The study set out to determine the influenza vaccination rate and to identify factors important in the process of vaccination acceptance decision making for a group of the well elderly in the A.C.T. Prediction of vaccination acceptance was compared using three measures: stated behavioural intention, report of past vaccination acceptance and a multiattribute utility decision model. In this study no one method of prediction was obviously better than another. The most important findings of this study included the marked variations in vaccination rates based on type of residence of the group members. Of the 15 variables of the decision model, factors related to the infection of influenza and possible complications of influenza were seen as the most important factors by both acceptors and nonacceptors of the vaccine in making the decision to have the injection. These findings can be incorporated into an area vital for nursing intervention, the planning of nursing programmes of health promotion and health maintence for the well elderly population.

published_or_final_version / Public Health / Master / Master of Public Health

Influenza is a serious public health problem that circulates worldwide affecting every age group and spreads easily from person to person. It can cause severe illnesses and deaths especially in high risk groups including the aged 65 or above. Influenza vaccination programme is an important issue in Hong Kong health care system. More preventive measures should be targeted on the elderly in practice. Mailing invitation, phone invitation, training-the-trainer program and home visit by nurse in primary care settings are found to be effective in increasing the influenza vaccination rate as evidenced by 10 systematic reviews. Several approaches of recommendations for increasing the utilization of influenza vaccination among elders in community have been proposed in this paper. Communication plan, pilot testing and evaluation plan have been discussed to implement and improve the proposed guidelines. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Aim: Thisstudy aimedto investigatethe knowledge and attitudes of healthcareworkers regardinginfluenza, influenza vaccination,and vaccination practicesin emergency departments in Gothenburg, Sweden. Method: This cross-sectional studyuseda self-administered questionnaire distributed tonurses, assistant nurses,and physiciansin three emergency departments atThe Sahlgrenska University Hospital in January–February2014. Results: Among214 participants, 56% were nurses, 27% assistant nurses,and 17% physicians. The response ratewas 77%. A total of 66 participants (31%)werevaccinated against influenza during the previous12 months.The highest vaccination coverage occurredin the oldestage group(56%;P&lt;0.05).Past vaccinationstrongly predicted future vaccinationbehavior (P&lt;0.001). Ourdata revealed nosignificant difference invaccination coverage betweenprofession, work experience, hospital,or gender. The mean knowledge score was higher among vaccinated vs. unvaccinated health care workers (17.9 ± 2.7vs.16.8 ± 2.6, respectively; P&lt; 0.05). Moreover, influenza risk perception was higher among participants who were vaccinated during the previous12 months compared to unvaccinated participants (P&lt; 0.001). Interestingly, more un vaccinated health care workers believed that personal behavior determines health (higher internal locus of control) compared to vaccinated workers(P&lt; 0.05). More than half of vaccinated health care workers stated that they got vaccinated to avoid influenza. Almost half of the unvaccinated workers voiced concern about vaccine side effects. Fourteen percent of all respondents mentioned patient protection as an important factor in their decision to receive influenza vaccination. Conclusion:This study demonstrates a need for improved knowledge about influenza and influenza vaccinationin health care workers. Increased risk perception of influenza can increase vaccination coverage in emergency department personnel,and may reduce the incidence of healthcare-associated influenza. / <p>ISBN 978-91-86739-77-5</p>

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2016-04-04T16:57:05Z No. of bitstreams: 1 Tiago Pereira de Souza Fatores....pdf: 1305801 bytes, checksum: 2cf226c83a5027d515c816ab9f57d2bb (MD5) / Approved for entry into archive by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2016-04-04T16:57:21Z (GMT) No. of bitstreams: 1 Tiago Pereira de Souza Fatores....pdf: 1305801 bytes, checksum: 2cf226c83a5027d515c816ab9f57d2bb (MD5) / Made available in DSpace on 2016-04-04T16:57:21Z (GMT). No. of bitstreams: 1 Tiago Pereira de Souza Fatores....pdf: 1305801 bytes, checksum: 2cf226c83a5027d515c816ab9f57d2bb (MD5) Previous issue date: 2015 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / INTRODUÇÃO: Embora a vacina influenza seja anualmente recomendada para todos trabalhadores de saúde, estudos revelam que a cobertura vacinal desse grupo frequentemente é baixa. Diferentes fatores podem influenciar a vacinação contra a influenza, sendo necessário utilizá-los a favor da ampliação da cobertura vacinal. OBJETIVO: Identificar fatores que influenciam a prática de vacinar-se contra influenza entre trabalhadores de saúde. MATERIAIS E MÉTODOS: estudo transversal, ocorrido num Complexo Hospitalar de Salvador, Bahia. Utilizou-se um questionário autoaplicável, e os modelos "Conhecimento, Atitudes e Práticas" (CAP) e "Health Belief Model" (HBM). A vacinação contra influenza em 2014 (autorreferida) representou a variável principal, e fatores sociodemográficos, histórico de outras vacinas, conhecimentos e atitudes constituíram variáveis independentes. Considerou-se haver "conhecimento adequado", quando 75,0% ou mais dos indivíduos julgaram determinada informação corretamente.As análises foram feitas por regressão logística no Stata, versão 13, utilizando-se o teste qui-quadrado ao nível de 5% de significância, odds ratio, e intervalos de confiança de 95%. O modelo multivariado foi ajustado por sexo, idade e profissão, sendo composto pelas variáveis com p valor igual ou inferior a 0,20 na análise bivariada. A verificação de modelos alternativos mais adequados foi feita por retirada retrógrada, utilizando-se como parâmetro o "Critério de Informação de Akaike" (AIC). RESULTADOS: A amostra foi de 755 indivíduos, destacando-se técnicos de enfermagem (41,4%), enfermeiros (15,2%) e médicos (14,7%). Predominaram trabalhadores do sexo feminino (82,5%), entre 19 e 39 anos (82,4%), com 5 anos ou menos de experiência (67,5%). A cobertura vacinal global foi de 61,5%, sendo a maior entre enfermeiros (69,0%) e a menor entre médicos (49,1%). Os principais motivadores da vacinação foram conhecer a recomendação da vacina para si (49,0%), confiar em vacinas no geral (41,6%) e na eficácia da vacina influenza (35,4%). Os principais desmotivadores foram esquecimento (37,3%), inconveniência de locais/horários (22,5%) e não saber da campanha (16,3%). A principal estratégia que facilitaria a vacinação foi vacinar os trabalhadores no seu próprio setor de trabalho (56,6%). O conhecimento foi adequado no julgamento de 9/16 das informações, com destaque para médicos (15/16) e enfermeiros (13/16). A maior adequação (94,6% de acerto) refere-se à indicação da vacina para todo trabalhador de saúde, e o conhecimento menos adequado foi sobre a incapacidade da vacina causar a influenza (32,0% de acerto). Os fatores associados à vacinação foram: conhecer que pessoas saudáveis também precisam se vacinar contra influenza (OR=3,15 ; IC95%: 1,74 - 5,71); saber que a vacina não protege por muitos anos (OR=2,08 ; IC95%: 1,30 - 3,33); e não ter medo dos efeitos adversos pós-vacinais (OR=1,93 ; IC95%: 1,26 - 2,95). CONCLUSÕES: a vacinação contra influenza é influenciada por conhecimentos, atitudes e questões organizacionais/operacionais.Medidas educativas e de desmistificação de questões relacionadas à influenza e à vacina, bem como ampliação de dias/horários e locais de vacinação de acordo com a conveniência dos trabalhadores de saúde, devem compor as estratégias voltadas à elevação da cobertura da vacina influenza neste grupo. / INTRODUCTION: Although the influenza vaccine is recommended annually for all health workers, studies show that vaccination coverage of this group is often low. Different factors can influence the vaccination against influenza, it is necessary to use them in favor of the expansion of vaccination coverage. GOAL: To identify factors that influence the practice of vaccination against influenza among health workers. MATERIALS AND METHODS: A cross-sectional study, which took place in a hospital complex in Salvador, Bahia. We used a self-administered questionnaire, and the models "Knowledge, Attitudes and Practices"(CAP) and "Health Belief Model"(HBM). Influenza vaccination in 2014 (self-reported) was the main variable, and sociodemographic factors, history of other vaccines, knowledge and attitudes were independent variables. Considered to be "appropriate knowledge" as 75.0% or more of subjects judged certain information correctly. Analyses were performed by logistic regression using Stata, version 13, using the chi-squared test at 5% significance, odds ratio, and 95% confidence intervals. The multivariate model was adjusted for sex, age and profession, being composed of the variables that had a pvalue less than or equal to 0.20 in the bivariate analysis. The verification of most suitable alternative models was performed by backward withdrawal, using as a parameter the "Akaike Information Criteria" (AIC). RESULTS: The sample consisted of 755 individuals, mainly nursing technicians (41.4%), nurses (15.2%) and physicians (14.7%). There was a predominance of female workers (82.5%), between 19 and 39 years (82.4%), with five years or less experience (67.5%). The global vaccination coverage was 61.5%, the highest among nurses (69.0%) and lowest among physicians (49.1%). The main motivators to get vaccinated were to know the recommendation of the vaccine for themselves (49.0%), trust in vaccines in general (41.6%) and in the effectiveness of influenza vaccine (35.4%). The main demotivating were forgetfulness (37.3%), inconvenience locations/times (22.5%) and not knowing the campaign (16.3%). The main strategy would facilitate the vaccination was to inoculate workers in their own work sector (56.6%). The knowledge was adequate in evaluating 9/16 of information, especially physicians (15/16) and nurses (13/16). Most adequacy (94.6% accuracy) refers to the indication of the vaccine for all healthcare workers, and less adequate knowledge was about the inability of the vaccine cause influenza (32.0% accuracy). The factors associated with vaccination were: to know that healthy people also need to be vaccinated against influenza (OR = 3.15; CI95%: 1.74 to 5.71); know that the vaccine does not protect for many years (OR = 2.08, CI95%: 1.30 to 3.33); and not be afraid of post-vaccination adverse events (OR = 1.93; CI95%: 1.26 to 2.95). CONCLUSIONS: Influenza vaccination is influenced by the knowledge, attitudes and organizational/operational issues. Educational measures and demystifying issues related to influenza and the vaccine, as well as expansion of days/times and vaccination sites according to the convenience of healthcare workers, should compose strategies aimed at raising the coverage of influenza vaccine in this group.

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in Baltimore, Maryland. The study also examined the belief that the influenza vaccine causes the flu and the effect this belief may have on influenza vaccination rates. The public health critical race theory served as the framework for the study. Previously validated survey instruments, the Health Care System Distrust Scale and the Adult Influenza Immunization Survey, were obtained with permission and used to collect data from the members of a Baltimore city church. The study used chi-square analysis, multivariable logistic regression, and narrative discussion to address the research questions and analyze the data of 105 completed surveys. Results of the study determined that distrust of the medical community was not a relevant factor in the influenza vaccination rates of study participants, and that participants' vaccination status was influenced by factors other than distrust. Implications for social change included improving the influenza vaccination rate among Black Americans and decreasing their influenza mortality rates.

M Family Medicine research report - Faculty of Health Sciences / Residents of old age homes are at increased risk for the complications of influenza. Studies in developed countries have consistently shown that influenza vaccination of old age home residents and staff can significantly decrease morbidity and mortality rates and that influenza vaccination is one of the most cost effective interventions possible in this population. No studies have been done on the cost benefit of using influenza vaccine in old age home residents in South Africa. The aim of this study was to evaluate the costs of treating influenza and influenza-like illnesses in old age home residents, and to compare the costs in people who had received the influenza vaccine to those who had not. The study population comprised 151 people residing in two old age homes in Johannesburg, namely Sandringham Gardens and Nazareth House. The study population was divided into two groups- those who received influenza vaccine and those who had not been vaccinated. The residents of Nazareth House who gave consent had all been vaccinated. The subjects at Sandringham Gardens were sub- divided into two groups, namely: “Residents” and “Frail care / wards” section. The general health of the “Frail care” people was poorer than that of the “residents”. Medical records were reviewed, and details of the number of doctor consultations, medication and physiotherapy prescribed, special investigations performed and hospital referrals related to influenza and influenza-like infections were recorded. The costs were then calculated using “medical aid rates”. There were no significant differences in the treatment costs, comparing those who had been vaccinated to those who had not been vaccinated. There are a number of possible explanations for this. These include, most importantly, a low to moderate epidemic activity of influenza in the season that the study was conducted. Other explanations are low patient numbers, the use of symptoms for diagnosis and the use of over the counter therapy. Despite the findings in the present study, the international literature supports the view that influenza vaccination is a cost-effective intervention in the older adult population, particularly those at higher risk. These findings have been implemented in the official guidelines of many countries, including the South African Adult Influenza Vaccination Guideline.

Background: Vaccination is one of the most cost-effective preventive measures against infectious diseases. A proper administration of the vaccine is critical. Therefore, only authorized and trained health care personnel including pharmacists can administrate vaccines safely and effectively. However, in Sweden, several laws and regulations prevent pharmacists to perform vaccinations. Aim: The aim was to elucidate the conditions and regulations of influenza vaccination administration by pharmacists at pharmacies in other countries compared to Sweden. Methods: A literature review were performed. Two different databases, PubMed and Web of Science were used. In addition, reports of governmental and various organizations were used. Interviews have been used as a complement. Results: Involving pharmacists in vaccination administration improves the vaccine coverage. This result was confirmed by pharmacist performing vaccine administration in other countries such as the USA, Canada, UK and Norway. However, these benefits are limited in Sweden due to the regulation HSLF-FS 2017:37, which hampers vaccines administration by pharmacists. Nevertheless, the regulation SOSFS 1997:14 could be interpreted as allowing clinical doctors to delegate vaccination to pharmacists. However, this needs to be further investigated. All Swedish representatives interviewed in this report, supported the idea that pharmacists should be able to perform vaccines at Swedish pharmacies. Conclusions: Modification of the regulation HSLF-FS 2017: 37 as well as proper education and training are required to allow pharmacists to perform vaccinations in Swedish pharmacies.

To improve U.S. residents' health, advocates are focusing their efforts on workplace health. Researchers have found that unionization is a positive influence on workers' participation in health promotion programs relating to smoking and obesity prevention. However, the effect of union membership on other health promotion initiatives, such as influenza vaccination compliance among health care workers, has not been examined. The purpose of this quantitative study was to address this knowledge gap between a union and a nonunion health care facility in the U.S. state of Pennsylvania. The health belief model was used to determine if different domains of influenza vaccination perception predicted vaccination behaviors among union and nonunion health care workers. A secondary analysis was performed on the 2013-2014 Influenza Vaccination Survey, which was completed by 2,480 health care workers. While a chi-square analysis showed that vaccination compliance was not statistically different between facilities, a binary logistic regression revealed a significant difference in predicted vaccination behaviors for each domain of influenza vaccination perceptions. Among union health care workers, perceived barriers yielded the highest positive predictability of vaccination compliance, whereas perceived benefits were positively associated with vaccination compliance among nonunion workers. These study findings affect social change by identifying vaccine compliance predictors among union and nonunion health care workers. By focusing on these predictors, health care facilities may be able to improve levels of vaccination compliance and achieve the Joint Commissions' vaccination goal of 90% compliance amongst all healthcare workers.

Since 2012-2013 influenza season, World Health Organization (who) recommends the formulation of tetravalent vaccines. Globally, many countries already use tetravalent vaccines in their national immunization programs, while in Latin America only a small number. Two Influenza b lineages co-circulate, their epidemiological behavior is unpredictable. On average they represent 22.6% of influenza cases and more than 50% in predominant seasons. The lack of concordance between recommended and circulating strains was 25 and 32% in the 2010-2017 and 2000-2013 seasons, respectively. There are no clinical differences between influenza A and B. It occurs more frequently from five to 19 years of age. Influenza b has a higher proportion of attributable deaths than influenza a (1.1 vs. 0.4%), or 2.65 (95% ci 1.18-5.94). A greater number of hospitalizations when the strains mismatch (46.3 vs. 28.5%; p <.0001). Different evaluations have demonstrated its cost effectiveness. The compilation of this information supports the use of quadrivalent vaccines in Latin American countries. / Revisión por pares