Page 73 - Preventing pertussis in early infancy - Visser

Chapter 5
Quantitative study HCWs
48.6%, and 41.2%, respectively). Part of the participating HCWs were uncertain about vaccination (24.1%, 28.0%, and 35.0%, respectively) and anticipated regret (negative affect) for refusing vaccination if one of their patients contracted pertussis (59.5%, 47.3%, and 36.0%, respectively). Univariate logistic regression of the personal determinants showed that acceptance of a previously offered influenza vaccination was associated with the intention to accept pertussis vaccination in the three HCW groups presented here. All the psychosocial determinants, except perceived control and autonomy for the paediatric nurses, were significantly associated with intention (Table 3).
In the multivariate analyses, the attitude of the maternity assistants, midwives, and paediatric nurses, the anticipated affect regarding non-acceptance and decisional uncertainty were uniquely associated with the intention to accept a pertussis vaccination in the three target groups. Previous influenza vaccination, social norm, perceived capacity, and anticipated affect regarding acceptance showed a unique association only for one or two specific groups (Table 4).
Determinants of attitude
Most maternity assistants, midwives, and paediatric nurses classified pertussis in infants as severe (97.9%, 95.6%, and 92.0%, respectively) and said they would feel very bad if they had infected an infant patient (98.8%, 97.5%, and 98.0%, respectively). Only some HCWs felt susceptible to pertussis themselves (15.8%, 5.9%, and 8.5%, respectively), although they believed that there was a higher susceptibility for HCWs in their profession in general (25.1%, 29.1%, and 32.0%, respectively). About half the maternity assistants (46.9%) and midwives (44.9%) felt that hygienic measures would reduce the chance of their transmitting pertussis to an infant versus 25.5% of the paediatric nurses. While 54.4% of the midwives and 51.0% of the paediatric nurses agreed with a policy advising the pertussis vaccination of HCWs with infant contact, 76.1% of the maternity assistants agreed. The participants who felt morally responsible to help prevent patients from contracting pertussis included 71.2% of the maternity assistants, 60.9% of the midwives, and 48.5% of the paediatric nurses.
Univariate linear regression of the determinants of attitude showed that most of these determinants were significantly associated with the attitude towards pertussis cocooning vaccination (p < 0.001 and r > 0.3; Appendix 2). In the multivariate analysis, general vaccination beliefs, agreement with policy advice to vaccinate HCWs, perceived cost–benefit ratio, and perceived personal responsibility to prevent pertussis were uniquely associated with the attitude towards pertussis cocooning vaccination of all target groups. Several risk perception determinants, beliefs about general vaccination policy, and the perceived efficacy of cocooning showed a unique association only for one or two of the target groups (Table 5).
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