MacKenzie Nicole E, Tutelman Perri R, Chambers Christine T, Parker Jennifer A, MacDonald Noni E, McMurtry C Meghan, Pluye Pierre, Granikov Vera, Taddio Anna, Barwick Melanie, Birnie Kathryn A, Boerner Katelynn E
Dalhousie University, Department of Psychology and Neuroscience, Halifax, Nova Scotia, Canada.
IWK Health Centre, Centre for Pediatric Pain Research, Halifax, Nova Scotia, Canada.
BMC Health Serv Res. 2021 Apr 16;21(1):355. doi: 10.1186/s12913-021-06326-2.
Vaccination is a common painful procedure for children. Parents' concern regarding vaccination pain is a significant driver of vaccine hesitancy. Despite the wealth of evidence-based practices available for managing vaccination pain, parents lack knowledge of, and access to, these strategies. Knowledge translation (KT) tools can communicate evidence-based information to parents, however little is known about what factors influence parents' use of these tools. A two-page, electronic KT tool on psychological, physical, and pharmacological vaccination pain management strategies for children, was shared with parents as part of a larger mixed methods study, using explanatory sequential design, exploring factors related to uptake of this KT tool. The aim of this qualitative study was to understand what influenced parents' perceptions of the relevance of the KT tool, as well as their decision as to whether to use the tool.
A qualitative descriptive design was used. A total of 20 parents of children aged 0-17 years (n = 19 mothers) reviewed the KT tool ahead of their child's upcoming vaccination and participated in a semi-structured interview at follow-up. Interviews were recorded, transcribed verbatim, and analyzed with reflexive thematic analysis using an inductive approach.
The analysis generated three interrelated themes which described factors related to parents' use of the KT tool: (1) Relevance to parents' needs and circumstances surrounding their child's vaccination; (2) Alignment with parents' personal values around, and experiences with, vaccination pain management (e.g., the importance of managing pain); and (3) Support from the clinical environment for implementing evidence-based strategies (e.g., physical clinical environment and quality of interactions with the health care provider).
Several factors were identified as central to parents' use of the KT tool, including the information itself and the clinical environment. When the tool was perceived as relevant, aligned with parents' values, and was supported by health care providers, parents were more inclined to use the KT tool to manage their children's vaccination pain. Future research could explore other factors related to promoting engagement and uptake when creating parent-directed KT tools for a range of health-related contexts.
疫苗接种对儿童来说是一种常见的痛苦程序。父母对疫苗接种疼痛的担忧是导致疫苗犹豫的一个重要因素。尽管有大量基于证据的方法可用于管理疫苗接种疼痛，但父母对这些策略缺乏了解，也无法获取相关信息。知识转化（KT）工具可以向父母传达基于证据的信息，然而对于影响父母使用这些工具的因素却知之甚少。作为一项更大规模的混合方法研究的一部分，采用解释性序列设计，探索与该KT工具使用相关的因素，向父母分享了一份两页的关于儿童疫苗接种疼痛心理、物理和药理学管理策略的电子KT工具。这项定性研究的目的是了解哪些因素影响了父母对KT工具相关性的认知，以及他们是否使用该工具的决定。
采用定性描述性设计。共有20名0至17岁儿童的父母（19名母亲）在其孩子即将进行疫苗接种之前查看了KT工具，并在随访时参加了半结构化访谈。访谈进行了录音，逐字转录，并采用归纳法通过反思性主题分析进行分析。
分析产生了三个相互关联的主题，描述了与父母使用KT工具相关的因素：（1）与父母围绕孩子疫苗接种的需求和情况的相关性；（2）与父母在疫苗接种疼痛管理方面的个人价值观和经历相一致（例如，管理疼痛的重要性）；（3）临床环境对实施基于证据的策略的支持（例如，物理临床环境以及与医疗保健提供者互动的质量）。
确定了几个对父母使用KT工具至关重要的因素，包括信息本身和临床环境。当该工具被认为相关、与父母的价值观一致且得到医疗保健提供者的支持时，父母更倾向于使用KT工具来管理孩子的疫苗接种疼痛。未来的研究可以探索在为一系列与健康相关的情境创建面向父母的KT工具时，与促进参与和使用相关的其他因素。
