儿科医生疫苗介绍行为及影响因素分析

Recommendation practice on childhood vaccine and its determinants among pediatricians in China

目的了解儿科医生疫苗相关服务情况及其影响因素。方法2020年11月—12月,采用方便抽样的方法,在杭州、长春、西安、重庆、京津冀、深圳和海口7个培训地点对289名儿科医生进行问卷调查,分析儿科医生在接诊适龄儿童时的疫苗介绍行为,并采用多因素有序logistic回归分析其影响因素。结果儿科医生在接诊适龄儿童时经常介绍、有时介绍、基本不介绍儿童疫苗的比例分别为25.3%(73/289),50.2%(145/289)和24.5%(71/289)。不主动介绍相关疫苗的原因主要是没有相关要求和职责,占89.7%。虽然84.8%(245/289)的儿科医生过去一年收到过儿童家长咨询疫苗相关问题,但仅有30.1%(87/289)认为自己有足够的疫苗知识来回答家长咨询。多因素回归分析显示,高级职称组(OR=2.124,95%CI=1.169~3.858)更有可能介绍儿童疫苗;自身接种过流感疫苗(OR=2.237,95%CI=1.296~3.861)、接受过疫苗相关培训(OR=1.830,95%CI=1.112~3.012)、经常接受到家长咨询(OR=6.604,95%CI=3.042~14.338)、有充足的疫苗知识(OR=1.984,95%CI=1.152~3.418)、认为介绍疫苗是自身工作职责(OR=5.6,95%CI=3.083~10.172)的儿科医生介绍疫苗的频率更高。结论总是/经常介绍儿童相关疫苗的儿科医生较少,需增强儿科医生预防服务和群医学意识,提高儿科医生开展疫苗等预防咨询服务和健康教育的积极性。

Objective To examine the behavior of recommendation on childhood vaccines and its influencing factors among pediatricians.Methods Using convenient sampling,we conducted a web-based voluntary anonymous questionnaire survey among 289 pediatricians at seven professional training sites in Beijing-Tianjin-Hebei Region and six municipalities in central,southern and northern China during November-December 2020.Multivariate ordinal logistic regression analysis was adopted to explore factors associated with the recommendation behavior.Results Of all the respondents,25.3%(73/289),50.2%(145/289),and 24.5%(71/289)reported often,sometimes,and occasionally recommending childhood vaccines to the parents of child clinic attendees,respectively.The main reason reported by 89.7%of the pediatricians not recommending childhood vaccines was there being no requirements and responsibilities on the vaccination recommendation.Among all the respondents,only 30.1%(87/289)considered being with adequate knowledge about childhood vaccines to answer relevant questions from child clinic attendees'parents,although 84.8%(245/289)reported having been consulted by the parents on the issues during past one year.The results of multivariate logistic regression analysis revealed that the respondents with following characteristics were more likely to conduct the vaccination recommendation:with senior professional titles(odds ratio[OR]=2.124,95%confidence interval[95%CI]:1.169-3.858),having received influenza vaccination(OR=2.237,95%CI:1.296-3.861),ever receiving vaccine-related training(OR=1.830,95%CI:1.112-3.012),having been consulted by child clinic attendees'parents frequently(OR=6.604,95%CI:3.042-14.338),with adequate knowledge about childhood vaccines(OR=1.984,95%CI:1.152-3.418),and having perceived professional responsibilities for the vaccination recommendation(OR=5.6,95%CI:3.083-10.172).Conclusion Recommendation on childhood vaccines is not often conducted by pediatricians and the situation needs to be improved in China.