School of Nursing and Midwifery, Edith Cowan University, Perth, Australia.
School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
BMC Public Health. 2021 Oct 12;21(1):1845. doi: 10.1186/s12889-021-11907-1.
Midwives are well placed to promote vaccination awareness throughout a women's pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children.
A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher's exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05.
Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth's Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge.
Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives' capacity to play a more substantial role in influencing vaccination coverage in Perth's Aboriginal children.
助产士在女性怀孕期间非常适合提高疫苗接种意识，并在出院后加强儿童疫苗接种需求。在西澳大利亚州珀斯，土著儿童的疫苗接种率是全国最低的。为了确定在目标人群中预防更高疫苗接种率的因素，对两家珀斯妇产医院的助产士进行了一项基于理论的研究，以探讨围绕疫苗接种提供和接种给土著儿童的疫苗的行为特征、知识、态度和信念。
为在两家珀斯公立妇产医院工作的助产士设计了一份专门的问卷。使用计划行为理论的近端结构来构建问卷，以确定并行为定位阻碍更高疫苗接种率的因素。描述性统计数据描述了研究样本的人口统计学特征。卡方检验和 Fisher 精确检验用于识别助产士特征与对覆盖范围的认识之间的关联。显著性水平设置为 α = 0.05。
在完成研究问卷的 58 名助产士中，77.2%的人不知道珀斯土著儿童的疫苗接种率不理想。教育水平（p = 0.53）和作为执业助产士的工作年限（p = 0.47）与对覆盖范围的认识无关。大约 50%的助产士报告对儿童疫苗的功效有些担忧，44.4%的人对自己的疫苗知识没有信心，而 33.3%的人在出院前没有与父母定期讨论儿童疫苗接种问题。
研究中的主要发现表明，一系列教育、领导和系统问题正在影响助产士在影响珀斯土著儿童疫苗接种率方面发挥更大作用的能力。
