Demandas y expectativas de padres y madres que rechazan la vacunación y perspectiva de los profesionales sanitarios sobre la negativa a vacunar / Demands and expectations of parents who refuse vaccinations and perspective of health professional on the refusal to vaccinate

OBJETIVOS: Explorar las opiniones, creencias y actitudes sobre la vacunación, de padres y madres que deciden no vacunar a sus hijos/as. Conocer las opiniones y las actitudes de profesionales sanitarios sobre el comportamiento de estas personas hacia la vacunación. MÉTODO: Investigación cualitativa basada en entrevistas semiestructuradas y grupo focal a padres/madres de Granada que deciden no vacunar a sus hijos/as y a profesionales sanitarios implicados en la vacunación infantil. Análisis de contenido de tipo semántico con categorización de respuestas en unidades temáticas. RESULTADOS: Los padres argumentan el beneficio de presentar enfermedades inmunoprevenibles de un modo natural, sin productos antinaturales, tóxicos o agresivos. Consideran la vacunación innecesaria si se dan adecuadas condiciones higiénico-sanitarias, de eficacia no demostrada, y más peligrosa que las enfermedades que evitan, especialmente las vacunas polivalentes. Piensan que los programas de vacunación están movidos por estudios sesgados e intereses distintos de la prevención de perfil comercial. Los profesionales opinan que los que rechazan la vacunación tienen temores de base seudocientífica, que es necesario mejorar los sistemas de información/comunicación, tener una postura conciliadora y una sólida formación sobre seguridad vacunal. CONCLUSIONES: Los no vacunadores han perdido la percepción del balance beneficio de la vacunación frente al riesgo individual de presentar enfermedades inmunoprevenibles y plantean la necesidad del consentimiento informado. Los profesionales consideran poco contrastadas las argumentaciones de los no vacunadores y exponen la existencia de fallos en las coberturas reales de vacunación y en los sistemas de registro de la información. Como mejoras se plantea centralizar los registros, compararlos con los listados de educación, trabajar con líderes locales e informar periódicamente sobre la situación de las enfermedades inmunoprevenibles

OBJECTIVES: To examine the opinions, beliefs and attitudes about vaccination, of parents who decide not to vaccinate their children. To determine the opinions and attitudes of the health professionals on the behaviour towards childhood vaccination. METHOD: Qualitative research based on semi-structured interviews and focal groups in Granada, Spain, including parents who chose to not vaccinate their children, and healthcare professionals who can provide a technical point of view. An analysis was made of the semantic content, and answers were categorized in thematic units. RESULTS: The parents argued on the benefit of suffering vaccine-preventable diseases in a natural way, without non-natural, aggressive or toxic products. Vaccination was considered unnecessary, if given adequate hygienic-sanitary conditions, effectiveness unproven and more dangerous than the diseases they prevent, especially the polyvalent vaccines. They believed that vaccination programs are moved by biased studies and interests other than prevention. Health care professionals believe that they had fears without scientific basis, which requires improving information systems. CONCLUSIONS: Non-vaccinators are unaware of the benefit/risk ratio between the vaccination and the individual risk for preventable diseases, and ask for informed consent. Health care professionals believe that non-vaccinators' arguments are not correctly contrasted and expose the existence of failures in actual vaccination coverage and information registration systems. It was suggested to centralize registers and compare them in schools, working with local leaders and reporting regularly on the status of vaccine-preventable diseases

[Demands and expectations of parents who refuse vaccinations and perspective of health professional on the refusal to vaccinate]. / Demandas y expectativas de padres y madres que rechazan la vacunación y perspectiva de los profesionales sanitarios sobre la negativa a vacunar.

OBJECTIVES: To examine the opinions, beliefs and attitudes about vaccination, of parents who decide not to vaccinate their children. To determine the opinions and attitudes of the health professionals on the behaviour towards childhood vaccination. METHOD: Qualitative research based on semi-structured interviews and focal groups in Granada, Spain, including parents who chose to not vaccinate their children, and healthcare professionals who can provide a technical point of view. An analysis was made of the semantic content, and answers were categorized in thematic units. RESULTS: The parents argued on the benefit of suffering vaccine-preventable diseases in a natural way, without non-natural, aggressive or toxic products. Vaccination was considered unnecessary, if given adequate hygienic-sanitary conditions, effectiveness unproven and more dangerous than the diseases they prevent, especially the polyvalent vaccines. They believed that vaccination programs are moved by biased studies and interests other than prevention. Health care professionals believe that they had fears without scientific basis, which requires improving information systems. CONCLUSIONS: Non-vaccinators are unaware of the benefit/risk ratio between the vaccination and the individual risk for preventable diseases, and ask for informed consent. Health care professionals believe that non-vaccinators' arguments are not correctly contrasted and expose the existence of failures in actual vaccination coverage and information registration systems. It was suggested to centralize registers and compare them in schools, working with local leaders and reporting regularly on the status of vaccine-preventable diseases.

El Análisis de Texto asistido por Ordenador en la Investigación Cualitativa / Computer assisted text analysis in qualitative research

El objetivo de este artículo es presentar un proceso de análisis del texto apoyado en un programa informático. Se proponen dos tipos de análisis: Análisis de Contenido y Análisis de Discurso. El Análisis de Contenido se desarrolla en tres niveles: a) Sintáctico: búsqueda de palabras o caracteres, b) Semántico: busca el sentido de las palabras y el análisis de las categorías propuestas. c) Pragmático: trata de descubrir las circunstancias en las que la comunicación tiene lugar. El Análisis de Discurso busca captar el sistema de creencias que subyace al lenguaje verbal y describir sentidos, significados e interacciones entre los entrevistados. Existen programas informáticos que facilitan la tarea de organización y análisis de la información textual, cumpliendo tres funciones básicas: 1) codificación del texto y capacidad de relacionar categorías y sujetos de forma automática; 2) elaboración de tipologías o perfiles con base en las variables sociodemográficas y de opinión; y, 3) posibilidad de trabajar con grandes cantidades de información de forma simultánea, (AU)

[Perception of environmental risks: qualitative study done in the affected by the Aznalcóllar toxic spill area]. / Percepción de riesgos ambientales: estudio cualitativo realizado en la zona del vertido tóxico de Aznalcóllar.

BACKGROUND: This paper is based on a qualitative study undertaken between July and August 1998 among the residents of the area close the mining waste spill that occurred the 25th of April 1998 in Aznalcóllar, Seville, Spain. OBJECTIVES: To contribute to the identification of some clues about risk perceptions among the population living at the vicinity of the toxic spill, focusing especially on the perceived health risks, the sources of information, their credibility, and the expectations for the future. METHODOLOGY: Combined qualitative research methodologies were used, including interviews and focal groups. RESULTS: The findings show the existence of a perception of the economic consequences of the spill. In a second level possible the consequences for the health status were relevant. Perceived health risks referred to long term effects, such as malformations and cancer. No changes in habits and behaviour are expressed. The information comes from the media, even if mistrust and perplexity are associated with the information received. There is low of credibility towards the administration, ecologist groups and the media. The role of the health system appears poorly defined. The perceived absence of an adequate information to the audience is noted, and there is a demand from the affected population for an informed participation in the process of management of environmental risks. CONCLUSIONS: The findings of this work stress the importance of an adequate communication process in the management of health risks associated with environmental hazards. Moreover, it also highlights the need to improve the knowledge about environmental risk perceptions in our country through both quantitative and qualitative research, in the context of the modern risk management and the growing relevance of environmental topics in the social agenda.