Woodin K A, Rodewald L E, Humiston S G, Carges M S, Schaffer S J, Szilagyi P G
Department of Pediatrics, University of Rochester, NY School of Medicine and Dentistry, USA.
Arch Pediatr Adolesc Med. 1995 Aug;149(8):845-9. doi: 10.1001/archpedi.1995.02170210019003.
To determine parent and physician opinions regarding the administration of multiple childhood immunizations by injection.
Confidential mailed survey to physicians and residents; interview of parents during office visits for immunizations.
Physicians and parents from Rochester, NY.
The survey included 215 practicing physicians and 74 residents; response rate was 82%. Of the 197 parents interviewed, 93% were mothers, 68% were white; the mean (+/- SD) age was 25.8 +/- 5.2 years, with 12.8 +/- 1.8 years of education; 59% had private insurance, and 35% had Medicaid coverage. Of the parents, 31% had strong concerns about their child receiving a single injection; an additional 10% (total, 41% vs 31%; chi 2 = 4.05, P = .04) had the same concerns about their child receiving three injections. More practicing physicians than parents had strong concerns about children 7 months old or younger receiving three injections (60% vs 41%; chi 2 = 7.71, P < or = .01). Physician concern increased further when physicians were asked about administration of four injections (80% vs 60%; chi 2 = 18.77, P < .001). Of the parents, 64% preferred one rather than two visits to have three injections administered, if their physician recommended it; 58% still preferred one visit even if four injections were needed.
Physicians have more concerns than parents about the administration of multiple injections at a single visit. Pain for the child was the main concern of all respondents. While most physicians have strong concerns about administering three or more injections at one visit, most parents prefer this practice. Continued education and reassurance of parents and physicians is needed to address concerns about children becoming "pincushions" from immunizations.
确定家长和医生对于儿童多次注射免疫接种的看法。
向医生和住院医师邮寄保密调查问卷；在免疫接种门诊就诊时对家长进行访谈。
来自纽约罗切斯特的医生和家长。
调查包括215名执业医生和74名住院医师；回复率为82%。在接受访谈的197名家长中，93%为母亲，68%为白人；平均（±标准差）年龄为25.8±5.2岁，受教育年限为12.8±1.8年；59%有私人保险，35%有医疗补助。在家长中，31%非常担心孩子接受单次注射；另有10%（总计41%对31%；卡方检验=4.05，P=0.04）对孩子接受三次注射有同样的担忧。与家长相比，更多执业医生非常担心7个月及以下的儿童接受三次注射（60%对41%；卡方检验=7.71，P≤0.01）。当询问医生关于四次注射的接种情况时，医生的担忧进一步增加（80%对60%；卡方检验=18.77，P<0.001）。在家长中，如果医生建议，64%更倾向于分一次而不是两次就诊来进行三次注射；即使需要四次注射，58%仍然更倾向于一次就诊。
与家长相比，医生更担心单次就诊时进行多次注射。孩子的疼痛是所有受访者的主要担忧。虽然大多数医生非常担心一次就诊时进行三次或更多次注射，但大多数家长更喜欢这种做法。需要持续对家长和医生进行教育并给予安抚，以解决对儿童因免疫接种而变成“针垫”的担忧。
