Associations of influenza and pneumococcal vaccinations with burdens of older family caregivers: The Japan Gerontological Evaluation study (JAGES) cross-sectional study
Associations of influenza and pneumococcal vaccinations with burdens of older family caregivers: The Japan Gerontological Evaluation study (JAGES) cross-sectional study
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DOI：
10.1016/j.vaccine.2022.11.047
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发表时间：
2022-12-30
期刊：
影响因子：
5.5
通讯作者：
Kondo，Katsunori
中科院分区：
文献类型：
--
作者：
Iwai-Saito，Kousuke;Sato，Koryu;Kondo，Katsunori
背景：流感和肺炎在老年人中往往很严重；因此，预防这些疾病需要接种疫苗。接种疫苗对老年家庭照护者尤其重要，不仅可以防止他们生病，而且还可以防止家庭照护者继发感染，他们大多是体弱的老年人，患严重疾病的风险更高。因此，我们调查了老年人的照顾负担是否与接种疫苗有关。方法采用日本老年学评价研究（JAGES）的横断面数据，该研究于2019年11月至2020年1月在日本64个城市进行。目标人群包括26,177名65岁或以上的独立人士，不需要公共长期护理。主要结果是流感和肺炎球菌疫苗接种或两者均接种。进行多项逻辑回归，将未接种疫苗的人作为参照组。结果：在参与者中，分别有23.3%、25.8%、9.4%和41.5%的人不接种疫苗、只接种流感疫苗、只接种肺炎球菌疫苗或两种疫苗。FCR的护理频率、每天的护理时间或痴呆与流感疫苗接种呈负相关（几乎每天护理：相对风险比{RRR}: 0.39, 95%可信区间{95% CI}[0.24-0.63]；几乎每天护理：0.44,95% CI: 0.23-0.85； FCR护理：RRR:0.55, 95% CI: 0.34-0.91）。另一方面，这些照顾负担与肺炎球菌或两种疫苗接种无关。有一个家庭医生减轻了照顾负担对接种疫苗的所有负面影响。结论护理负担是流感疫苗接种的障碍，而不是肺炎球菌疫苗接种的障碍，并且无论负担类型如何，有医生都可以减轻负面影响。
BackgroundInfluenza and pneumonia tend to be severe in older adults; thus, vaccination is necessary to prevent these illnesses. Vaccination is especially important for older family caregivers (OFCs) not only to prevent them from becoming ill, but also to prevent secondary infections in the family care receivers (FCRs), who are mostly frail older adults and have a higher risk of severe illness. Thus, we investigated whether caregiving burdens were associated with the vaccinations among older adults.MethodsWe used cross-sectional data from the Japan Gerontological Evaluation Study (JAGES), which was conducted in 64 Japanese municipalities from November 2019 to January 2020. The target population consisted of 26,177 individuals aged 65 years or older who were independent and did not need public long-term care. The primary outcome was the uptakes of either or both influenza and pneumococcal vaccinations. Multinomial logistic regressions were performed, setting those who underwent neither vaccinations as the reference group.ResultsAmong the participants, 23.3 %, 25.8 %, 9.4 %, or 41.5 % underwent neither, only influenza, only pneumococcal, or the both vaccinations, respectively. The caregiving frequency, time length in a day, or dementia of FCR were negatively associated with influenza vaccination (caregiving almost every day: relative risk ratio {RRR}: 0.39, 95 % confident interval {95 % CI} [0.24–0.63]; caregiving almost all day: 0.44, 95 % CI: 0.23–0.85; caregiving for FCR: RRR:0.55, 95 % CI: 0.34–0.91). On the other hand, those caregiving burdens were not associated with pneumococcal only or the both vaccinations. Having a family physician mitigated all the negative effect of the caregiving burdens on the vaccinations.ConclusionOur results suggest that the caregiving burden is a barrier to influenza vaccination but not to pneumococcal vaccination and that having a physician mitigates the negative effect regardless of the burden kind.