上海市60岁及以上人群流感疫苗接种服务及策略优化的定性研究  

A qualitative study on optimizing influenza vaccination services and strategies for people aged 60 and above in Shanghai

作　　者：王潇兰 杨天 薛曹怡 吴琳琳 费怡 杨肖光 徐飚[1] WANG Xiaoan;YANG Tian;XUE Caoyi;WU Linin;FEI Yi;YANG Xiaoguang;XU Biao(School of Public Health,Fudan University,Key Laboratory of Health Technology Assessment,National Health Commission,Shanghai,200032,China;Department of Immunization Program,Pudong New Area Center for Disease Control and Prevention,Shanghai,200136,China;Department of Immunization Program,Shanghai Municipal Center for Disease Control and Prevention,Shanghai,200336,China;China Hospital Development Institute,Shanghai Jiao Tong University School of Medicine,Shanghai,China)

机构地区：[1]复旦大学公共卫生学院,国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032 [2]浦东新区疾病预防控制中心免疫规划所,上海200136 [3]上海市疾病预防控制中心免疫规划所,上海200336 [4]上海交通大学中国医院发展研究院,上海200025

出　　处：《上海预防医学》2024年第10期977-982,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2023-29)。

摘　　要：【目的】了解影响上海市老年人流感疫苗接种服务利用及接种决策的因素,探索流感疫苗接种服务提供情况及面临的困难,为优化流感免疫接种策略提供参考。【方法】基于疫苗犹豫决定因素矩阵,采用目的抽样法,于2024年1—2月,在上海市选取老年人流感疫苗接种服务利益相关者为研究对象。对象纳入以达到主题饱和为原则。访谈资料经录音、转录和NVivo 20软件编码整理,采用主题框架法分析。【结果】共纳入研究对象25例,包括9名医务人员,12名60岁及以上老年人和4名家属。上海市流感疫苗接种服务全程管理规范,但基层对疫苗的宣传积极性不高。疫苗自费及老年人文化观念对其疫苗接种有负面影响;家人朋友及医务人员推荐对接种有重要促进作用,且不同类型医务人员推荐效果不同;街镇居委对疫苗接种的推广有助于传递信息到目标人群。此外,互联网及社交媒体使用、新型冠状病毒疫苗的接种对流感疫苗接种有双向作用。疫苗免疫策略优化应重视价格优惠、宣传方式和途径,重视提升医务人员的服务意识、专业水平及主动推荐意愿。【结论】上海市流感疫苗服务流程完善规范,但需重视老年人家庭及其他支持系统的作用,提升医务人员专业水平、服务意识及推荐意愿,同时有效结合互联网社交媒体技术及街镇居委工作职能,开展系统性干预及宣传。[Objective]To understand the process and influencing factors affecting the utilization of influenza vaccination services and vaccination decision-making among the elderly in Shanghai,to explore the delivery of influenza vaccination services and the difficulties faced by the health service system,and to provide guidance for optimizing immunization strategies.[Methods]Based on the vaccine hesitancy determinants matrix,semi-structured personal interviews were conducted with stakeholders involved in influenza vaccination services in Shanghai from January to February 2024,using a purposive sampling method.Participants were included until thematic saturation was achieved.Interview data were audio-recorded,transcribed,coded,and organized using NVivo 20 software,and analyzed using the thematic framework method.[Results]A total of 25 interviewees were included,including 9 medical staff,12 elderly people aged 60 and above,and 4 family members.The study found that Shanghai had a well-managed and standardized influenza vaccination service.However,the promotion of vaccinerelated information at the grassroots level was passive and limited.Out-of-pocket payment of the vaccine and cultural beliefs of the elderly negatively impacted vaccination rates.Meanwhile,recommendations from family,friends,and medical staff facilitated vaccination,although the impact varied depending on the type of medical staff.Neighborhood committees in townships and streets played a crucial role in delivering vaccination information to the target population.Additionally,the internet,social media,and the COVID-19 vaccine had both positive and negative impacts on influenza vaccination.Strategic optimization of vaccination should prioritize price concessions,enhance publicity strategies,and improve awareness,professionalism,and willingness among medical and healthcare workers to recommend vaccination.[Conclusion]The influenza vaccination service in Shanghai is well-managed and standardized.However,it is essential to consider the influence of family and othe

关 键 词：流感疫苗 疫苗犹豫决定因素矩阵 老年人群 疫苗接种 影响因素 

分 类 号：R183[医药卫生—流行病学]