社區醫務人員知識態度和行為對老年人接種流感疫苗的影響_《中國循證醫學雜志》

作者：

朱小鳳 ¹ , 黃婷 ² , 祝小平 ² , 唐雪峰 ² , 余宏杰 ³ , 許真 ³ , 馮奧 ⁴ , 劉磊 ² , 欒榮生 ¹ ,  楊維中 ³

1. 四川大學華西公共衛生學院流行病學教研室（成都 610041）；2. 四川省疾病預防與控制中心（成都 610041）；3. 中國疾病預防與控制中心（北京 102206）；4. 大連大學附屬中山醫院（大連 116001）;

關鍵詞：

流感疫苗老年人醫務人員社區醫療

DOI：

10.7507/1672-2531.20130096

視頻：

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目的　探討社區衛生服務中心醫務人員的知識、態度、行為（KAP）對其所在社區的老年人接種流感疫苗的影響。
方法　采用單純隨機抽樣方法，從成都市5城區中各隨機抽取2個社區，每個社區又各抽取1個居民小區，對小區內≥60歲的老年人進行入戶調查；同時對抽中社區的衛生服務中心醫務人員進行問卷調查。
結果　社區醫務人員對流感疫苗有效性的肯定，明確知道接種的重點人群，在流感季節建議前來就診的老年人接種疫苗以及參加流感的宣傳教育活動，能顯著提高老年人流感疫苗的接種率。以上每項的正確率每提高1%，接種率能分別提高2.747%、1.299%、0.864%和0.602%。
結論　社區醫務人員的知識和行為可影響老年人流感疫苗的接種率，醫務人員的知識、行為和態度的提升對促進老年人群流感疫苗的接種率具有重要意義。

引用本文： 朱小鳳,黃婷,祝小平,唐雪峰,余宏杰,許真,馮奧,劉磊,欒榮生,楊維中. 社區醫務人員知識態度和行為對老年人接種流感疫苗的影響. 中國循證醫學雜志, 2013, 13(5): 543-547. doi: 10.7507/1672-2531.20130096 復制

1.	Michael M, Helm E, Van Graafeiland B, et al. Influenza vaccination with a live attenuated vaccine. Am J Nurs, 2009, 109(10): 44-48.
2.	Forleo-Neto E, Halker E, Santos VJ, et al. Influenza. Rev Soc Bras Med Trop, 2003, 36(2): 267-274.
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4.	Mato Chaín G, Mariano Lázaro A, Alcudia Pérez F, et al. Flu vaccination in the elderly. Rev Esp Geriatr Gerontol, 2011, 46(2): 89-95.
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14.	Perez LE, Merrill GA, Delorenzo RA, et al. Evaluation of the specificity and sensitivity of a potential rapid influenza screening system. Diagn Microbiol Infect Dis, 2013, 75(1): 77-80.
15.	Lambert ND, Ovsyannikova IG, Pankratz VS, et al. Understanding the immune response to seasonal influenza vaccination in older adults: a systems biology approach. Expert Rev Vaccines, 2012, 11(8): 985-994.
16.	Rothberg MB, Haessler SD, Brown RB. Complications of viral influenza. Am J Med, 2008, 121(4): 258-264.
17.	Bergsaker M, Hungnes O, Iversen B. Vaccination against influenza--why, for whom and with which vaccine? Tidsskr Nor Laegeforen, 2006, 126(21): 2814-2817.
18.	Domínguez A, Castilla J, Godoy P, et al. Effectiveness of pandemic and seasonal influenza vaccines in preventing pandemic influenza-associated hospitalization. Vaccine, 2012, 30(38): 5644-5650.
19.	Goka E, Vallely P, Mutton K, et al. Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respi Viruses, 2012 Oct 19. doi: 10.1111/irv.12020. [Epub ahead of print].
20.	Brydak L, Roiz J, Faivre P, et al. Implementing an influenza vaccination programme for adults aged ≥65 years in Poland: a cost-effectiveness analysis. Clin Drug Investig, 2012, 32(2): 73-85.
21.	Toplak N, Avcin T. Influenza and autoimmunity. Ann N Y Acad Sci. 2009, 1173: 619-626. doi: 10.1111/j.1749-6632.2009.04759.x.
22.	劉長暖節譯. 流感疫苗（WHO 最新立場性文件）. 中國生物制品學雜志, 2007, 20(1): 69-72.
23.	中國流行性感冒疫苗預防接種指導意見. 中國衛生部, 2005.
24.	Kositanont U, Assantachai P, Wasi C, et al. Kinetics of the Antibody Response to Seasonal Influenza Vaccination Among the Elderly. Viral Immunol, 2012, 25(6): 471-476.
25.	Chen J, Li YT, Gu BK, et al. Estimation of the Direct Cost of Treating People Aged More Than 60 Years Infected by Influenza Virus in Shanghai. Asia Pac J Public Health, 2012 Oct 2. [Epub ahead of print].
26.	Mannino S, Villa M, Apolone G, et al. Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. Am J Epidemiol, 2012, 176(6): 527-533.
27.	Gilbert SC. Advances in the development of universal influenza vaccines. Influenza Other Respi Viruses, 2012 Sep 24. doi: 10.1111/irv.12013. [Epub ahead of print].
28.	董振英, 王全意, 吳疆, 等. 北京市城區流感和流感疫苗知識、態度和行為調查. 中華流行病學雜志, 2005, 26(2): 152.
29.	Li HY, Wu SS, Yang P, et al. Influenza vaccination coverage rates and factors associated with vaccine use among the elderly in Beijing during 2008-2010. Zhonghua Liu Xing Bing Xue Za Zhi, 2012, 33(2): 247-248.
30.	李永成, 王淑惠, 楊雪瑩, 等. 天津市城區老年人流感疫苗及影響因素分析. 中國公共衛生, 2007, 23(3): 264-266.
31.	張小平, 許二萍, 劉艷, 等. 杭州市城區老年人流感疫苗接種情況及其影響因素分析. 浙江預防醫學, 2011, 23(9): 31-32.
32.	Takahashi O, Noguchi Y, Rahman M, et al. Influence of family on acceptance of influenza vaccination among Japanese patients. Fam Pract, 2003, 20(2): 162-166.
33.	Burns VE, Ring C, Carroll D. Factors influencing influenza vaccination uptake in an elderly, community-based sample. Vaccine, 2005, 23(27): 3604-3608.
34.	Kohlhammer Y, Schnoor M, Schwartz M, et al. Determinants of influenza and pneumococcal vaccination in elderly people: a systematic review. Public Health, 2007, 121(10): 742-751.
35.	Zimmerman RK, Santibanez TA, Janosky JE, et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. Am J Med, 2003, 114(1): 31-38.
36.	Kwong EW, Lam IO, Chan TM. What factors affect influenza vaccine uptake among community-dwelling older Chinese people in Hong Kong general outpatient clinics? J Clin Nurs, 2009, 18(7): 960-971.
37.	Avelino-Silva VI, Avelino-Silva TJ, Miraglia JL, et al. Campaign, counseling and compliance with influenza vaccine among older persons. Clinics (Sao Paulo), 2011, 66(12): 2031-2035.
38.	Blank PR, Bonnelye G, Ducastel A, et al. Attitudes of the General Public and General Practitioners in Five Countries towards Pandemic and Seasonal Influenza Vaccines during Season 2009/2010. PLoS One, 2012, 7(10): e45450.

1. Michael M, Helm E, Van Graafeiland B, et al. Influenza vaccination with a live attenuated vaccine. Am J Nurs, 2009, 109(10): 44-48.
2. Forleo-Neto E, Halker E, Santos VJ, et al. Influenza. Rev Soc Bras Med Trop, 2003, 36(2): 267-274.
3. 中華人民共和國衛生部. 中國流行性感冒疫苗預防接種指導意見. 國際呼吸雜志, 2006, 26(1): 3, 7.
4. Mato Chaín G, Mariano Lázaro A, Alcudia Pérez F, et al. Flu vaccination in the elderly. Rev Esp Geriatr Gerontol, 2011, 46(2): 89-95.
5. Derber CJ, Shankaran S. Health-Care Worker Vaccination for Influenza: Strategies and Controversies. Curr Infect Dis Rep, 2012, 14(6): 627-632.
6. Maggi S. Vaccination and healthy aging. Expert Rev Vaccines, 2010, 9(3 Suppl): 3-6.
7. Lang PO, Mendes A, Socquet J, et al. Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence. Clin Interv Aging, 2012, 7(1): 55-64.
8. Kasten MJ, Poland GA. Influenza vaccination and the elderly: pandemic preparedness. Drugs Aging, 2008, 25(3): 179-186.
9. Booy R, Lindley RI, Dwyer DE, et al. Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial. PLoS One, 2012, 7(10): e46509.
10. Biagi E, Candela M, Turroni S, et al. Ageing and gut microbes: Perspectives for health maintenance and longevity. Pharmacol Res, 2013, 69(1): 11-20.
11. Monto AS, Ansaldi F, Aspinall R, et al. Stephenson I Influenza control in the 21st century: Optimizing protection of older adults. Vaccine, 2009, 27(37): 5043-5053.
12. Orosi P, Borbely A, Szidor J, et al. Factors affecting influenza vaccine uptake among health care workers at the Medical and Health Sciences Center of Debrecen University, Hungary. Orv Hetil, 2012, 153(13): 505-513.
13. Liu X, Guo J, Han S, et al. Enhanced immune response induced by a potential influenza A vaccine based on branched M2e polypeptides linked to tuftsin. Vaccine, 2012, 30(46): 6527-6533.
14. Perez LE, Merrill GA, Delorenzo RA, et al. Evaluation of the specificity and sensitivity of a potential rapid influenza screening system. Diagn Microbiol Infect Dis, 2013, 75(1): 77-80.
15. Lambert ND, Ovsyannikova IG, Pankratz VS, et al. Understanding the immune response to seasonal influenza vaccination in older adults: a systems biology approach. Expert Rev Vaccines, 2012, 11(8): 985-994.
16. Rothberg MB, Haessler SD, Brown RB. Complications of viral influenza. Am J Med, 2008, 121(4): 258-264.
17. Bergsaker M, Hungnes O, Iversen B. Vaccination against influenza--why, for whom and with which vaccine? Tidsskr Nor Laegeforen, 2006, 126(21): 2814-2817.
18. Domínguez A, Castilla J, Godoy P, et al. Effectiveness of pandemic and seasonal influenza vaccines in preventing pandemic influenza-associated hospitalization. Vaccine, 2012, 30(38): 5644-5650.
19. Goka E, Vallely P, Mutton K, et al. Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respi Viruses, 2012 Oct 19. doi: 10.1111/irv.12020. [Epub ahead of print].
20. Brydak L, Roiz J, Faivre P, et al. Implementing an influenza vaccination programme for adults aged ≥65 years in Poland: a cost-effectiveness analysis. Clin Drug Investig, 2012, 32(2): 73-85.
21. Toplak N, Avcin T. Influenza and autoimmunity. Ann N Y Acad Sci. 2009, 1173: 619-626. doi: 10.1111/j.1749-6632.2009.04759.x.
22. 劉長暖節譯. 流感疫苗（WHO 最新立場性文件）. 中國生物制品學雜志, 2007, 20(1): 69-72.
23. 中國流行性感冒疫苗預防接種指導意見. 中國衛生部, 2005.
24. Kositanont U, Assantachai P, Wasi C, et al. Kinetics of the Antibody Response to Seasonal Influenza Vaccination Among the Elderly. Viral Immunol, 2012, 25(6): 471-476.
25. Chen J, Li YT, Gu BK, et al. Estimation of the Direct Cost of Treating People Aged More Than 60 Years Infected by Influenza Virus in Shanghai. Asia Pac J Public Health, 2012 Oct 2. [Epub ahead of print].
26. Mannino S, Villa M, Apolone G, et al. Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. Am J Epidemiol, 2012, 176(6): 527-533.
27. Gilbert SC. Advances in the development of universal influenza vaccines. Influenza Other Respi Viruses, 2012 Sep 24. doi: 10.1111/irv.12013. [Epub ahead of print].
28. 董振英, 王全意, 吳疆, 等. 北京市城區流感和流感疫苗知識、態度和行為調查. 中華流行病學雜志, 2005, 26(2): 152.
29. Li HY, Wu SS, Yang P, et al. Influenza vaccination coverage rates and factors associated with vaccine use among the elderly in Beijing during 2008-2010. Zhonghua Liu Xing Bing Xue Za Zhi, 2012, 33(2): 247-248.
30. 李永成, 王淑惠, 楊雪瑩, 等. 天津市城區老年人流感疫苗及影響因素分析. 中國公共衛生, 2007, 23(3): 264-266.
31. 張小平, 許二萍, 劉艷, 等. 杭州市城區老年人流感疫苗接種情況及其影響因素分析. 浙江預防醫學, 2011, 23(9): 31-32.
32. Takahashi O, Noguchi Y, Rahman M, et al. Influence of family on acceptance of influenza vaccination among Japanese patients. Fam Pract, 2003, 20(2): 162-166.
33. Burns VE, Ring C, Carroll D. Factors influencing influenza vaccination uptake in an elderly, community-based sample. Vaccine, 2005, 23(27): 3604-3608.
34. Kohlhammer Y, Schnoor M, Schwartz M, et al. Determinants of influenza and pneumococcal vaccination in elderly people: a systematic review. Public Health, 2007, 121(10): 742-751.
35. Zimmerman RK, Santibanez TA, Janosky JE, et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. Am J Med, 2003, 114(1): 31-38.
36. Kwong EW, Lam IO, Chan TM. What factors affect influenza vaccine uptake among community-dwelling older Chinese people in Hong Kong general outpatient clinics? J Clin Nurs, 2009, 18(7): 960-971.
37. Avelino-Silva VI, Avelino-Silva TJ, Miraglia JL, et al. Campaign, counseling and compliance with influenza vaccine among older persons. Clinics (Sao Paulo), 2011, 66(12): 2031-2035.
38. Blank PR, Bonnelye G, Ducastel A, et al. Attitudes of the General Public and General Practitioners in Five Countries towards Pandemic and Seasonal Influenza Vaccines during Season 2009/2010. PLoS One, 2012, 7(10): e45450.

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社區醫務人員知識態度和行為對老年人接種流感疫苗的影響

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《中國循證醫學雜志》

社區醫務人員知識態度和行為對老年人接種流感疫苗的影響

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