Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China.
Clinical 5+3 Integration, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Public Health. 2022 May 19;10:853041. doi: 10.3389/fpubh.2022.853041. eCollection 2022.
Influenza is associated with a large number of disease burdens, and it is generally recommended that all healthcare workers (HCWs) get an influenza vaccination. However, the vaccination rates among HCWs are still low. This study aimed to assess HCWs' knowledge, attitude, and practice (KAP) about the influenza vaccine, and by establishing a structural equation model (SEM) to explore the influencing factors of medical personnel's influenza vaccination in Chongqing, China.
From September to November 2019, we conducted a cross-sectional survey in four sentinel hospitals and four non-sentinel hospitals in Chongqing, China. We calculated knowledge, attitude, and behavior scores for each study participant and assessed the level of knowledge, attitude, and behavior of the medical staff. An SEM was used to evaluate the relationship between latent variables, and the path graph between knowledge, attitude, and behavior was established.
A total of 1,412 valid questionnaires were collected in this survey, including four sentinel hospitals ( = 606, 42.92%) and four non-sentinel hospitals ( = 806, 57.08%). Women ( = 1,102, 78.05%) were more than men ( = 310, 21.95%), with an average age of 32.36 ± 7.78 years old and under 30 years old ( = 737, 52.20%), respectively. Nurses (741, 52.48%) were the main subjects, followed by physicians (457, 32.37%). The final SEM model was obtained after the model was modified and adjusted. A bootstrap analysis of path coefficients was carried out on the final model. Knowledge has a direct influence on behavior. The normalized path coefficient is 0.071 (95% CI: 0.002-0.161), and the value of of the hypothesis test result of the path coefficient is 0.042. The direct influence of knowledge on attitude standardization was 0.175 (95% CI: 0.095-0.281). The direct influence of attitude on practice standardization was 0.818 (95% CI: 0.770-0.862). The indirect effect of knowledge on the standardization of practice through attitude was 0.144 (95% CI: 0.076-0.235).
According to the SEM, there is a direct positive correlation between KAP and the influenza vaccine. The indirect influence of knowledge on the standard of behavior through attitude is about two times as much as the direct influence on behavior, indicating that attitude plays a strong mediating role between knowledge and practice.
流感会导致大量疾病负担，一般建议所有医护人员（HCWs）接种流感疫苗。然而，医护人员的疫苗接种率仍然较低。本研究旨在评估医护人员对流感疫苗的知识、态度和实践（KAP），并通过建立结构方程模型（SEM）来探讨中国重庆医务人员流感疫苗接种的影响因素。
本研究于 2019 年 9 月至 11 月在重庆市四家哨点医院和四家非哨点医院进行了横断面调查。我们为每位研究参与者计算了知识、态度和行为得分，并评估了医务人员的知识、态度和行为水平。采用结构方程模型（SEM）评估潜在变量之间的关系，并建立知识、态度和行为之间的路径图。
本调查共收集了 1412 份有效问卷，包括四家哨点医院（n=606，42.92%）和四家非哨点医院（n=806，57.08%）。女性（n=1102，78.05%）多于男性（n=310，21.95%），平均年龄为 32.36±7.78 岁，其中 30 岁以下（n=737，52.20%）。护士（n=741，52.48%）是主要人群，其次是医生（n=457，32.37%）。经过模型修正和调整，最终得到 SEM 模型。对最终模型进行路径系数的bootstrap 分析。知识对行为有直接影响。标准化路径系数为 0.071（95%CI：0.002-0.161），路径系数假设检验结果的 值为 0.042。知识对态度标准化的直接影响为 0.175（95%CI：0.095-0.281）。态度对实践标准化的直接影响为 0.818（95%CI：0.770-0.862）。知识通过态度对实践标准化的间接影响为 0.144（95%CI：0.076-0.235）。
根据 SEM，KAP 与流感疫苗之间存在直接正相关。知识通过态度对行为标准的间接影响是直接影响的两倍多，表明态度在知识和实践之间起着很强的中介作用。
