医护人员沟通实践与住院儿童流感疫苗接种的关联。
Associations Between Health Care Professional Communication Practices and Influenza Vaccination of Hospitalized Children.
机构信息
Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash.
Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash.
出版信息
Acad Pediatr. 2021 Sep-Oct;21(7):1142-1150. doi: 10.1016/j.acap.2021.06.014. Epub 2021 Jul 2.
BACKGROUND
Health care professionals (HCPs) (eg, nurses, doctors) play a key role in vaccine uptake. Few studies describe HCP influenza vaccine communication with parents of hospitalized children.
METHODS
This study included English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a tertiary care pediatric hospital between October 2018 and May 2019. A survey was completed online or via telephone 2 to 15 weeks (median 4 weeks) after discharge. It examined parental intent to vaccinate their child during hospitalization and parent-reported inpatient HCP communication practices (eg, vaccine recommendation strength, format for initiating the recommendation). Multivariable logistic regression examined the associations between HCP communication practices and influenza vaccination during hospitalization, adjusting for demographic, clinical, and visit characteristics.
RESULTS
Parents (n = 194; 63.0% response rate) were mostly white (66.8%) and English-speaking (97.4%). Their children were primarily 5 through 17 years (67.0%) with chronic disease (68.6%); 24.7% were vaccinated before discharge. Most parents initially had no plan (55.6%) or planned to decline (31.1%) influenza vaccine for their child during hospitalization. Of these parents, 22.2% decided to accept the vaccine, 66.7% citing a HCP conversation as the main reason for changing their mind. Overall, 75.3% recalled a HCP conversation about influenza vaccination. Of these parents, 61.0% reported a HCP recommendation (53.8% described it as "very strong"; 11.1% noted a presumptive initiation format). A parent-reported HCP conversation (adjusted odds ratio [AOR] 5.23, 95% confidence interval [CI] 1.64-16.68) and recommendation (AOR 5.59, 95% CI 2.01-15.51) were associated with influenza vaccination during hospitalization.
CONCLUSION
This study highlights the importance of discussing and recommending influenza vaccination with parents of hospitalized children.
背景
医疗保健专业人员（例如护士、医生）在疫苗接种中起着关键作用。很少有研究描述医疗保健专业人员与住院儿童的父母进行流感疫苗接种沟通。
方法
本研究纳入了 2018 年 10 月至 2019 年 5 月期间在一家三级儿科医院住院的、有资格接种流感疫苗的儿童的英语和西班牙语父母。在出院后 2 至 15 周（中位数为 4 周），他们在线或通过电话完成了一项调查。调查内容包括父母在住院期间为孩子接种疫苗的意愿以及父母报告的住院医疗保健专业人员沟通实践（例如疫苗推荐强度、推荐启动方式）。多变量逻辑回归分析了医疗保健专业人员沟通实践与住院期间流感疫苗接种之间的关联，调整了人口统计学、临床和就诊特征。
结果
父母（n=194；63.0%的回复率）主要为白人（66.8%）和英语使用者（97.4%）。他们的孩子主要为 5 至 17 岁（67.0%），患有慢性病（68.6%）；24.7%在出院前已接种疫苗。最初，大多数父母（55.6%）没有计划或计划在住院期间拒绝（31.1%）为孩子接种流感疫苗。在这些父母中，22.2%决定接受疫苗，66.7%表示是医疗保健专业人员的对话促使他们改变了主意。总体而言，75.3%的父母记得与医疗保健专业人员进行过流感疫苗接种的对话。在这些父母中，61.0%报告了医疗保健专业人员的推荐（53.8%表示推荐“非常强烈”；11.1%注意到一种假定的启动方式）。父母报告的医疗保健专业人员对话（调整后的优势比[OR]5.23，95%置信区间[CI]1.64-16.68）和推荐（OR5.59，95%CI2.01-15.51）与住院期间的流感疫苗接种有关。
结论
本研究强调了与住院儿童的父母讨论和推荐流感疫苗接种的重要性。
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