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了解疫苗接种后不良反应监测中报告实践和障碍感知:印度喀拉拉邦儿科医生的横断面调查。

Understanding reporting practices and perceptions of barriers in adverse events following immunisation surveillance: A cross-sectional survey of paediatricians in Kerala, India.

机构信息

Institute for Global Health, University of Siena, Siena, Italy.

Department of Community Medicine, Believers Church Medical College, Thiruvalla, Kerala, India.

出版信息

Vaccine. 2021 Jul 30;39(33):4678-4684. doi: 10.1016/j.vaccine.2021.06.052. Epub 2021 Jul 6.

Abstract

PURPOSE

The role of health care professionals (HCPs) is central to adverse event following immunisation (AEFI) surveillance. A cross-sectional survey was conducted among paediatricians practising in Kerala, India, to assess their knowledge and reporting behaviour in AEFI surveillance as well as to identify barriers to reporting.

RESULTS

A random sample of 380 paediatricians were contacted of whom, 243 (63.9%) participated in the survey. The understanding scores were distributed as follows: 30.9% very high or high, 40.3% moderate, and 28.8% low. Formal training was significantly associated with higher understanding scores, and increased AEFI detection and reporting. Only 42.0% of respondents had formal training; paediatricians in the public sector had higher access to training than those in the private sector. There were 141 respondents (58.0%) who identified an AEFI in the previous year, of whom 66 (46.8%) reported it. The main barriers to AEFI reporting were: difficulties with reporting process (28.9%); fear of raising public alarm (28.1%); time constraints (22.3%); fear of personal consequences (15.7%); and belief that health authorities rarely take useful action (11.6%).

CONCLUSION

Training in AEFI surveillance should be prioritised for HCPs with greater emphasis in medical education programmes. Study showed that a user-friendly reporting mechanism and a blame-free culture are crucial to improve AEFI reporting practices.

摘要

目的

医疗保健专业人员(HCP)在疫苗接种后不良反应(AEFI)监测中发挥着核心作用。本研究在印度喀拉拉邦开展了一项横断面调查,以评估儿科医生在 AEFI 监测中的知识和报告行为,并确定报告障碍。

结果

联系了喀拉拉邦的 380 名儿科医生,其中 243 名(63.9%)参与了调查。理解评分分布如下:30.9%为非常高或高,40.3%为中等,28.8%为低。正规培训与更高的理解评分、增加 AEFI 的检出和报告显著相关。只有 42.0%的受访者接受过正规培训;公共部门的儿科医生比私人部门的儿科医生更容易获得培训。在过去一年中,有 141 名(58.0%)受访者发现了 AEFI,其中 66 名(46.8%)报告了 AEFI。AEFI 报告的主要障碍是:报告过程困难(28.9%);担心引起公众恐慌(28.1%);时间限制(22.3%);担心个人后果(15.7%);以及认为卫生当局很少采取有效行动(11.6%)。

结论

应优先为 HCP 提供 AEFI 监测培训,在医学教育计划中应更加重视。研究表明,用户友好的报告机制和无责文化对于改进 AEFI 报告实践至关重要。

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