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1.
Article in English | MEDLINE | ID: mdl-38836412

ABSTRACT

CONTEXT: The role of political identities in determining attitudes to vaccines has attracted a lot of attention in the last decade. Explanations have tended to focus on the influence of party representatives on their sympathizers (partisan cues). METHODS: Four representatives samples of the French adult population completed online questionnaires between July 2021 and May 2022 (N = 9,177). Bivariate and multivariate analyses were performed to test whether partisan differences in attitudes to vaccines are best explained by partisan cues or by parties' differences in propensity to attract people who distrust the actors involved in vaccination policies. FINDINGS: People who feel close to parties at the far left, the far right and to green parties are more vaccine hesitant. We found a small evidence for the effect of partisan cues and a much stronger effect of trust. But more importantly, we show that the more politically sophisticated are less vaccine hesitant and that the non-partisan are the biggest and most vaccine-hesitant group. CONCLUSIONS: The literature has focused on the case of the USA but turning the attention towards countries where disenchantment with politics is more marked helps better understand the different ways trust, partisanship and political sophistication can affect attitudes to vaccines.

2.
J Health Polit Policy Law ; 49(4): 567-598, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38324348

ABSTRACT

CONTEXT: In 2021, French health authorities strongly promoted vaccination against COVID-19. The authors assumed that refusing this vaccine became a stigma, and they investigated potential public stigma toward unvaccinated people among the French population. METHODS: A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. The authors focused on participants who were already vaccinated against COVID-19 or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and the authors investigated associated factors with logistic regressions. FINDINGS: Regarding attitudes toward unvaccinated people, a majority of respondents supported several pejorative statements, and a significant minority also endorsed social rejection attitudes. The authors found four contrasting attitudinal profiles: moral condemnation only (32% of respondents), full stigma (26%), no stigma (26%), and stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes, and being aged 65 or older were the main factors associated with stigmatizing attitudes toward unvaccinated people. CONCLUSIONS: The authors found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. The authors discuss their results with reference to the concept of "folk devils" and from a public health perspective.


Subject(s)
COVID-19 Vaccines , COVID-19 , Social Stigma , Vaccination Refusal , Humans , France , Male , Female , Middle Aged , Adult , COVID-19 Vaccines/administration & dosage , Vaccination Refusal/psychology , Aged , COVID-19/prevention & control , Surveys and Questionnaires , Young Adult , Adolescent , Vaccination/psychology
4.
Fam Med Community Health ; 12(1)2024 01 11.
Article in English | MEDLINE | ID: mdl-38216208

ABSTRACT

OBJECTIVES: To our best knowledge, no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19. 'Patients' voice is an excellent means to capture data on primary care pathways.We aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences, and to test whether these clusters were associated with a higher risk of poor clinical outcomes. DESIGN: Cross-sectional online survey using life-event calendars. SETTING: All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in France. PARTICIPANTS: 312 patients responded to the survey. MAIN OUTCOME MEASURES: From the day of symptom onset to the day of hospitalisation, we defined a symptom sequence as the time-ordered vector of the successive symptom grades (grade 1, grade 2, grade 3). State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom sequences. Multivariate logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit (ICU) and COVID-19 sequelae after hospitalisation. RESULTS: Three clusters of symptom sequences were identified among 312 complete prehospital pathways. A specific group of patients (29%) experienced extended symptoms of severe COVID-19, persisting for an average duration of 7.5 days before hospitalisation. This group had a significantly higher probability of being admitted to ICU (adjusted OR 2.01). They were less likely to know a loved one who was a healthcare worker, and more likely to have a lower level of education. Similarly, this group of patients, who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time, may have been inclined to postpone reassessment when their health worsened.Their relatives played a decisive role in their hospitalisation. CONCLUSION AND RELEVANCE: This study highlights the negative impact of delayed hospitalisation on the health outcomes of French patients with severe COVID-19 symptoms during the first wave and underscores the influence of socioeconomic factors, such as lower education levels and limited connections to the medical field, on patients' experiences.


Subject(s)
COVID-19 , Emergency Medical Services , Humans , COVID-19/therapy , SARS-CoV-2 , Cross-Sectional Studies , Patient Outcome Assessment
5.
Soc Sci Med ; 328: 115952, 2023 07.
Article in English | MEDLINE | ID: mdl-37245262

ABSTRACT

How much does endorsement of complementary and alternative medicine (CAM) correlate with negative attitudes towards vaccines? One of the difficulties of analysing the relationship between attitudes to CAM and attitudes towards vaccines rests in the complexity of both. Which form of CAM endorsement is associated with what type of reticence towards vaccines? While the literature on the relationship between CAM and attitudes towards vaccines is growing, this question has not yet been explored. In this study we present the results of a survey conducted in July 2021 among a representative sample of the French mainland adult population (n = 3087). Using cluster analysis, we identified five profiles of CAM attitudes and found that even among the most pro-CAM group, very few respondents disagreed with the idea that CAM should only be used as a complement to conventional medicine. We then compared these CAM attitudes to vaccine attitudes. Attitudes to CAM had a distinct impact as well as a combined effect on attitudes to different vaccines and vaccines in general. However, we also found a) that attitudes to CAM provide a very limited explanation of vaccine hesitancy and b) that, among the hesitant, pro-CAM attitudes are often combined with other traits associated with vaccine hesitancy such as distrust of health agencies, radical political preferences and low income. Indeed, we found that both CAM endorsement and vaccine hesitancy are more prevalent among the socially disadvantaged. Drawing on these results, we argue that, to better understand the relationship between CAM and vaccine hesitancy, it is necessary to look at how both can reflect lack of access and recourse to mainstream medicine and distrust of public institutions.


Subject(s)
Complementary Therapies , Vaccines , Adult , Humans , Cross-Sectional Studies , Vaccination , Health Knowledge, Attitudes, Practice , Vaccines/therapeutic use , France
6.
BMC Public Health ; 23(1): 628, 2023 04 01.
Article in English | MEDLINE | ID: mdl-37005583

ABSTRACT

BACKGROUND: The human papillomavirus (HPV) vaccine reduces the burden of cervical and other cancers. In numerous countries, a slow uptakeof this vaccine persists, calling for a better understanding of the structural factors leading to vaccine acceptation. We aimed to assess the attitudes toward HPV vaccination among its intended public to explore its specific characteristics. METHODS: A random cross-sectional telephone survey of the French general population provided data from a sample of 2426 respondents of the target public: the parents of young women and the young women aged 15-25 themselves. We applied cluster analysis to identify contrasting attitudinal profiles, and logistic regressions with a model averaging method to investigate and rank the factors associated with these profiles. RESULTS: A third of the respondents had never heard of HPV. However, most of the respondents who had heard of it agreed that it is a severe (93.8%) and frequent (65.1%) infection. Overall, 72.3% of them considered the HPV vaccine to be effective, but 54% had concerns about its side effects. We identified four contrasting profiles based on their perceptions of this vaccine: informed supporters, objectors, uninformed supporters, and those who were uncertain. In multivariate analysis, these attitudinal clusters were the strongest predictors of HPV vaccine uptake, followed by attitudes toward vaccination in general. CONCLUSIONS: Tailored information campaigns and programs should address the specific and contrasted concerns about HPV vaccination of both young women and of their parents.


Subject(s)
Papillomavirus Infections , Papillomavirus Vaccines , Uterine Cervical Neoplasms , Humans , Female , Vaccination Hesitancy , Health Knowledge, Attitudes, Practice , Papillomavirus Infections/prevention & control , Cross-Sectional Studies , Patient Acceptance of Health Care , Vaccination , Uterine Cervical Neoplasms/epidemiology , Parents , Surveys and Questionnaires
7.
Fam Pract ; 2022 Oct 21.
Article in English | MEDLINE | ID: mdl-36267023

ABSTRACT

BACKGROUND: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end. OBJECTIVES: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. METHODS: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients' medical trajectories were collected using a biographical approach. RESULTS: The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. CONCLUSION: GPs should first systematically explore patients' aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.

8.
BMC Public Health ; 22(1): 1500, 2022 08 05.
Article in English | MEDLINE | ID: mdl-35932014

ABSTRACT

BACKGROUND: In view of experts' warnings about the potential negative mental health consequences of the sudden nationwide lockdowns implemented in many countries to limit the spread of the COVID-19 pandemic, we sought to study the incidence of posttraumatic stress disorder (PTSD) after traumatic events related to this unprecedented lockdown in the French general population. METHODS: This longitudinal study among adults (aged =18) consisted of two surveys: the first during the last days of the lockdown and the second a month later. We estimated PTSD incidence with the PCL-5 and ran multiple Poisson regression models to identify factors associated with PTSD. RESULTS: Among the 1736 participants, 30.1% reported at least one traumatic event. PTSD incidence was 17.5% (95% confidence interval CI = 15.7-19.3). It was higher in participants who reported multiple traumatic events, who had high COVID-19-related media use, who had general anxiety disorder (GAD-7) during the lockdown, and who had GAD, depression (PHQ-9), or sleep problems 1 month later. In addition, 43.1% of people with PTSD reported suicidal thoughts. CONCLUSIONS: These results should help clinicians to target people who are at high risk of developing PTSD after a pandemic-related lockdown and could benefit from preventive measures. Collaboration between the media and mental health professionals could be envisioned to inform the population about care resources. Follow-up recommendations should also be disseminated to general practitioners to facilitate PTSD screening and ensure that they are aware of the appropriate management.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adult , Aged , Anxiety/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Depression/epidemiology , Depression/psychology , Humans , Incidence , Longitudinal Studies , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology
9.
Hum Vaccin Immunother ; 18(5): 2076524, 2022 11 30.
Article in English | MEDLINE | ID: mdl-35709342

ABSTRACT

To achieve the full benefits of vaccination, it is key to understand the underlying causes of low vaccination by researching the barriers to vaccination at a local level. This systematic literature review aims to identify the reasons given by community members for the non-vaccination and under-vaccination of children and adolescents in sub-Saharan Africa. PubMed, Web of Science, PsycINFO, African Index Medicus, and African Journals Online databases were searched to identify articles published between 2010 and 2020. A total of 37 articles were included. As 17 studies did not report the reasons for non-vaccination and under-vaccination separately, we considered these two outcomes as "incomplete vaccination". The most common reasons for incomplete vaccination were related to caregiver's time constraints, lack of knowledge regarding vaccination, the unavailability of vaccines/personnel in healthcare facilities, missed opportunities for vaccination, caregiver's fear of minor side effects, poor access to vaccination services, and caregiver's vaccination beliefs.


Subject(s)
Vaccination , Vaccines , Adolescent , Africa South of the Sahara , Child , Health Facilities , Humans , Vaccination/psychology , Vaccines/adverse effects
10.
J Stud Alcohol Drugs ; 83(2): 169-174, 2022 03.
Article in English | MEDLINE | ID: mdl-35254239

ABSTRACT

OBJECTIVE: The measures put in place to contain the coronavirus epidemic in France have led to fears of a massive increase in the consumption of alcohol, tobacco, and other drugs. METHOD: Taking advantage of an ongoing weekly Internet survey monitoring living conditions of the French population during the containment, we introduced questions on alcohol and tobacco use 1 month after the start of the first containment. Analyses were conducted with multivariate Poisson regressions. RESULTS: Tobacco consumption remained almost unchanged. By contrast, more than a third of French people did change their weekly alcohol intake: 13% increased it, whereas 21% decreased it, indicating that the containment measures were often taken as an opportunity to reduce alcohol consumption, especially among those who drank less than 4 days per week before. Men were more likely to decrease their alcohol intake and less likely to increase it than women, probably because of a differential impact of the reduction of social activities on gendered social roles. The people most affected were smokers and those living in a dwelling in which someone had been infected, including themselves. CONCLUSIONS: The crisis tended to polarize alcohol consumption toward extremes. If the new drinking habits were to continue, the consequences could be beneficial for occasional drinkers but harmful for heavier drinkers.


Subject(s)
COVID-19 , Alcohol Drinking/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Female , France/epidemiology , Humans , Male , SARS-CoV-2 , Tobacco Use/epidemiology
11.
Therapie ; 77(5): 591-602, 2022.
Article in English | MEDLINE | ID: mdl-35101281

ABSTRACT

OBJECTIVES: In the early stages of the coronavirus disease 2019 (COVID-19) pandemic, chloroquine and its derivatives such as hydroxychloroquine (HCQ) were widely commented upon both within the scientific community and in the media. This paper explores the different factors that influenced public perceptions in France of the efficacy of HCQ as well as their evolution between April 2020 and June 2021. METHODS: This article draws on 5 surveys conducted among representative samples of the French population (projects COCONEL and TRACTRUST; quota method, n=1006; 1004; 2006; 1014 and 1005). We asked questions on the effectiveness of chloroquine against COVID-19. We also collected sociodemographic variables and attitudes toward politics and science. RESULTS: Between April and June 2021, the proportion of respondents who believed in the efficacy of HCQ decreased rapidly from 35% to 14%. The proportion of respondents who believed that HCQ is ineffective rose gradually from 6% to 21%. After adjusting for the temporal effect, the logistic regression showed a very strong association between political orientation and the belief in the efficacy of HCQ. Respondents who felt closest to the more radical parties (far-right and far-left) were more likely to believe in the efficacy of HCQ than those who felt closest to the political center (O.R. 2.48 [1.95-3.15] and 1.87 [1.44-2.43]). The role of trust in the government and in science and of the degree of political engagement were investigated in the two waves conducted after the scientific consensus was established during the summer of 2020. High levels of trust in the government and in science and of politicization are associated with belief of HCQ proven inefficacy. Across the whole period, a majority of respondents were uncertain. Even in 2021, 41.5% stated that the data were insufficient to decide whether or not HCQ is effective and 25.2% stating that they did not know. CONCLUSION: Because media coverage of scientific controversies is higher in times of uncertainty than after these controversies have died down, the publicization of therapeutic promises can have lasting consequences on attitudes towards science and medicine.


Subject(s)
COVID-19 Drug Treatment , Hydroxychloroquine , Antiviral Agents/therapeutic use , Chloroquine , Humans , Hydroxychloroquine/therapeutic use , Public Opinion , SARS-CoV-2
13.
Clin Microbiol Infect ; 28(3): 433-439, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34774756

ABSTRACT

OBJECTIVES: Reaching the last pockets of unvaccinated people is challenging, and has led to the consideration of mandatory vaccination for coronavirus disease 2019 (COVID-19). Our aim was to assess attitudes toward mandatory COVID-19 vaccination in France before the announcement of-and factors associated with opposition to-this type of policy. METHODS: Between the 10th and 23rd May 2021, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over, and a specific sample of the French senior population aged over 65. RESULTS: Among 3056 respondents, 1314 (43.0%) were in favour of mandatory COVID-19 vaccination, 1281 (41.9%) were opposed to such a policy, and 461 (15.1%) were undecided. Among opponents to mandatory COVID-19 vaccination for the general population, 385 (30.05%) were in favour of mandatory COVID-19 vaccination for healthcare workers (HCWs). In multivariate analysis, the age groups 18-24 and 25-34 years were significantly more opposed than the reference group (>75 years old) with respective adjusted odds ratio (aOR) and 95% confidence interval (95%CI) 4.67 (1.73-12.61) and 3.74 (1.57-8.93). Having no intention of getting COVID-19 vaccination was strongly associated with opposition to mandatory vaccination (aOR 10.67, 95%CI 6.41-17.76). In comparison with partisans of the centre, partisans of the far left and green parties were more likely to be opposed to mandatory COVID-19 vaccine, with respective aORs (95%CI) of 1.89 (1.06-3.38) and 2.08 (1.14-3.81). CONCLUSION: Attitudes toward mandatory COVID-19 vaccination are split in the French general population, and the debate might become politicized.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , France/epidemiology , Humans , Policy , Public Opinion , SARS-CoV-2 , Vaccination
14.
Hum Vaccin Immunother ; 17(12): 5082-5088, 2021 12 02.
Article in English | MEDLINE | ID: mdl-34905467

ABSTRACT

The French health authorities extended vaccination against COVID-19 to adolescents in June 2021, during the epidemic resurgence linked to the delta variant and because of insufficient vaccination coverage to ensure collective protection. In May 2021, we conducted a national online cross-sectional survey of 2533 adults in France to study their attitudes toward COVID-19 vaccines and their acceptance of child/adolescent vaccination according to targeted age groups (<6 years; 6-11; 12-17) and its determinants. We applied a multi-model averaged logistic regression for each of these age groups to study the determinants of favorability to vaccination. Among the respondents, 62.7% (1597) accepted COVID-19 vaccination for adolescents, 48.3% (1223) for children aged 6-11 years, and only 31% (783) for children under 6 years. Acceptance increased with fear of contracting COVID-19 and trust in institutions and decreased as the COVID-19 vaccine risk perception score increased. People favorable to vaccination in general and those sensitive to social pressure were also more often favorable to vaccinating children/adolescents than those who were not. Drivers of acceptance were ranked differently for the different age groups. Understanding these differences is essential to anticipating obstacles to vaccination of these age groups and designing appropriate information and motivational strategies to support it.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Cross-Sectional Studies , Humans , SARS-CoV-2 , Vaccination
15.
Hum Vaccin Immunother ; 17(10): 3421-3432, 2021 10 03.
Article in English | MEDLINE | ID: mdl-34292140

ABSTRACT

As the coronavirus disease 2019 (COVID-19) spreads across the world, the rapid distribution of an effective vaccine and its acceptability among the population constitute priorities for health authorities. This study aimed to document attitudes of the general population toward a future vaccine against COVID-19. We used the national COCONEL surveys conducted during the lockdown to identify factors associated with vaccine refusal, in the whole population, and separately among men and women. We investigate the role of socioeconomic and demographic factors as well as exposure to COVID-19. Among the 5,018 participants, 24.0% reported their intention to refuse the vaccine. Thinking this vaccine would not be safe, being against vaccination in general, and perceiving COVID-19 to be harmless were the three main reasons given to explain vaccine refusal. Women were more likely to refuse the vaccine, especially due to a reluctance toward vaccination in general or the perception that a COVID-19 vaccine would not be safe. Some factors associated with the intention to refuse the vaccine were the same among men and women such as a lack of prior vaccination against influenza, and concern over being infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while others differed slightly according to gender such as age, and high prevalence of COVID-19 in their region of residence. Authorities should therefore guarantee that all the necessary precautions are taken before marketing the vaccine and communicate transparently on the process of its development, and on the coverage rate required to reach herd immunity.Abbreviation: EHI: Equivalized Household Income per month; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.


Subject(s)
COVID-19 , Influenza Vaccines , COVID-19 Vaccines , Communicable Disease Control , Cross-Sectional Studies , Female , France/epidemiology , Humans , Intention , Male , SARS-CoV-2 , Vaccination
17.
PLoS One ; 16(5): e0251707, 2021.
Article in English | MEDLINE | ID: mdl-34014974

ABSTRACT

INTRODUCTION: With France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17-May 10). This study explored the perception of the adult population about the need for-and access to-psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown. MATERIAL AND METHOD: This online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7-10, 2020). RESULTS: One in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35-64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019. CONCLUSION: The perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities' understanding of the population's psychological needs in this situation and to enhance HCPs' abilities to meet them. In particular, further research of its specific impact on youth is necessary.


Subject(s)
COVID-19/psychology , Communicable Disease Control , Health Services Accessibility , Health Services Needs and Demand , Mental Health Services , Quarantine/psychology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , France/epidemiology , Humans , Male , Middle Aged , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Young Adult
19.
Sleep Med ; 78: 115-119, 2021 02.
Article in English | MEDLINE | ID: mdl-33422813

ABSTRACT

BACKGROUND: The outbreak of the Covid-19 pandemic and the accompanying lockdown measures have had a major impact on societies around the world, leading to sleep problems for a large part of the population. In order to assess the sustainability of sleeping troubles related to the sanitary crisis, it was crucial to measure its prevalence after the end of the Covid-19 confinement. METHODS: As part of an epidemiological survey on Covid and Confinement (COCONEL), we enquired on sleep disorders using two items in 4 repetitive cross-sectional surveys. The first took place during the first week of the French confinement (March 31 to April 2; N = 1005 participants). The second took place in the middle of this period (April 15-17; N = 1005). The two last surveys were held at the end of the confinement (May 7-10; N = 2003) and one month after the end (June 10-12; N = 1736). Using a random constant, the mixed model took into account the longitudinal character of the last two waves (intra-individual correlations for individuals surveyed in waves 3 and 4). RESULTS: The prevalence of sleep problems significantly decreased during the last weeks of the confinement, and this trend was confirmed one month after the end of confinement. One quarter of the population reported that their sleep was better one month after the end of the confinement. Sleep improvement was reported more often by women and people aged less than 65. Such improvement was less frequent among those who were still highly exposed to the pandemic's media coverage after the end of the confinement. CONCLUSION: The possibility of recovering a good sleep largely depends on the type of sleep disorder. The decrease in sleep problems occurred mainly among people with mild sleep problems during the confinement. Further research is needed to assess the long-term effects of the Covid-19 pandemic and its confinement period on sleep quality in the general population.


Subject(s)
COVID-19/psychology , Health Behavior , Patient Isolation/psychology , Sleep Initiation and Maintenance Disorders/psychology , Adult , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , France/epidemiology , Humans , Male , Mental Health/statistics & numerical data , Quality of Life , Quarantine/psychology , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/prevention & control
20.
Vaccine ; 39(3): 521-528, 2021 01 15.
Article in English | MEDLINE | ID: mdl-33328141

ABSTRACT

BACKGROUND: The contemporary crisis of trust in vaccines has severely impaired acceptance of the HPV vaccine, especially in France, where its uptake culminated at 23.7% in 2018 (complete course at age 16). Physicians' recommendations strongly influence its acceptance/refusal. Our study sought to understand the decision processes leading physicians to recommend this vaccine (or not). METHODS: Qualitative interviews of French physicians (general practitioners, gynecologists, and pediatricians). We first randomly selected doctors in a national register of medical professionals and then resorted to snowballing to build a convenience sample. We coded the interviews in a thematic analysis built both inductively and deductively from our research questions and data. RESULTS: Two thirds of the participants (19/28) were favorable to HPV vaccination, some (4) opposed it, while the others were hesitant about recommending it. In explaining their opinions, most participants mentioned that they trusted the stakeholders within the vaccination system: the less trust they had, the more critical they were of the vaccine and the more importance they attributed to patients' opinions. We identified three different ways they interacted with patients on this topic: informing and convincing; adapting to patients' opinions; refusing compromise about vaccination. Crossing these various themes, we found 5 types of physicians: dissidents (mistrustful of the healthcare system and HPV vaccine), hesitant (finding it difficult to make up their minds about this vaccination), laissez-faire (letting patients decide by themselves, but very favorable to HPV vaccination), educator (very favorable), and uncompromising vaccinators (refusing debate). Pediatricians were overrepresented among the latter two types. CONCLUSIONS: Physicians' judgment was influenced by their trust in the stakeholders involved in designing and implementing the HPV vaccination strategy. In this sense, doctors did not differ substantially from laypeople. They were, nonetheless, strongly influenced by their professional style and ethos.


Subject(s)
Papillomavirus Infections , Papillomavirus Vaccines , Adolescent , Attitude of Health Personnel , France , Health Knowledge, Attitudes, Practice , Humans , Papillomavirus Infections/prevention & control , Practice Patterns, Physicians' , Vaccination
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