icu后期流感和COVID-19疫苗决策的影响因素

Stacey J. Carter MSN, RN, FNP-C , Jana Lauderdale PhD, RN , Joanna L. Stollings PharmD , Carla M. Sevin MD , Jennifer Cunningham-Erves PhD , Shahristan Kokoy PharmD , Kate Clouse PhD, MPH , Leanne M. Boehm PhD, RN, ACNS-BC
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引用次数: 0

摘要

COVID-19疫苗的引入暴露了疫苗的波动性和犹豫不决。一些卫生保健模式,包括ICU康复诊所(ICU- rc),旨在提供疫苗咨询。然而,在这种急性后情况下,有关提供者和患者疫苗对话的信息有限。研究问题:围绕流感和COVID-19疫苗接种,哪些因素影响ICU住院存活患者的决策过程?研究设计和方法为了进一步了解危重疾病后对疫苗的看法,利用一项随机对照试验的转录本进行了二次定性专题分析,该试验旨在开发和完善ICU康复的远程医疗方法。出院12周内,对19名成年患者和13名护理人员进行了33次ICU-RC访问。该分析以计划行为理论为指导。结果从数据中引出5个主题。前四个主题来自TPB:(1)行为和态度信念(不容易感染流感,担心COVID-19疫苗会导致生育问题,并且没有得到足够的测试),(2)规范性信念(他们认识的每个人都在接种流感疫苗,所以他们也接种流感疫苗),(3)控制疫苗信念(如果容易获得,患者更有可能接种COVID-19疫苗),以及(4)接种疫苗的意图。另一个与TPB无关的主题出现了,可能有助于疫苗的意图和行为:(5)卫生团队与患者和护理人员的接触(允许ICU临床医生实时纠正疫苗错误信息)。利用我们研究中获得的信息,危重疾病或其他急性疾病事件后的一段时间可能是设计行动计划以提高公众对疫苗的信任和提高整体完成率的一个特别富有成效的目标;然而,还需要进一步的研究。审判RegistryClinicalTrials.gov;不。: NCT03926533;URL: www.clinicaltrials.gov
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Influencing Influenza and COVID-19 Vaccine Decision-Making in the Post-ICU Period

Background

The introduction of COVID-19 vaccines exposed volatility and hesitancy around vaccines. Some health care models, including ICU recovery clinics (ICU-RCs), are structured to provide vaccine counseling. However, information regarding provider and patient vaccine conversations is limited in this postacute setting.

Research Question

What factors influence the decision-making process of patients who have survived an ICU stay surrounding influenza and COVID-19 vaccination?

Study Design and Methods

To understand further vaccine perceptions after critical illness, a secondary qualitative thematic analysis was performed using transcripts from a randomized controlled trial designed to develop and refine a telemedicine approach to ICU recovery. Thirty-three ICU-RC visits with 19 adult patients and 13 caregivers were conducted within 12 weeks of hospital discharge. The analysis was guided by the theory of planned behavior (TPB).

Results

Five themes were elicited from the data. The first four themes arose from the TPB: (1) behavioral and attitudinal beliefs (not being susceptible to the flu, concerns about the COVID-19 vaccine causing fertility issues, and not being tested enough), (2) normative beliefs (everyone they know is getting the influenza vaccine so they are, too), (3) control vaccine beliefs (patients are more likely to get the COVID-19 vaccine if it is easy to obtain), and (4) intention to vaccinate. Another theme not related to the TPB arose and could contribute to vaccine intent and behavior: (5) health team engagement with patients and caregivers (allowing for ICU clinicians to correct vaccine misinformation in real time).

Interpretation

Using the information learned in our study, the period after critical illness or other acute illness events may be an especially fruitful target for designing an action plan for improving public trust in vaccines and improving overall completion rates; however, further research is needed.

Trial Registry

ClinicalTrials.gov; No.: NCT03926533; URL: www.clinicaltrials.gov

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CHEST critical care
CHEST critical care Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine
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