医院工作者的经历、风险认知与 COVID-19 疫苗接种结果。
Experiences, risk perceptions, and COVID-19 vaccination outcomes among hospital workers.
机构信息
Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI, USA.
出版信息
Vaccine. 2023 Feb 3;41(6):1247-1253. doi: 10.1016/j.vaccine.2023.01.012. Epub 2023 Jan 9.
BACKGROUND
Although COVID-19 vaccinations have been available to hospital workers in the U.S. since December 2020, coverage is far from universal, even in groups with patient contact. The aim of this study was to describe COVID-19-related experiences at work and in the personal lives of nurses, allied health workers, and non-clinical staff with patient contact, and to assess whether these experiences relate to COVID-19 vaccination.
METHODS
Health care workers at a large Midwestern hospital in the U.S. were contacted to participate in an online cross-sectional survey during February 2021. A logistic regression model was used to estimate odds ratios (OR) for vaccination by different experiences, and we assessed mediation through models that also included measures of risk perceptions.
RESULTS
Among 366 nurse practitioners / nurse midwives / physician assistant, 1,698 nurses, 1,798 allied health professionals, and 1,307 non-clinical staff with patient contact, the proportions who had received or intended to receive a COVID-19 vaccination were 94 %, 87 %, 82 %, and 88 %, respectively. Working and being physically close to COVID-19 patients was not significantly associated with vaccine intent. Vaccination intent was significantly lower among those with a previous COVID-19 diagnosis vs not (OR = 0.33, 95 % CI: 0.27, 0.40) and higher for those who knew close family members of friends hospitalized or died of COVID-19 (OR = 1.33, 95 % CI: 1.10, 1.60).
CONCLUSION
Even when COVID-19 vaccination was available in February 2021, a substantial minority of hospital workers with patient contact did not intend to be vaccinated. Moreover, their experiences working close to COVID-19 patients were not significantly related to vaccination intent. Instead, personal experiences with family members and friends were associated with vaccination intent through changes in risk perceptions. Interventions to increase uptake among hospital workers should emphasize protection of close family members or friends and the severity of COVID-19.
背景
自 2020 年 12 月以来，美国的医院工作人员已经可以接种 COVID-19 疫苗，但覆盖率远未达到普遍水平，即使是在有患者接触的群体中也是如此。本研究的目的是描述有患者接触的护士、辅助卫生人员和非临床工作人员在工作和个人生活中与 COVID-19 相关的经历，并评估这些经历是否与 COVID-19 疫苗接种有关。
方法
联系美国中西部一家大型医院的卫生保健工作者，于 2021 年 2 月参加在线横断面调查。使用逻辑回归模型估计不同经历与接种疫苗的比值比（OR），我们通过还包括风险认知测量的模型评估中介作用。
结果
在 366 名执业护士/护士助产士/医师助理、1698 名护士、1798 名辅助卫生专业人员和 1307 名有患者接触的非临床工作人员中，已接种或打算接种 COVID-19 疫苗的比例分别为 94%、87%、82%和 88%。与 COVID-19 患者近距离工作和身体接触与疫苗接种意愿没有显著相关性。与没有 COVID-19 既往诊断的人相比，有 COVID-19 既往诊断的人接种疫苗的意愿显著降低（OR=0.33，95%CI：0.27，0.40），而与知道亲密家人或朋友因 COVID-19 住院或死亡的人相比，接种疫苗的意愿更高（OR=1.33，95%CI：1.10，1.60）。
结论
即使在 2021 年 2 月可以接种 COVID-19 疫苗时，仍有相当一部分有患者接触的医院工作人员不打算接种疫苗。此外，他们与 COVID-19 患者近距离接触的经历与接种疫苗的意愿没有显著关系。相反，与家人和朋友的个人经历通过改变风险认知与接种疫苗的意愿相关。提高医院工作人员疫苗接种率的干预措施应强调保护亲密家人或朋友和 COVID-19 的严重程度。
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