Explanation of intention toward influenza vaccination among cardiovascular disease patients: An application of the extended protection motivation theory

Objective

Patients with cardiovascular disease (CVD) are susceptible to influenza virus infection, and influenza vaccination is effective in preventing influenza, but its uptake remains low. This study will investigate the influencing factors affecting patients' intention to receive influenza vaccination based on the extended protection motivation theory (PMT) and explore whether there are differences in this psychological pathway among patients with different levels of illness perception.

Study design

Cross-sectional study.

Methods

In this study, the extended PMT model was used, which consists of the original construct (threat and coping assessment) and the extended construct (social norms and trust). Based on this, the model used to explain influenza vaccination intentions in CVD patients was constructed. Structural equation modelling was then used to test the extended theory from the overall population, the high-illness-perception and low-illness-perception populations, respectively.

Results

Intention toward influenza vaccination was positively correlated with severity (β = .211), vulnerability (β = .154), response efficacy (β = .243), self-efficacy (β = .154), and social norms (β = .179), while being negatively associated with response costs (β = −.244). Social norms influenced intention by mediating response efficacy and self-efficacy, while trust in information sources was mediated by self-efficacy. Extended PMT had higher interpretative efficacy in patients with high illness perception than in patients with low illness perception (75.1 % vs 35.2 %).

Conclusions

The study found that the extended PMT is appropriate for explaining the intention toward influenza vaccination of patients with CVD. Patients with different illness perception levels have differences in the paths. It is suggested that patients with different levels of illness perception be subdivided, and intervention strategies should be developed by considering the theoretical models of each subgroup.