Tron Arthur, Schlegel Vincent, Pinot Juliette, Bruel Sébastien, Ecollan Marie, Bel Josselin Le, Rossignol Louise, Gauchet Aurélie, Gagneux-Brunon Amandine, Mueller Judith, Banaszuk Anne-Sophie, Thilly Nathalie, Gilberg Serge, Partouche Henri
Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France.
Institut de recherche et de documentation en économie de la santé (IRDES), 117 bis rue Manin, Paris, 75019, France.
Arch Public Health. 2024 Jan 4;82(1):2. doi: 10.1186/s13690-023-01227-8.
In France, human papillomavirus (HPV) vaccination coverage is low, with 30.7% of 17-year-old girls having received a complete HPV vaccination schedule in 2020.
To determine the perspective and behaviors of general practitioners (GPs) regarding HPV vaccination with their patients and if a reluctance is observed.
A qualitative study based on semi-directed individual interviews was conducted between December 2019 and December 2020. A representative sample of GPs with various profiles were included in 4 French regions.
A purposive sampling was used and interviews were continued until data saturation was reached. The analysis was based on the grounded theory.
Twenty-six GPs aged 29-66 years were interviewed. The measures taken by the French health authorities (lowering the target age, reimbursing the vaccine, extending the target population to boys) were perceived as facilitators. The reported barriers were organizational, due to low attendance of adolescents, and relational, mainly due to parental vaccine hesitancy. Physicians had to deal with fears about the perceived risks and concerns about sexuality conveyed by HPV vaccination and linked to the socio-cultural characteristics of the families. Physicians developed strategies, including scientific knowledge mobilization, empowerment of families by promoting health through prevention, repetition of the vaccination proposals, personal experience and relationship. Different practices were identified according to three GP typologies: effective, convinced but unpersuasive, and reluctant physicians.
Based on these results, specific interventions, including communication techniques, especially for hesitant or unpersuasive physicians, are needed to enable GPs to become more effective.
在法国，人乳头瘤病毒（HPV）疫苗接种率较低，2020年只有30.7%的17岁女孩完成了HPV疫苗全程接种。
确定全科医生（GP）与患者讨论HPV疫苗接种时的观点和行为，以及是否存在抵触情况。
2019年12月至2020年12月期间进行了一项基于半定向个人访谈的定性研究。法国4个地区纳入了具有不同特征的全科医生代表性样本。
采用目的抽样法，访谈持续进行直至数据饱和。分析基于扎根理论。
采访了26名年龄在29 - 66岁之间的全科医生。法国卫生当局采取的措施（降低目标年龄、报销疫苗、将目标人群扩大到男孩）被视为促进因素。报告的障碍包括组织方面的，因为青少年就诊率低，以及人际关系方面的，主要是由于家长对疫苗的犹豫态度。医生们必须应对HPV疫苗接种所传达的对感知风险的恐惧以及与性相关的担忧，这些担忧与家庭的社会文化特征有关。医生们制定了策略，包括动员科学知识、通过预防促进健康来增强家庭权能、重复疫苗接种建议、分享个人经验以及建立医患关系。根据三种全科医生类型确定了不同的做法：高效型、信服但缺乏说服力型和抵触型医生。
基于这些结果，需要采取具体干预措施，包括沟通技巧，特别是针对犹豫或缺乏说服力的医生，以使全科医生更有成效。
