Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
College of Medicine, Department of Medical Education, King Saud University, P O Box 2925, 11461, Riyadh, Saudi Arabia.
BMC Med Educ. 2023 Sep 4;23(1):637. doi: 10.1186/s12909-023-04590-w.
Research has shown that physicians are encountering an increase in vaccine-hesitant parents (VHPs) numbers. This study examined physicians' vaccination knowledge, vaccine-related discussions with VHPs, beliefs about and responses to vaccine hesitancy, and challenges faced while discussing immunization with VHPs.
This cross-sectional, descriptive study was performed at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, in September 2020. The data were collected through a questionnaire distributed via email. The sample comprised 90 physicians who routinely treat children and reported they frequently have appropriate vaccine discussions when encountering VHPs.
Ninety participants (59% were females) completed the questionnaire. Of these, 37.8% were from family medicine, 7.8% from primary care, and 54.4% from paediatrics. The most discussed topics were vaccine necessity, reasons for vaccine refusal, and vaccine safety. Seventeen participants (18.8%) reported being extremely confident, and (42.2%) were confident in their vaccine-specific knowledge. Regarding confidence in communication skills, 22.2% reported being extremely confident and (45.6%) were confident. Determinants of higher confidence in the knowledge and communication skills were physician age (p = 0.001 and p = 0.0001, respectively), years of practice (p = 0.002 and (p = 0.005), and patients seen per workday (p = 0.0001 and p = 0.024). Other factors such as physician sex (p = 0.062), the field of practice (p = 0.329), and hours of work per week (p = 0.061) were not significantly different. Forty-six (51%) physicians sometimes find it challenging to conduct appropriate vaccine-related discussions because of having too many other issues to discuss during the consultation. Furthermore, 53 (59%) participants agreed/strongly agreed that parental refusal to vaccinate would raise suspicions of negligence. On the other hand, 59 (65%) disagreed/strongly disagreed that parental refusal of vaccines is a parental right. Participants expressed the need to refer VHPs to a specialised advisory clinic with excellent experience and negotiation skills to overcome the challenges.
Vaccine safety and necessity are the topics of most concern to VHPs, and a knowledgeable physician with competent communication skills is critical in responding to such situations. This study highlights the most reported barriers to successful vaccine-related discussions. It raises underlying ethical principles such as parental autonomy and the need to train physicians in VHPs. To train physians for succucful vaccine counceling of VHPs.
研究表明，医生遇到的疫苗犹豫家长（VHP）数量不断增加。本研究调查了医生的疫苗知识、与 VHP 进行疫苗相关讨论、对疫苗犹豫的信念和反应，以及在与 VHP 讨论免疫接种时面临的挑战。
本横断面描述性研究于 2020 年 9 月在沙特阿拉伯利雅得的沙特国王大学医学城（KSUMC）进行。通过电子邮件分发问卷收集数据。样本包括 90 名经常治疗儿童的医生，他们报告说在遇到 VHP 时经常进行适当的疫苗讨论。
90 名参与者（59%为女性）完成了问卷。其中，37.8%来自家庭医学，7.8%来自初级保健，54.4%来自儿科。讨论最多的话题是疫苗的必要性、疫苗拒绝的原因和疫苗的安全性。17 名参与者（18.8%）表示非常自信，而（42.2%）对他们的疫苗特定知识有信心。关于沟通技巧的信心，22.2%表示非常自信，而（45.6%）有信心。对知识和沟通技巧更有信心的决定因素是医生的年龄（p=0.001 和 p=0.0001），实践年限（p=0.002 和 p=0.005），以及每个工作日看诊的患者数量（p=0.0001 和 p=0.024）。其他因素，如医生性别（p=0.062）、实践领域（p=0.329）和每周工作时间（p=0.061）没有显著差异。46 名（51%）医生有时发现，由于在咨询期间有太多其他问题要讨论，因此很难进行适当的疫苗相关讨论。此外，53 名（59%）参与者同意/强烈同意，父母拒绝接种疫苗会引起疏忽的怀疑。另一方面，59 名（65%）参与者不同意/强烈不同意父母拒绝疫苗是父母的权利。参与者表示需要将 VHP 转介给经验丰富且谈判技巧高超的专门咨询诊所，以克服这些挑战。
疫苗安全性和必要性是 VHP 最关心的问题，知识渊博且沟通能力强的医生在应对此类情况时至关重要。本研究强调了成功进行疫苗相关讨论最常报告的障碍。它提出了潜在的伦理原则，如父母自主权和培训医生识别 VHP 的必要性。
