Department of Biological Sciences, University of Toronto, Toronto, Canada.
Department of Internal Medicine, Abington Memorial Hospital/Abington-Jefferson Health, Abington, PA, USA.
Health Promot Int. 2022 Feb 17;37(1). doi: 10.1093/heapro/daab099.
In spite of the overwhelming evidence that highlights the effectiveness of routine vaccination, an increasing number of people are refusing to follow recommended vaccination schedules. While the majority of research in this area has focussed on vaccine hesitancy in parents, there is little research on the factors that promote vaccine hesitancy in health care providers (HCPs). Identifying factors that promote vaccine hesitancy in HCPs is essential because it may help broaden our understanding of vaccine hesitancy in patients. Therefore, the goal of this investigation was to review 21 studies and examine how professional autonomy and risk perception may promote vaccine acceptance, rejection and delay in physicians and nurses. We found that vaccine hesitant nurses and physicians shared similar views towards vaccines; both groups believed that their decision to vaccinate was separate from their role as an HCP. This belief comprised of three themes: decisional autonomy, personal risk perception and alternatives to vaccination. Both groups believed that mandatory vaccine policies reduced their ability to decide whether vaccination was in their best interests. We argue that decisional autonomy may weaken risk perception of disease, which in turn may encourage beliefs and behaviours that reinforce a 'hero persona' that reduces appropriate preventive and hygiene measures. We employ the Health Belief Model to discuss the crucial role that risk perceptions may play in reinforcing autonomy in vaccine hesitant physician and nurses. We conclude this paper by providing a set of recommendations that aim to improve the decision-making process surrounding mandatory vaccinations for HCPs.
尽管有大量证据强调了常规疫苗接种的有效性,但越来越多的人拒绝遵循推荐的疫苗接种计划。虽然该领域的大多数研究都集中在父母对疫苗的犹豫上,但对促进医疗保健提供者(HCP)对疫苗犹豫的因素的研究却很少。确定促进 HCP 对疫苗犹豫的因素至关重要,因为这可能有助于我们更全面地了解患者对疫苗的犹豫。因此,本研究的目的是回顾 21 项研究,探讨专业自主性和风险感知如何促进医生和护士对疫苗的接受、拒绝和延迟。我们发现,对疫苗犹豫不决的护士和医生对疫苗有相似的看法;这两个群体都认为他们接种疫苗的决定与他们作为 HCP 的角色无关。这种信念包括三个主题:决策自主性、个人风险感知和疫苗替代方案。这两个群体都认为强制性疫苗政策降低了他们决定接种疫苗是否符合自己利益的能力。我们认为,决策自主性可能会削弱对疾病的风险感知,这反过来又可能鼓励强化“英雄形象”的信念和行为,从而减少适当的预防和卫生措施。我们运用健康信念模型来讨论风险感知在增强对疫苗犹豫不决的医生和护士的自主性方面可能发挥的关键作用。最后,我们提出了一系列旨在改善强制性疫苗接种决策过程的建议。