孕婦接種流感疫苗－護理人員的因應策略探討

孕婦接種流感疫苗除了能夠有效降低孕婦罹患流感的風險及衍生後續併發症的危險外，所產生的抗體亦可保護出生6個月內的新生兒免於流感威脅。許多研究顯示流感疫苗對孕婦及胎兒是安全且有益的，世界衛生組織及國家防疫政策也皆建議孕婦接種，但國內孕婦對於接種流感疫苗的意願仍普遍偏低。鑑於護理人員在孕婦接種流感疫苗執行策略上有著舉足輕重的第一線角色，本文將從實務面上探討如何強化護理人員的專業能力及服務效能，以提升疫苗接種的覆蓋率（coverage rate），相關建議包括提升護理人員與孕婦對接種流感疫苗的專業知識及正面態度、加強孕婦及其家屬的衛教品質與溝通技巧、落實孕婦流感疫苗接種嚴重疫苗不良事件通報機制及正確訊息等，期能藉此強化孕婦對接種流感疫苗的信心及意願，以維護母體與胎兒的健康。

關鍵字

流感疫苗；疫苗接種；孕婦；護理人員；因應策略

並列摘要

Influenza vaccinations may decrease the risk of contracting influenza and its complications significantly in pregnant women and effectively help infants less than six months of age avoid hospitalization. Based on scientific evidence supporting the safety and benefits of the influenza vaccination for pregnant women and fetuses, the epidemic prevention policy of both the World Health Organization and Taiwan's Ministry of Health and Welfare recommend that pregnant women receive the influenza vaccination. However, low acceptance of the influenza vaccine among pregnant women is an ongoing concern in Taiwan. Nursing staffs play a key role in implementing the influenza vaccination program for pregnant women. Therefore, strengthening the professional competency and service effectiveness of nursing staffs may be expected to significantly improve the vaccination coverage rate. This article offers practical methods for achieving this, including promoting nursing staffs' professional knowledge and positive attitudes regarding influenza vaccinations for pregnant women, improving nursing staffs' related education and skills in communication with pregnant women and their families, and improving the implementation of the notification mechanism for disseminating accurate information regarding the vaccine and vaccine adverse events. Our ultimate goal is to enhance the confidence and willingness of pregnant women with regard to receiving influenza vaccinations in order to promote the health of mothers and their fetuses.

並列關鍵字

influenza vaccine ； vaccination ； pregnant women ； nursing staff ； coping strategy

參考文獻

陳孟妤、黃薇伊、陳逸瑄、黃婉婷（2017）．2015年臺灣醫療人員對季節性流感疫苗接種後不良事件之知識，態度與行為調查．疫情報導，33（17），315–323。[Chen, M. Y., Huang, W. I., Chen, Y. H., & Huang, W. T. (2017). Survey on adverse events of seasonal influenza vaccines: Knowledge, attitude, and behavior on medical professions in Taiwan. Taiwan Epidemiology Bulletin, 33(17), 315–323.] https://doi.org/10.6524/EB.20170905.33(17).001

Bisset, K. A., & Paterson, P. (2018). Strategies for increasing uptake of vaccination in pregnancy in high-income countries: A systematic review. Vaccine, 36(20), 2751–2759. https://doi.org/10.1016/j.vaccine.2018.04.013

Eick, A. A., Uyeki, T. M., Klimov, A., Hall, H., Reid, R., Santosham, M., & O'Brien, K. L. (2011). Maternal influenza vaccination and effect on influenza virus infection in young infants. Archives of Pediatrics & Adolescent Medicine, 165(2), 104–111. https://doi.org/10.1001/archpediatrics.2010.192

Ellingson, M., & Chamberlain, A. T. (2018). Beyond the verbal: Pregnant women's preferences for receiving influenza and Tdap vaccine information from their obstetric care providers. Human Vaccines & Immunotherapeutics, 14(3), 767–771. https://doi.org/10.1080/21645515.2018.1425114

Håberg, S. E., Trogstad, L., Gunnes, N., Wilcox, A. J., Gjessing, H. K., Samuelsen, S. O., ... Stoltenberg, C. (2013). Risk of fetal death after pandemic influenza virus infection or vaccination. The New England Journal of Medicine, 368(4), 333–340. https://doi.org/10.1056/NEJMoa1207210

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孕婦接種流感疫苗－護理人員的因應策略探討

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