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老年人肺炎球菌疫苗接种的决定因素:范围综述。

Determinants of pneumococcal vaccination among older adults: A scoping review.

机构信息

Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

出版信息

Public Health. 2024 Dec;237:245-260. doi: 10.1016/j.puhe.2024.10.008. Epub 2024 Oct 26.

Abstract

OBJECTIVES

To identify the range of factors that impact health behaviours pertaining to the uptake of pneumococcal vaccination (PV) among older persons.

STUDY DESIGN

Scoping review.

METHODS

This review followed Arksey and O'Malley's framework. Five databases: PubMed, CINAHL, PsycINFO, Scopus and Embase were searched for relevant studies on PV uptake among outpatient older adults ≥65 years published between January 2013 and October 2023. Data were extracted and verified using a standardised template, and synthesised using inductive content analysis. Findings were classified according to Andersen's behavioural model of health services use (BMHSU).

RESULTS

Twenty-seven papers were included in the final analysis. Reception of PV was influenced by predisposing factors such as (i) awareness and risk perception, (ii) demographic characteristics, and (iii) cultural beliefs towards preventive medicine; enabling factors including (i) disease and vaccine literacy, (ii) past experience with preventive health services, and (iii) access to relevant resources; as well as reinforcing factors namely, (i) vaccine efficacy and safety, (ii) social influence, (iii) support from healthcare professionals, and (iv) vaccine administration environment.

CONCLUSIONS

Older adults' health behaviours, particularly their attitudes towards vaccination are often complex and this attests to the need for multidimensional, cross-sector barrier-specific strategies to raise PV coverage. Key issues identified in this review highlight the focus areas that healthcare providers, policy makers and other stakeholders should collaborate on to resolve underutilisation of preventive medicine and promote health among this population.

摘要

目的

确定影响老年人接种肺炎球菌疫苗(PV)相关健康行为的因素范围。

研究设计

范围综述。

方法

本综述遵循 Arksey 和 O'Malley 的框架。在 2013 年 1 月至 2023 年 10 月期间,在五个数据库(PubMed、CINAHL、PsycINFO、Scopus 和 Embase)中搜索有关门诊老年人(年龄≥65 岁)接种 PV 的相关研究。使用标准化模板提取和验证数据,并使用归纳内容分析进行综合。根据 Andersen 的健康服务使用行为模型(BMHSU)对研究结果进行分类。

结果

最终分析纳入了 27 篇论文。PV 的接受程度受到多种因素的影响,包括:(i)意识和风险感知;(ii)人口统计学特征;(iii)对预防医学的文化信仰等倾向因素;(i)疾病和疫苗知识;(ii)过去预防保健服务的经验;(iii)获取相关资源等使能因素;以及(i)疫苗疗效和安全性;(ii)社会影响;(iii)来自医疗保健专业人员的支持;(iv)疫苗接种管理环境等强化因素。

结论

老年人的健康行为,尤其是他们对疫苗接种的态度往往很复杂,这证明需要采取多维、跨部门、针对具体障碍的策略来提高 PV 覆盖率。本综述中确定的关键问题突出了医疗保健提供者、政策制定者和其他利益相关者应合作解决预防医学利用不足和促进这一人群健康的重点领域。

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