considered in the development of a Knowledge Translation (KT) intervention to improve the school vaccination experience.
学校疫苗接种过程中的疼痛、恐惧和昏厥管理情况并不理想。本研究旨在探讨利益相关者对更好实践的障碍和促进因素的看法。方法:在安大略省尼亚加拉地区开展了6个半结构化焦点小组讨论:2个家长组(n = 7);1个七年级至八年级学生组(n = 9);2个护士组(n = 12);以及1个学校工作人员组(n = 6)。参与者分享了对学校疫苗接种诊所以及特定策略和工具实施情况的看法。焦点小组讨论进行了录音和转录。采用实施研究综合框架(CFIR)作为分析框架。
利益相关者的反馈被归类为CFIR的四个领域:干预特征、内部环境、外部环境和个体特征。干预特征包括:疫苗教育材料、接种设施、分散注意力技巧、局部麻醉剂和食物。内部环境因素包括:学校疫苗接种程序、学校工作人员与护士之间的关系、学生恐惧的评估和记录,以及导致疫苗接种诊所混乱的因素。外部环境因素有:社会环境以及满足家长和学生的需求。在个体特征中讨论了利益相关者的角色。
本研究确定了有助于和挑战减轻疼痛和恐惧工具及策略的因素;在开发知识转化(KT)干预措施以改善学校疫苗接种体验时应考虑这些因素。