Johns Hopkins University, Baltimore, MD USA.
Emory University, Atlanta, GA, USA.
Health Educ Behav. 2020 Jun;47(3):449-456. doi: 10.1177/1090198120915432. Epub 2020 Apr 20.
Immunization is one of the most effective ways to prevent infectious diseases. However, vaccination rates are suboptimal in the United States. Obstetric providers are critical in influencing vaccine decision making among pregnant women, as trust between a patient and provider may facilitate willingness to accept vaccination. Little is known about how power between a patient and provider affects vaccine acceptance. This study explored pregnant women's trust in obstetric providers within the context of vaccines. Using concepts from the relational theory of power, we conducted 40 in-depth interviews with a purposive sample of pregnant women from four Ob-Gyn practices each in Georgia and Colorado. Results suggest that to enhance trust, providers could gain distributive power by conveying empathy. Designated power through medical experience was associated with both trust and distrust, as some women trusted their providers because of their authority and medical credentials, while others viewed authority and experience as reasons to distrust their provider. To increase acceptance, providers should acknowledge the underlying power dynamics within these interpersonal relationships and strengthen rapport with patients through empathy and dialogue.
免疫接种是预防传染病最有效的方法之一。然而，美国的疫苗接种率并不理想。妇产科医生在影响孕妇疫苗接种决策方面起着至关重要的作用，因为患者和医生之间的信任可能有助于接受疫苗接种。关于医患之间的权力如何影响疫苗接种接受程度，目前知之甚少。本研究探讨了在疫苗接种背景下孕妇对妇产科医生的信任。我们使用权力关系理论的概念，对来自佐治亚州和科罗拉多州四个妇产科诊所的 40 名孕妇进行了深入访谈。研究结果表明，为了增强信任，医生可以通过表达同理心来获得分配性权力。通过医疗经验获得的指定权力既与信任有关，也与不信任有关，因为一些女性信任她们的医生是因为他们的权威和医学背景，而另一些女性则认为权威和经验是不信任医生的原因。为了提高接受程度，医生应该承认这些人际关系中潜在的权力动态，并通过同理心和对话与患者建立良好关系。
