Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University.
Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo.
J Epidemiol. 2022 Sep 5;32(9):401-407. doi: 10.2188/jea.JE20200505. Epub 2021 Jul 17.
Increasing the coverage of vaccinations recommended by the World Health Organization in the older adult population is an urgent issue, especially in the context of avoiding co-epidemics during the current coronavirus disease 2019 crisis. The aim of this study was to examine factors associated with the quality of perceived patient-physician communication and whether this variable was associated with increased odds of vaccination.
We used cross-sectional data from the Japan Gerontological Evaluation Study conducted from October 2016 to January 2017. The participants were 22,253 physically and cognitively independent individuals aged 65 or older living in 39 municipalities in Japan. Multilevel logit models were used to estimate the odds of vaccination.
Among the participants, 40.0% and 58.8% had received pneumococcal and influenza vaccinations as per the recommended schedule, respectively. People with low educational levels were more likely to have a family physician but rate their experience in asking questions lower than those with higher educational levels. Having a family physician and high rating for physicians' listening attitude were positively associated with increased odds of pneumococcal and influenza vaccinations. High rating for patients' questioning attitude and shared decision-making, compared to an ambiguous attitude toward medical decision-making, were positively associated with increased odds of pneumococcal vaccination.
The results suggest that promotion of having a family physician, better patient-physician communication, and shared decision-making may encourage older adults to undergo recommended vaccinations.
提高世界卫生组织推荐的老年人疫苗接种覆盖率是一个紧迫的问题,尤其是在当前 2019 年冠状病毒病危机中避免同时发生传染病的背景下。本研究的目的是研究与感知医患沟通质量相关的因素,以及该变量是否与增加接种疫苗的几率相关。
我们使用了 2016 年 10 月至 2017 年 1 月期间进行的日本老年评估研究的横断面数据。参与者是居住在日本 39 个市町村的 22253 名身体和认知功能正常的 65 岁及以上老年人。采用多水平逻辑回归模型估计接种疫苗的几率。
在参与者中,分别有 40.0%和 58.8%的人按照推荐的时间表接种了肺炎球菌和流感疫苗。受教育程度较低的人更有可能有家庭医生,但他们对提问的体验评价低于受教育程度较高的人。有家庭医生和对医生倾听态度的高度评价与肺炎球菌和流感疫苗接种几率增加呈正相关。与对医疗决策的模糊态度相比,对患者提问态度和共同决策的高度评价与肺炎球菌疫苗接种几率增加呈正相关。
研究结果表明,促进有家庭医生、更好的医患沟通和共同决策可能会鼓励老年人接受推荐的疫苗接种。