Understanding non-vaccinating parents' views to inform and improve clinical encounters: a qualitative study in an Australian community
Understanding non-vaccinating parents' views to inform and improve clinical encounters: a qualitative study in an Australian community
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DOI：
10.1136/bmjopen-2018-026299
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发表时间：
2019-05-01
期刊：
影响因子：
2.9
通讯作者：
Carter, Stacy
中科院分区：
文献类型：
--
作者：
Helps, Catherine;Leask, Julie;Carter, Stacy
目的解释澳大利亚父母拒绝接种疫苗的原因。设计定性设计，在确定的人群中进行有目的的抽样。在澳大利亚地区设置一个约3万人的地理受限社区，拒绝接种疫苗的发生率很高。参与者对32名未接种疫苗的父母进行了半结构化访谈：9名父亲，22名母亲和1名孕妇。对决定停止或拒绝为其子女接种疫苗的父母进行有目的的抽样。通过当地广告招聘，然后滚雪球。结果主题分析集中在解释父母拒绝接种疫苗的决策路径。父母描述的常见模式包括：感觉到西方社会健康状况的恶化；个人经历导致对疫苗安全性的怀疑；对同意的担忧；与卫生专业人员的各种接触(不屑一顾、阻碍和帮助)；对“真实真相”的追求；对系统不灵活的反应和持续的风险评估。结论我们建议从未接种疫苗的父母的角度进行应对，以帮助专业人员理解并保持与这一重要患者群体的共情临床关系。
Objectives To explain vaccination refusal in a sample of Australian parents.Design Qualitative design, purposive sampling in a defined population.Setting A geographically bounded community of approximately 30 000 people in regional Australia with high prevalence of vaccination refusal.Participants Semi structured interviews with 32 non-vaccinating parents: 9 fathers, 22 mothers and 1 pregnant woman. Purposive sampling of parents who had decided to discontinue or decline all vaccinations for their children. Recruitment via local advertising then snowballing.Results Thematic analysis focused on explaining decision-making pathways of parents who refuse vaccination. Common patterns in parents' accounts included: perceived deterioration in health in Western societies; a personal experience introducing doubt about vaccine safety; concerns regarding consent; varied encounters with health professionals (dismissive, hindering and helpful); a quest for 'the real truth'; reactance to system inflexibilities and ongoing risk assessment.Conclusions We suggest responses tailored to the perspectives of non-vaccinating parents to assist professionals in understanding and maintaining empathic clinical relationships with this important patient group.