Factors associated with intention of pandemic influenza A (H1N1) vaccination among health care workers at extended care hospitals in Hong Kong

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Factors associated with intention of pandemic influenza A (H1N1) vaccination among health care workers at extended care hospitals in Hong Kong


Author: Fok, Wai-yi Fiona
Title: Factors associated with intention of pandemic influenza A (H1N1) vaccination among health care workers at extended care hospitals in Hong Kong
Degree: M.Sc.
Year: 2011
Subject: Hong Kong Polytechnic University -- Dissertations
H1N1 influenza -- China -- Hong Kong -- Prevention
H1N1 influenza -- Vaccination -- China -- Hong Kong
Department: Faculty of Health and Social Sciences
Pages: xi, 141 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2426761
URI: http://theses.lib.polyu.edu.hk/handle/200/6060
Abstract: Background: With the emergence of pandemic influenza A (H1N1) virus in April 2009, World Health Organization declared it as a global influenza pandemic on June 11, 2009. While influenza is a vaccine preventable disease and influenza vaccination is one of the most effective measures for controlling the virus. In Hong Kong, Chor et al conducted a local study in May 2009 with a convenience sample of 389 HCWs in an acute hospital, reporting only 47.9% of HCWs willingly accepted the pandemic vaccine. It created particular concerns why less than 50% of HCWs accepted the vaccination at this critical moment. Moreover, the acceptability and compliance with the pandemic vaccines in the local extended care hospitals was unknown and the factors affected these HCWs to have pandemic flu vaccination were unclear. Aim of the study: The study aimed to identify HCWs’ intention of receiving pandemic vaccination and examine the factors affecting their intention of Hong Kong Extended Care Hospitals at WHO alert level phase 6 with sustained evidence of human to human transmission. This study used a modified health belief model as a study framework to organize factors in a systematic way to help explain the responses regarding the intention among HCWs. The suggested result could help design future vaccine program and plan interventions to achieve positive changes in health behavior. Methodology: This was a cross-sectional survey using a self-administered questionnaire for data collection. It was undertaken over four weeks since December 2009 and it overlapped for 10 days with the official commencement of the pandemic influenza vaccination program. By convenient sampling, it comprised 737 subjects from five extended care hospitals located at four clusters under the management of the local public hospital system. The participants in this study were doctors, nurses, allied health professional and clinical / health care assistants. The research student was the coordinator at the workplace and also the chief coordinator of four hospitals, in which four liaison nurses assisted in delivering and collecting questionnaires from their workplaces and returned them to the research student for data analysis.
Result: Altogether 1576 questionnaires were distributed and the response rate was 49% (n=768) but only 737 questionnaires were valid for data analysis and 29% (n=208) of them had intention to receive the pandemic vaccine. The global public health alarm did not help increase the intention to receive pandemic vaccination among HCWs. Regarding the logistics regression model for multivariate analysis, the findings showed that pandemic vaccine acceptance was significantly associated with "male HCWs", "HCWs with the length of employment at or below 10 years", "history of seasonal flu vaccination", "health beliefs’ factors" including higher "perceived susceptibility", higher "perceived severity" of the pandemic influenza infection, and "perceived more benefits" and "perceived less barriers" towards the pandemic vaccines, and social influence and professional advice as cues to action to prompt HCWs take actions. Conclusion: In this study, HCWs' intention to receive pandemic vaccine was strongly associated with health beliefs. Thus, the future vaccine educational program should focus on influencing the HCWs' health beliefs such as highlighting the risk and emphasizing the consequences of getting influenza infection and promoting the benefits and rationales. Despite this, the greatest barrier to doubts about the vaccine safety and efficacy so promulgating the vaccine safety and efficacy in advance before the commencement of vaccination program. In this study, the main difference between the factor associated with the intention to receive pandemic vaccines and acceptance of seasonal flu vaccination was the "length of employment at or below 10 years", which was the group more willingly to receive pandemic vaccine than others. For those female HCWs with length of employment over ten years might be more reluctant to receive vaccination. Tailor vaccination campaigns for these two groups of HCWs will help maximize the uptake rate. Moreover, when HCWs receive more social influence and professional advice, the acceptance of vaccination could also be enhanced. Of the HCWs, nurses have the lowest intention & doctors have the highest intention among groups to receive pandemic vaccines. A further study on the uptake rate of vaccination among them is suggested. If HCWs such as nurses and doctors have low intention to receive pandemic influenza vaccination, they might not be motivated to recommend vaccination to patients in their care and might also undermine the patient's confidence in being vaccinated. Thus, a vaccine program should be designed carefully if it works effectively it could maximize the uptake rate and limit the circulation of influenza virus in the hospitals for patients and HCWs' protection even minimizing health care associated influenza infection.

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