Mackay K, Namdaran F, Upton P
Health Bull (Edinb). 1995 Mar;53(2):120-5.
To assess the influence of the Chief Medical Officer's annual guidelines on influenza immunisation and to estimate vaccine uptake particularly of those resident in long-stay residential facilities and of other recommended at-risk groups.
Postal questionnaires.
Lothian, Scotland (population 750,000).
All consultants caring for patients in long stay National Health Service facilities; a random sample of all general practitioners (GP's) in Lothian; managers/charge nurses of all local authority, private and voluntary long stay facilities in Lothian and continuing care facilities in the National Health Service including adults and children.
Number (%) of general practitioners offering influenza vaccine to at-risk groups as defined in the Chief Medical Officer's guidelines; number (%) of hospital consultants caring for long-stay patients in hospital in Lothian who offer influenza vaccine to the same at-risk groups; percentage of long-stay residents/patients who received influenza vaccine in 1992-3.
Seventy nine (75%) GPs said they offered influenza vaccine to all at-risk groups; 15 (14%) GPs said they did not care for patients in long-stay facilities but offered vaccine to the other at-risk groups; 12 (11%) GPs who did have long-stay residents on their list, offered vaccine to some of them only and to all other at-risk groups; 14 (56%) hospital consultants did not offer influenza vaccine to long-stay patients; 10 (40%) immunised only those at risk from chronic medical conditions if their quality of life was good; 1 (4%) consultant offered vaccine to all long-stay patients. In the winter of 1992-3, the mean proportion of residents immunised in private nursing homes was 65%, in residential homes 68.5%, and in long-stay National Health Service wards 4.5%. GPs commented that annual publicity was confusing for the public, vaccine was not available at the right time and there was uncertainty on the efficacy of the vaccine. Hospital consultants were reluctant to immunise patients with a poor quality of life or who were demented and unable to give consent.
A large majority of GPs followed official advice and offered influenza vaccine to long-stay patients and other at risk groups. Hospital consultants offered influenza vaccine only to a small proportion of their long-stay patients, primarily those with a good quality of life.
评估首席医疗官年度流感疫苗接种指南的影响，并估计疫苗接种率，尤其是长期居住在养老院的人群以及其他推荐的高危人群的接种率。
邮寄问卷调查。
苏格兰洛锡安（人口75万）。
所有在国民保健服务长期设施中照料患者的顾问医生；洛锡安所有全科医生（GP）的随机样本；洛锡安所有地方当局、私立和志愿性长期设施以及国民保健服务中包括成人和儿童的持续护理设施的经理/护士长。
按照首席医疗官指南中定义的，向高危人群提供流感疫苗的全科医生数量（%）；在洛锡安医院照料长期住院患者的医院顾问医生中，向相同高危人群提供流感疫苗的数量（%）；1992 - 1993年期间接受流感疫苗接种的长期居民/患者的百分比。
79名（75%）全科医生表示他们向所有高危人群提供流感疫苗；15名（14%）全科医生表示他们不照料长期设施中的患者，但向其他高危人群提供疫苗；12名（11%）在其名单上有长期居民的全科医生，只向其中一些长期居民以及所有其他高危人群提供疫苗；14名（56%）医院顾问医生未向长期住院患者提供流感疫苗；10名（40%）仅对那些患有慢性疾病且生活质量良好的高危患者进行免疫接种；1名（4%）顾问医生向所有长期住院患者提供疫苗。在1992 - 1993年冬季，私立养老院中接种疫苗的居民平均比例为65%，养老院为68.5%，国民保健服务长期病房为4.5%。全科医生评论称，年度宣传让公众感到困惑，疫苗在合适时间无法获取，且疫苗的效力存在不确定性。医院顾问医生不愿为生活质量差或患有痴呆症且无法给予同意的患者进行免疫接种。
绝大多数全科医生遵循官方建议，向长期住院患者和其他高危人群提供流感疫苗。医院顾问医生仅向一小部分长期住院患者提供流感疫苗，主要是那些生活质量良好的患者。
