'I don't think anybody explained to me how it works': qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
'I don't think anybody explained to me how it works': qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England
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DOI：
10.1136/bmjopen-2018-028228
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发表时间：
2019-08-01
期刊：
影响因子：
2.9
通讯作者：
Mounier-Jack, Sandra
中科院分区：
文献类型：
--
作者：
Bell, Sadie;Edelstein, Michael;Mounier-Jack, Sandra
目的 本研究探讨了波兰和罗马尼亚社区的疫苗接种态度和行为，以及获得初级卫生保健服务的相关机会。设计一项定性研究，对波兰和罗马尼亚大型社区地区参与疫苗接种的波兰和罗马尼亚社区成员 (CM) 和卫生保健工作者 (HCW) 进行深入的半结构化访谈。 CM 讨论了他们的疫苗接种态度以及在英国接种疫苗的经历。医护人员分享了他们为波兰和罗马尼亚社区接种疫苗的经验。招聘地点集中在英格兰波兰和罗马尼亚人口较多的三个地理区域（伦敦、林肯郡和伯克郡）。参与者包括 20 名波兰和 10 名罗马尼亚 CM 以及 20 名医护人员。大多数 CM 是母亲或孕妇，是从伦敦或林肯郡招募的。医护人员包括从目标地理区域招募的执业护士、健康访问员和学校护士。 结果 尽管大多数 CM 报告按照英国时间表接种疫苗，但接种疫苗的障碍仍然突出。 CM 在驾驭和信任英国初级医疗保健系统方面遇到了困难，在获取波兰语和罗马尼亚语的可靠疫苗接种信息方面也遇到了挑战。 CM 疫苗接种预期主要建立在波兰和罗马尼亚的知识和经验之上，但往往无法满足。这是由于英格兰疫苗接种安排和服务提供的差异造成的，例如由护士而不是医生提供疫苗。 CM 报告称，人们对流感疫苗的接受度较低，这主要是由于对该疫苗的重要性和功效的看法。医护人员报告了在翻译和理解疫苗接种历史、克服口头沟通障碍以及确保在英格兰和波兰或罗马尼亚之间旅行的家庭中疫苗接种计划的完整性方面面临的挑战。 结论 这项研究确定了疫苗接种和交付问题以及改进建议。医护人员应讨论卫生服务期望，强调各国之间疫苗接种安排和交付的差异，并促进对英国初级卫生保健系统的更多了解，以鼓励这些社区的疫苗接种。
Objectives This study explored vaccination attitudes and behaviours among Polish and Romanian communities, and related access to primary healthcare services.Design A qualitative study using in-depth semistructured interviews with Polish and Romanian community members (CMs) and healthcare workers (HCWs) involved in vaccination in areas with large Polish and Romanian communities. CMs discussed their vaccination attitudes and their experiences of accessing vaccinations in England. HCWs shared their experiences in vaccinating Polish and Romanian communities.Setting Recruitment focused on three geographical areas in England with large Polish and Romanian populations (in London, Lincolnshire and Berkshire).Participants 20 Polish and 10 Romanian CMs, and 20 HCWs. Most CMs were mothers or pregnant women and were recruited from London or Lincolnshire. HCWs included practice nurses, health visitors and school nurses recruited from the targeted geographical areas.Results Although most CMs reported vaccinating according to the UK schedule, obstacles to vaccination were highlighted. CMs experienced difficulties navigating and trusting the English primary healthcare system, and challenges in accessing credible vaccination information in Polish and Romanian. CM vaccination expectations, largely built on knowledge and experiences from Poland and Romania, were often unmet. This was driven by differences in vaccination scheduling and service provision in England, such as nurses delivering vaccines instead of doctors. CMs reported lower acceptance of the influenza vaccine, largely due to perceptions around the importance and efficacy of this vaccine. HCWs reported challenges translating and understanding vaccination histories, overcoming verbal communication barriers and ensuring vaccination schedule completeness among families travelling between England and Poland or Romania.Conclusions This study identified vaccination uptake and delivery issues and recommendations for improvement. HCWs should discuss health service expectations, highlight differences in vaccination scheduling and delivery between countries, and promote greater understanding of the English primary healthcare system in order to encourage vaccination in these communities.