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与疫苗犹豫家长沟通:叙事综述。

Communicating With Vaccine-Hesitant Parents: A Narrative Review.

机构信息

Johns Hopkins Bloomberg School of Public Health (RJ Limaye, MZ Dudley, and DA Salmon), Baltimore, Md.

Seattle Children's (DJ Opel), Seattle, Wash.

出版信息

Acad Pediatr. 2021 May-Jun;21(4S):S24-S29. doi: 10.1016/j.acap.2021.01.018.

Abstract

Although vaccines are considered one of the most effective medical interventions to prevent vaccine preventable disease and associated morbidity and mortality, a number of recent outbreaks are threatening the gains made by vaccines. Vaccine hesitancy is a key driver of vaccine refusal and has been associated with vaccine preventable outbreaks. While parents seek information from many sources to inform their vaccine decision-making process, they continue to view their child's pediatric provider as a trusted source of vaccine information. The communication that occurs between a provider and parent with regards to vaccination is critical in reducing concerns and nudging parents toward vaccine acceptance. However, vaccine-hesitant parents raise issues in this encounter that many providers feel ill-equipped to answer, due to lack of training on evidence-based communication strategies. We focus on promising approaches related to patient-provider communication within the context of vaccination. We found empirical evidence that the use of a presumptive format to recommend vaccines, motivational interviewing, and tailoring information to increase message salience are approaches that can positively affect vaccine acceptance. As providers continue to serve as important influencers in the vaccine decision-making process, it is evident that there is a need to continue to identify evidence-based, and practically implementable approaches to mitigate parental vaccine hesitancy. Providers play a key role in improving coverage rates, and therefore it is paramount to seek ways to improve how providers communicate about vaccines.

摘要

尽管疫苗被认为是预防疫苗可预防疾病及其相关发病率和死亡率的最有效医学干预措施之一,但最近的一些疫情爆发正在威胁疫苗取得的成果。疫苗犹豫是拒绝接种疫苗的一个关键驱动因素,并且与疫苗可预防的疫情有关。虽然父母从许多来源获取信息来为他们的疫苗决策过程提供信息,但他们仍然将孩子的儿科医生视为疫苗信息的可靠来源。提供者与父母之间关于疫苗接种的沟通对于减少关注和推动父母接受疫苗至关重要。然而,疫苗犹豫的父母在这种情况下提出了许多提供者认为自己没有能力回答的问题,因为他们缺乏基于证据的沟通策略方面的培训。我们专注于与接种疫苗背景下的医患沟通相关的有前途的方法。我们发现了一些实证证据,表明使用假定格式推荐疫苗、采用动机性访谈以及根据信息增加信息显著性的方法可以积极影响疫苗接种的接受程度。由于提供者继续在疫苗决策过程中发挥重要影响者的作用,显然需要继续确定基于证据且切实可行的方法来减轻父母对疫苗的犹豫。提供者在提高覆盖率方面发挥着关键作用,因此,寻求改善提供者关于疫苗沟通的方法至关重要。

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