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研究生:吳美玲
研究生(外文):Mei-Ling Wu
論文名稱:影響醫院從業人員接種流感疫苗之因素探討
論文名稱(外文):Investigation of factors associated with influenza vaccination among hospital workers
指導教授:李素幸李素幸引用關係
指導教授(外文):Su-Hsing Lee
學位類別:碩士
校院名稱:長榮大學
系所名稱:職業安全與衛生學系碩士班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:154
中文關鍵詞:醫院從業人員流行性感冒流行性感冒疫苗知識態度行為
外文關鍵詞:hospital workersinfluenzainfluenza vaccinationKnowledgeAttitudeBehavior
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流行性感冒是一種具有高度傳染性的急性呼吸道疾病,醫院從業人員在職場暴露上不僅屬於高危險群,當他們罹患流行性感冒時亦會將病菌傳染給照護的病患與其他密切接觸者,增加病患嚴重併發症及死亡的危險。目前美國及歐洲等國醫院從業人員流行性感冒疫苗接種率偏低,但在國內衛生署統計每年的接種率近乎達百分之百,如此差別是否因為國內外醫護人員對流感之認知有所不同,尚待評估。因此本研究目的為:1)了解醫院從業人員對流行性感冒及流行性感冒疫苗之知識程度,2)了解醫院從業人員對流行性感冒疫苗接種之態度與行為,及3)探討影響醫院從業人員接種流行性感冒疫苗之態度與行為之相關因素以及未來接種行為傾向。本研究採橫斷調查方式,以來自台灣南部地區十三所醫院的523位從業人員為對象,利用立意取樣方式進行問卷調查,問卷內容包括五大部分:流行性感冒的認識、流感疫苗的認識、流感疫苗接種的態度行為、流感疫苗接種經驗及個人基本資料等。
研究結果顯示於97年度的流感疫苗疫苗研究樣本接種率為64%,年齡在40-49歲、醫師,及在門診、兒科及感染科工作者,接種率均達到80%以上。相關性分析發現醫院從業人員的流感知識與流感疫苗知識有正相關傾向(r=0.28, p<0.01),而流感知識與疫苗接種態度有負相關傾向(r=-0.12, p<0.01),疫苗知識與疫苗接種態度則無相關。多因子分析結果發現對於未來接種行為之預測,去年是否有接種疫苗、同事接種率及疫苗接種態度均有關;相對於去年(97年)有接種疫苗者,沒有接種疫苗的未來接種行為之OR為19.06(95%CI=9.06-40.13);相對於同事接種率高於九成以上者,同事接種率低於九成以下者的未來接種行為之OR為4.02(95%CI=1.87-8.63);及相對於疫苗接種態度高分組,疫苗接種態度低分組的未來接種行為之OR為3.84 (95%CI=1.71-8.65)。
本研究發現疫苗知識與疫苗接種態度並不呈現正相關性,而卻有負相關傾向,顯示除了流感相關知識的教育訓練外,醫療院所仍須擬定其他策略來增加醫護人員的接種率,例如針對去年未接種者及接種率偏低的單位來加強輔導。
Influenza is a highly contagious acute respiratory disease. Hospital workers not only are high risk population in terms of influenza exposure, but they can also transmit influenza to their patients, while under influence of the disease. In the US and the Europe, the vaccination rates among hospital workers were below 40%, yet according to the Centers for Disease Control in Taiwan, vaccination rates for hospital workers has almost reached 100%. Whether such discrepancy was resulted from perception of influenza knowledge or other factors, it needs further research. Therefore, this study was conducted to: a) understand hospital workers’ knowledge regarding to influenza and the vaccination, b) understand hospital workers’ attitude and behavior toward influenza vaccination, c) investigate relevant factors that affect attitude and behavior of influenza vaccination among hospital workers. This cross-sectional study included 523 workers who were purposively invited from 13 hospitals in southern Taiwan. A structure questionnaire was designed for data collection. Information collected in the questionnaire included: knowledge of influenza, knowledge of influenza vaccination, attitude toward influenza vaccination, personal influenza vaccination experience and demographics.
The study results show that influenza vaccination rate in the year of 2008 was 64%. The vaccination rate among workers who aged between 40 and 49, positioned as doctors, and worked in the department of outpatient, pediatrics, and infection control were all over 80%. Correlation analysis found that influenza knowledge was positively correlated with vaccination knowledge (r=0.28, p<0.01), yet influenza knowledge had a tendency of negative correlation with attitude of vaccination (r=-0.12, p<0.01), and vaccination knowledge and attitude of vaccination was not correlated. Multivariate analysis revealed that whether or not last year had received vaccination, vaccination rate among colleagues, and attitude of vaccination were significant predictors for behavior in future vaccination. Compared with those who received vaccination last year, OR of behavior in future vaccination for those who did not was 19.06 (95%CI=9.06-40.13). Compared with those whose colleagues had vaccination rate greater than 90%, OR of behavior in future vaccination for those whose colleagues did not was 4.02 (95%CI=1.87-8.63). Compared with those who were at the group of high score in attitude of vaccination, OR of behavior in future vaccination for those who were at the group of low score was 3.84 (95%CI=1.71-8.65).
This study found that influenza knowledge had a tendency of negative correlation with attitude of vaccination. It suggests that hospital managers need to incorporate more strategies, besides training that focuses on influenza knowledge, to increase vaccination rate among hospital workers, such as reinforcement on those who have not received vaccination in the previous year or on the unit that has lower vaccination rate in the previous year.
第一章 緒論
第一節 研究動機與背景
第二節 研究目的
第三節 研究問題
第四節 名詞界定
第二章 文獻探討
第一節 流行性感冒
第二節 流行性感冒疫苗
第三節 影響醫院從業人員接種流感疫苗之態度與行為的相關因子
第三章 研究方法及架構
第一節 研究流程
第二節 研究架構
第三節 研究對象與資料收集
第四節 研究工具
第五節 研究統計方法
第四章 研究結果
第一節 研究對象基本資料
第二節 醫院從業人員流感知識、流感疫苗知識及流感疫苗接種態度之現況分析
第三節 個人因素與流感知識、流感疫苗知識及疫苗接種態度之相關
第四節 流感知識、流感疫苗知識、疫苗接種態度及未來接種行為之相關性
第五節 個人因素對流感知識、流感疫苗知識、疫苗接種態度及未來接種行為之相關
第六節 醫院從業人員個人因素對疫苗接種態度之重要預測因素
第五章 討論
第六章 結論與建議
第一節 結論
第二節 建議
參考文獻
英文部分
中文部份
Canning, H. S., Phillips, J., & Allsup, S. (2005). Health care worker beliefs about influenza vaccine and reasons for non-vaccination--a cross-sectional survey. Journal of Clinical Nursing,14(8): 922-925.
Carman, W., Elder, A., Wallace, L., McAulay, K., Walker, A.. Murray, G., & Stott, D. (2000). Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomized controlled trial. Lancet,355:93–97.
Centers for Disease Control and Prevention (2001). Prevention and control of influenza Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 50(4):1–63.
Chan, A. L., Shie, H. J., Lee, Y. J., & Lin, S. J.(2008) The evaluation of free influenza vaccination in health care workers in a medical center in Taiwan. Pharmacy World&Science, 30(1): 39-43.
Christini, A. B., Shutt, K. A., & Byers, K. E.(2007). Influenza vaccination rates and motivators among healthcare worker groups. Infection Control Hospital Epidemiol, 28(2): 171-177.
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