以健康信念模式探討醫療照護人員對「醫療照護人員預防接種建議」之行為意願及其影響因素

An Application of the Health Belief Model to Investigate Factors Affecting the Willingness and Behavior of Adhesion to Vaccination Recommendations in Healthcare Personnel

徐士敏(Shih-Min Hsu)

指導教授 ： 苗迺芳

臺北醫學大學/護理學院/護理學研究所/碩士(2014年)

摘要

本研究在探討醫護人員對於「醫療照護人員預防接種建議」之疫苗接種意願與其影響因素，期能提供醫療機構推動醫療照護人員預防接種政策之參考，使醫院感染管制政策及員工保健措施能順利推行。採橫斷性方式研究，以健康信念模式(Health Belief Model, HBM)為理論基礎，設計結構式問卷為研究工具，並以2家區域醫院及1家醫學中心之小兒科、婦產科、急診專科及感染專科等四個專科的醫師及護理人員為研究對象。共發出496份問卷、回收496份，有效問卷486份，有效回收率97.98％。
研究結果顯示：（1）研究對象平均年齡31.59歲，平均年資8.17年，以女性及護理人員為主。（2）在醫療照護人員預防接種建議之相關知識上，整體平均答對率為83.95％，且其與年齡、年資與職別等個人背景變項呈顯著性差異。（3）九成以上的研究對象表示疫苗預防接種對自身健康是有幫助的，其中醫師的接種意願高於護理人員，而疫苗接種意願最高的科別是小兒科；疫苗預防接種意願與其認為幫助之程度，由高至低依序為：B肝疫苗，水痘疫苗，麻疹、腮腺炎、德國麻疹混合疫苗，成人白喉、破傷風及百日咳疫苗及季節性流感疫苗。（4）疫苗預防接種的障礙性方面，護理人員高於醫師，且影響預防接種意願的因素中，以疫苗的安全性為最高，其次為疫苗接種後的副作用症狀與疫苗接種費用，僅有少數表示其身體很健康，不需接種疫苗。（5）醫療照護人員預防接種建議之相關知識、自覺罹病的可能性、自覺罹病的嚴重性、自覺罹病後的傳染風險、自覺疫苗預防接種利益性與行動線索，對於醫療照護人員疫苗預防接種意願上呈現顯著正相關；醫療照護人員預防接種建議之相關知識、自覺疫苗預防接種利益性、自覺疫苗預防接種障礙性，能有效預測及影響疫苗預防接種的意願。
本研究結果有助於國家及醫院於推行醫療照護相關人員疫苗預防接種政策上及實務上之參考。

關鍵字

健康信念模式 ； 醫療照護人員 ； 預防接種建議

並列摘要

This research was to explore the factors affecting the willingness and behaviors of healthcare personnel’s (HCP) adhesion to HCP vaccination recommendations in order to propose strengthening HCP vaccination policy for medical institutions. This research was a crossectional study, an applicaton of Health Belief Model (HBM) in designing structured questionnaire as research tool, and the study subjects focused on physicians and nurses worked in Departments of Pediatric, Obstetrics and Gynecology, Emergency Medicine, and Infectious Disease of two Regional Hospitals and one Medical Center. A total of 496 questionnaires were distributed to the abovementioned subjects and all were collected, among them, 486 (97.98%) were effective questionnaires.
The research findings demonstrated that: (1) the majority of our research subjects were female and nurses, the mean age of our research subjects were 31.59years old with mean seniority of 8.17years; (2) for the HCP’s knowledge of vaccination recommendations, average correction rate were 83.95%, and were significant with personal background variables including age, seniority, and job title and rank; (3) more than 90% of our research subjects considered vaccination as helpful to their health. Among them, the physicians’ willingness of vaccination were higher than nurses’, and for the departmental analysis, the Department of Pediatrics ranked the highest. The highest willingness of receiving vaccination and degree of belief in vaccination would be helpful to health were hepatitis vaccine, followed by varicella vaccine, measles, mumps, and rubella vaccine (MMR), adult tetanus, diphtheria, pertussis ( Tdap) vaccine, and influenza vaccine; (4) for the barriers of receiving vaccination, the barriers were higher in nurses than in physicians, and the factors affecting willingness of vaccination were highest in the vaccine safety, followed by side effects and charges caused by vaccination, only few HCPs considered they are very healthy and do not need vaccination; and (5) their knowledge of HCP vaccination recommendations, perceived susceptibility to diseases, perceived severity of diseases, perceived transmission risk of diseases, perceived benefits and clues to action of vaccination showed significantly positive correlation with HCPs’ willingnesss of receiving vaccination. Furthermore, their knowledge of HCP vaccination recommendations, perceived benefits of vaccination and perceived barriers of vaccination provided effectively prediction and affected the willingness of receiving vaccination.
The results of this research provided constructive references for medical institutes in planning and promoting HCPs’ vaccination plans and strengthening health promotion measures.

並列關鍵字

Health Belief Model ； Healthcare Personnel ； Vaccination Recommendations

參考文獻

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