Physician response to parental requests to spread out the recommended vaccine schedule.
Physician response to parental requests to spread out the recommended vaccine schedule.
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DOI：
10.1542/peds.2014-3474
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发表时间：
2015-04
期刊：
影响因子：
8
通讯作者：
Stokley S
中科院分区：
文献类型：
--
作者：
Kempe A;O'Leary ST;Kennedy A;Crane LA;Allison MA;Beaty BL;Hurley LP;Brtnikova M;Jimenez-Zambrano A;Stokley S
评估美国医生（1）要求为2岁以下儿童提供推荐疫苗接种计划的频率，（2）对此类要求的态度，以及（3）响应此类要求所使用的策略和感知的有效性。2012年6月至2012年10月对全国具有代表性的儿科医生和家庭医生样本进行的电子邮件和邮件调查。回应率为66%（815人中的534人）。在一个典型的月份中，93%的人报告说，一些2岁以下儿童的父母要求分发疫苗; 21%的人报告说，≥10%的父母提出了这一要求。大多数受访者认为这些父母将他们的孩子置于疾病的风险之中（87%），这对孩子来说更痛苦（84%），但如果他们同意请求，这将建立与家庭的信任（82%）;此外，他们认为如果他们不同意，家庭可能会离开他们的做法（80%）。40%的人表示，这个问题降低了他们的工作满意度。大多数人同意在要求时传播疫苗，经常/总是（37%）或有时（37%）; 2%的人经常/总是，4%的人有时会，12%的人如果他们想传播主要系列，很少会从他们的实践中解雇家庭。医生们报告说，他们使用了各种各样的策略来回应请求，但并不认为它们是有效的。几乎所有的供应商在一个典型的月份都会遇到分发疫苗的请求，尽管存在担忧，但大多数供应商都同意这样做。供应商正在使用许多策略来应对，但认为很少有有效的。需要采取循证干预措施，以增加及时免疫接种，指导初级保健和公共卫生做法。
To assess among US physicians (1) frequency of requests to spread out recommended vaccination schedule for children <2 years, (2) attitudes regarding such requests, and (3) strategies used and perceived effectiveness in response to such requests. An e-mail and mail survey of a nationally representative sample of pediatricians and family physicians from June 2012 through October 2012. The response rate was 66% (534 of 815). In a typical month, 93% reported some parents of children <2 years requested to spread out vaccines; 21% reported ≥10% of parents made this request. Most respondents thought these parents were putting their children at risk for disease (87%) and that it was more painful for children (84%), but if they agreed to requests, it would build trust with families (82%); further, they believed that if they did not agree, families might leave their practice (80%). Forty percent reported this issue had decreased their job satisfaction. Most agreed to spread out vaccines when requested, either often/always (37%) or sometimes (37%); 2% would often/always, 4% would sometimes, and 12% would rarely dismiss families from their practice if they wanted to spread out the primary series. Physicians reported using a variety of strategies in response to requests but did not think they were effective. Virtually all providers encounter requests to spread out vaccines in a typical month and, despite concerns, most are agreeing to do so. Providers are using many strategies in response but think few are effective. Evidence-based interventions to increase timely immunization are needed to guide primary care and public health practice.
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