Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, Western, Australia.
School of Medicine, University of Western Australia, Crawley, Western, Australia.
PLoS One. 2022 Dec 12;17(12):e0277874. doi: 10.1371/journal.pone.0277874. eCollection 2022.
Influenza vaccination of children with medical comorbidities is critical due their increased risks for severe influenza disease. In Australia, hospitals are an avenue for influenza vaccine delivery to children with comorbidities but are not always effectively utilised. Qualitative enquiry sought to ascertainment the barriers and enablers for influenza vaccination recommendation, delivery, and recording of these children at Australian hospitals.
Semi-structured interviews and discussion group sessions were conducted with paediatricians and nurses at four tertiary paediatric specialist hospitals and two general community hospitals in three Australian states. Transcripts from interviews and group sessions were inductively analysed for themes. The Capability, Opportunity, Motivation, and Behaviour (COM-B) model was used to explore the elements of each theme and identify potential interventions to increase influenza vaccination recommendation and delivery behaviours by providers.
Fifteen discussion sessions with 28 paediatricians and 26 nurses, and nine in-depth interviews (five paediatricians and four nurses) were conducted. Two central thematic domains were identified: 1. The interaction between hospital staff and parents/patients for influenza vaccine recommendation, and 2. Vaccination delivery and recording in the hospital environment. Six themes across these domains emerged detailing the importance of dedicated immunisation services, hospital leadership, paediatricians' vaccine recommendation role, the impact of comorbidities, vaccination recording, and cocooning vaccinations. Supportive hospital leadership, engaged providers, and dedicated immunisation services were identified as essential for influenza vaccination of children with comorbidities in Australian hospital.
Recommendation of influenza vaccination for Australian children with comorbidities is impacted by the beliefs of paediatricians and the perceived impact of influenza disease on children's comorbidities. Dedicated immunisation services and supportive hospital leadership were drivers for influenza vaccine delivery at hospitals. Future interventions targeting hospital-based influenza vaccine delivery for children with comorbidities should take a rounded approach targeting providers' attitudes, the hospital environment and leadership support.
由于患有合并症的儿童患严重流感疾病的风险增加，因此为他们接种流感疫苗至关重要。在澳大利亚，医院是为患有合并症的儿童提供流感疫苗的途径，但并非总是有效利用。定性研究旨在确定澳大利亚医院为这些儿童推荐、提供和记录流感疫苗接种的障碍和促进因素。
在澳大利亚三个州的四家三级儿科专科医院和两家普通社区医院，对儿科医生和护士进行了半结构式访谈和小组讨论。对访谈和小组讨论的记录进行了归纳分析，以确定主题。使用能力、机会、动机和行为 (COM-B) 模型来探讨每个主题的要素，并确定潜在的干预措施，以增加提供者对流感疫苗接种的推荐和提供行为。
共进行了 15 次讨论会议，有 28 名儿科医生和 26 名护士参加，9 次深入访谈（5 名儿科医生和 4 名护士）。确定了两个中心主题领域：1. 医院工作人员与父母/患者之间的互动，以推荐流感疫苗，2. 医院环境中的疫苗接种和记录。这些领域的六个主题分别详细说明了专门的免疫服务、医院领导、儿科医生的疫苗推荐角色、合并症的影响、疫苗接种记录和茧状疫苗接种的重要性。有针对性的免疫服务、有参与意识的提供者和专门的免疫服务被认为是澳大利亚医院为患有合并症的儿童接种流感疫苗的必要条件。
澳大利亚患有合并症的儿童流感疫苗的推荐受到儿科医生的信念和流感对儿童合并症的影响的影响。专门的免疫服务和支持性的医院领导是医院提供流感疫苗的驱动力。未来针对医院为患有合并症的儿童提供流感疫苗接种的干预措施，应采取全面的方法，针对提供者的态度、医院环境和领导支持。
