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INTRODUCTION: The COVID-19 pandemic challenged the scientific community to find and develop a vaccine to fight the disease. However, problems with achieving high vaccine coverage have emerged, even among high-risk groups such as healthcare workers (HCWs). OBJECTIVE: The objective of this study is to examine factors that influence HCW's and the general population's adherence to COVID-19 vaccination and national policies to vaccinate HCWs and other target groups. METHODS: This study implemented a systematic review. The eligibility criterion for inclusion was being a HCW, target population for COVID-19 vaccination, or general population. Vaccination was the target intervention, and the COVID-19 pandemic was the context. We selected publications published between 1 January 2020 and 31 March 2022. Qualitative synthesis used a meta-aggregation approach. RESULTS: Nineteen articles were included in the review, with study samples varying from 48 to 5708 participants. Most of the evidence came from cross-sectional and qualitative studies. The main findings were related to vaccine hesitancy rather than acceptance. Factors associated with HCW vaccine hesitancy included subjective feelings such as safety concerns, rapid vaccine development, and insufficient testing. Countries have adopted few public policies to address this problem, and the main concern is whether to enforce vaccination and the extent to which measures are legal. CONCLUSION: The quality of the evidence base remains weak. Skepticism, mistrust, and hesitancy toward vaccination are global issues that can jeopardize vaccination coverage.
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Vacinas contra COVID-19 , COVID-19 , Pessoal de Saúde , Hesitação Vacinal , Humanos , COVID-19/prevenção & controle , COVID-19/psicologia , Vacinas contra COVID-19/administração & dosagem , Pessoal de Saúde/psicologia , Política de Saúde , SARS-CoV-2 , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Hesitação Vacinal/psicologia , Hesitação Vacinal/estatística & dados numéricosRESUMO
Objetivo: Determinar los factores asociados al rechazo de la contracepción posparto en un Hospital Público, 2021. Métodos: Estudio observacional, analítico, transversal; incluyó 251 puérperas inmediatas atendidas en un Hospital Público entre mayo y junio del 2021. La variable principal fue rechazo de la contracepción posparto y factores asociados: sociodemográficos, obstétricos, personal-cultural, institucional. Se usó un cuestionario válido y confiable. Además, la prueba Chi cuadrado de Pearson y Regresión de Poisson para el análisis estadístico y se tuvo aprobación de Comité de Ética. Resultados: El 16,7 % rechazó los contraceptivos modernos. El nivel educativo bajo (p < 0,011; RPa: 4,51; IC: 1,42-14,35), la percepción de una mala situación económica (p = 0,001; RPa: 3,65; IC: 1,72-7,76), las complicaciones durante el trabajo de parto y dos horas posparto (p = 0,041; RPa: 8,16; IC: 1,09-61,19), el embarazo planificado (p = 0,002; RPa: 2,51; IC: 1,38-4,55), la experiencia negativa de contracepción (p = 0,000; RPa: 11,26; IC: 5,85-21,66), la actitud negativa de la pareja (p = 0,006; RPa: 4,90; IC: 1,57-15,31) y la percepción de conocimiento insuficiente sobre contracepción (p = 0,049; RPa: 0,53; IC: 0,28-0,996); se asociaron al rechazo de contracepción en el posparto. Conclusión: El nivel educativo bajo, la percepción de una mala situación económica, las complicaciones durante el trabajo de parto y dos horas posparto, el embarazo planificado, la experiencia negativa de contracepción, la actitud negativa de la pareja, se asocian al rechazo de contracepción posparto; la percepción de conocimiento insuficiente sobre contracepción se asoció a la disminución de rechazo(AU)
Objective: To determine the factors associated with the refusal of postpartum contraception in a Public Hospital, 2021. Methods: Observational, analytical, cross-sectional study; included 251 immediate postpartum women treated in a Public Hospital between May and June 2021. The main variable was rejection of postpartum contraception and associated factors: sociodemographic, obstetric, personal-cultural, and institutional. A valid and reliable questionnaire was used. In addition, Pearson's Chi-square test and Poisson's regression were used for statistical analysis and the Ethics Committee was approved. Results: 16.7% rejected modern contraceptives. Low educational level (p < 0.011; PRa: 4.51; CI: 1.42-14.35), the perception of a bad economic situation (p = 0.001; RPa: 3.65; CI: 1.72-7.76), complications during labor and two hours postpartum (p = 0.041; PRa: 8.16; CI: 1.09-61.19), planned pregnancy (p = 0.002; PRa: 2.51; CI: 1.38-4.55), negative experience of contraception (p = 0.000; PRa: 11.26; CI: 5.85-21.66), the negative attitude of the partner (p = 0.006; RPa: 4.90; CI: 1.57-15.31) and the perception of insufficient knowledge about contraception (p = 0.049; RPa: 0.53; CI: 0.28-0.996); were associated with contraceptive rejection in the postpartum period. Conclusion: Low educational level, perception of a poor economic situation, complications during labor and two hours postpartum, planned pregnancy, negative contraceptive experience, negative partner attitude, are associated with postpartum contraceptive rejection; The perception of insufficient knowledge about contraception was associated with a decrease in rejection(AU)
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Humanos , Feminino , Gravidez , Cesárea , Anticoncepção , Parto , Período Pós-Parto , Fatores Socioeconômicos , Estudos Transversais , Comissão de Ética , Gravidez não Planejada , Acessibilidade aos Serviços de SaúdeRESUMO
BACKGROUND: Treatment discontinuation within Early Intervention Services (EIS) for psychosis poses a significant challenge to achieving better outcomes in the early stages of psychotic disorders. Prevalence and predictors of early disengagement from EIS located in low- and middle-income countries (LMICs) remain poorly investigated. We aimed to examine the rates and predictors of disengagement from the Ribeirão Preto Early Intervention Program for Psychosis (Ribeirão Preto-EIP) in Brazil. METHODS: We conducted a retrospective cohort study using data from patients referred to the Ribeirão Preto-EIP between January 01, 2015, and December 31, 2018. Exclusion criteria were individuals with a single consultation, a diagnosis other than a psychotic disorder, and documented cases of death. RESULTS: Our sample comprised 234 patients, with an overall median follow-up time of 14.2 months. Early treatment disengagement was observed in 26.5â¯% (n=62), with a median time to disengagement of 5.25 months. Univariable analysis identified non-white skin color (HR=2.10, 95â¯%CI 1.26-3.49), positive THC screening (HR=2.22, 95â¯%CI 1.23-4.01), and substance-induced psychosis (HR=2.15, 95â¯%CI 1.10-4.21) as significant predictors. In multivariable analysis, only non-white skin color remained a significant predictor of early disengagement (HR=1.87, 95â¯%CI 1.08-3.27). CONCLUSIONS: The observed rates of early disengagement in our sample are similar to those reported in wealthy countries, but higher than previously reported for LMICs. Non-white skin color predicted early disengagement in our sample, probably due to social disadvantages. Our data highlights the need for enhanced research elucidating the specific features of EIS in LMICs.
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Intervenção Médica Precoce , Transtornos Psicóticos , Humanos , Transtornos Psicóticos/terapia , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/diagnóstico , Masculino , Feminino , Estudos Retrospectivos , Adulto , Adulto Jovem , Intervenção Médica Precoce/estatística & dados numéricos , Brasil/epidemiologia , Adolescente , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricosRESUMO
Introduction: The pandemic of COVID-19 continues to impact people worldwide, with more than 755 million confirmed cases and more than 6.8 million reported deaths. Although two types of treatment, antiviral and immunomodulatory therapy, have been approved to date, vaccination has been the best method to control the spread of the disease. Objective: To explore factors associated with the intention to be vaccinated with the COVID-19 booster dose in Peru. Material and Methods: Cross-sectional study, using virtual and physical surveys of adults with two or more doses of COVID-19 vaccine, where the dependent variable was the intention to be vaccinated (IBV) with the booster dose. We calculated prevalence ratios with 95% confidence intervals, using generalized linear models of the Poisson family with robust varying, determining associations between sociodemographic, clinical, and booster dose perception variables. Results: Data from 924 adults were analyzed. The IBV of the booster doses was 88.1%. A higher prevalence was associated with being male (aPR = 1.05; 95% CI [1.01-1.10]), having a good perception of efficacy and protective effect (PR = 3.69; 95% CI [2.57-5.30]) and belonging to the health sector (PR = 1.10; 95% CI [1.04-1.16]). There was greater acceptance of the recommendation of physicians and other health professionals (aPR = 1.40; 95% CI [1.27-1.55]). Conclusions: Factors associated with higher IBV with booster dose include male gender, health sciences, physician recommendation, and good perception of efficacy.
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COVID-19 , Adulto , Humanos , Masculino , Feminino , COVID-19/epidemiologia , Vacinas contra COVID-19 , Estudos Transversais , Intenção , Peru/epidemiologiaRESUMO
Consensual homicide remains a crime in jurisdictions where active voluntary euthanasia has been legalized. At the same time, both jurisdictions, in which euthanasia is legal and those in which it is not, recognize that all patients (whether severely ill or not) have the right to refuse or withdraw medical treatment (including life-saving treatment). In this paper, I focus on the tensions between these three norms (the permission of active euthanasia, the permission to reject life-saving treatment, and the prohibition of consensual homicide), assuming a justification of euthanasia based on the right to (personal) autonomy. I argue that the best way to provide a coherent account of these norms is to claim that patients have two distinct rights: the right to autonomy and the right to bodily integrity. This solution has some relevant implications for the discussion of the legalization of active euthanasia.
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Eutanásia , Suicídio Assistido , Humanos , Homicídio , Direito a Morrer , Liberdade , Autonomia Pessoal , Recusa do Paciente ao Tratamento , Eutanásia Ativa , Eutanásia Ativa Voluntária , Eutanásia PassivaRESUMO
Despite the known importance of vaccines as one of the greatest achievements in medical science, vaccine hesitancy has been increasing in the last decade and has become a major threat to global health. The growth of vaccine hesitancy worldwide became more evident with the onset of COVID-19 and raised the fear that this hesitancy would also impact companion animal vaccination. This study aimed to characterize vaccine-hesitant groups regarding companion animals and human vaccinations, as well as to explore the possible association between vaccine hesitancy in pets and their owners. An anonymous online survey containing 27 closed questions was conducted, including questions about dog health, such as vaccination, neutering, and homeopathy use, as well as questions about the COVID-19 vaccination status of the owner and motivations for vaccinating or not vaccinating their pets. Most participants (81.5 %) reported receiving three or more doses of the COVID-19 vaccine. Not vaccinating against COVID-19 or having an incomplete vaccination protocol was associated with an increase in the age range of participants (odds ratio [OR] = 1.43), not having higher education (OR = 7.70), and being in extreme income ranges (less than two minimum wages [OR = 7.57] and more than 10 [OR = 5.20]). The use of homeopathy in humans (OR = 3.24) and dogs (OR = 3.74) was associated with non-vaccination against COVID-19. Owners who were not fully vaccinated against COVID-19 were almost six times more likely to not vaccinate their dogs (OR = 5.94). Non-vaccination of dogs was also associated with non-neutering (OR = 3.56), keeping the dog in contact with other dogs (OR = 2.09), and an increase in the number of dogs in the house increased the chance of not vaccinating the animals (OR = 1.30). The present study revealed a strong association between non-vaccination against COVID-19 and non-vaccination in companion dogs, raising the hypothesis that vaccination hesitancy is a growing challenge in veterinary medicine. In addition, the characteristics of Brazilians who are reluctant to be vaccinated against COVID-19 or immunize their companion animals are described here for the first time.
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Vacinas contra COVID-19 , COVID-19 , Doenças do Cão , Vacinação , Animais , Cães , Humanos , COVID-19/prevenção & controle , COVID-19/veterinária , Vacinas contra COVID-19/administração & dosagem , Doenças do Cão/prevenção & controle , Razão de Chances , Vacinação/veterináriaRESUMO
Resumo Objetivo Analisar a recusa familiar de doação de córnea para transplante em uma Organização de Procura de Órgãos. Métodos Estudo quantitativo do tipo transversal sobre as recusas de córnea de doadores em situação de morte encefálica. A fonte de dados foi constituída pelos Termos de Autorização de Doação de Órgãos e Tecidos firmados entre janeiro de 2001 a dezembro de 2020 em uma Organização de Procura de Órgãos. Os dados foram coletados, tabulados e analisados de forma descritiva e inferencial. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados Dos 2.447 Termos de Autorização de Doação de Órgãos e Tecidos firmados no período, 620 (25.34%) recusaram a doação de córneas. Com relação à tendência temporal de recusas de doação de córneas, o único período que apresentou significância foi de 2001 a 2009, quando as faixas etárias de zero a 11 anos e 12 a 19 anos demonstraram tendência decrescente, e a faixa etária maior ou igual a 60 anos, mostrou-se crescente. No período total de 2001 a 2020, as faixas etárias dos 20 a 40 anos, 41 a 59 anos e maior ou igual a 60 anos apresentaram, 48%, 59% e 73%, respectivamente, menores chances de recusa da doação de córneas. Conclusão A faixa etária apresentou associação com a recusa, tendo em vista que os indivíduos de maior idade apresentaram maiores índices.
Resumen Objetivo Analizar la negativa familiar de donación de córneas para trasplante en una Organización de Búsqueda de Órganos. Métodos: Estudio cuantitativo tipo transversal sobre la negativa de córnea de donantes en situación de muerte encefálica. La fuente de datos estuvo compuesta por los Términos de Autorización de Donación de Órganos y Tejidos firmados entre enero de 2001 y diciembre de 2020 en una Organización de Búsqueda de Órganos. Se recopilaron los datos, luego se tabularon y se analizaron de forma descriptiva e inferencial. El presente estudio fue aprobado por el Comité de Ética en Investigación. Resultados De los 2447 Términos de Autorización de Donación de Órganos y Tejidos firmados en el período, 620 (25,34 %) negaron la donación de córneas. Con relación a la tendencia temporal de negativas de donación de córneas, el único período que presentó significación fue de 2001 a 2009, cuando los grupos de edad de 0 a 11 años y de 12 a 19 años demostraron una tendencia decreciente, y el grupo de edad mayor o igual a 60 años se mostró creciente. En el período total de 2001 a 2020, los grupos de edad de 20 a 40 años, de 41 a 59 años y mayor o igual a 60 años presentaron un 48 %, un 59 % y un 73 %, respectivamente, menor probabilidad de negativa de donación de córneas. Conclusión El grupo de edad presentó relación con la negativa, considerando que los individuos de mayor edad presentan mayores índices.
Abstract Objective To analyze family refusals to donate a cornea for transplantation in an Organ Procurement Organization. Methods This was a quantitative cross-sectional study on corneal donation refusals from potential brain-dead donors. The data source was based on the Terms of Authorization for Donation of Organs and Tissues signed from January 2001 to December 2020 in an Organ Procurement Organization. Data were collected, tabulated, and analyzed in a descriptive and inferential manner. The present study was approved by the Research Ethics Committee. Results Of the 2,447 Terms of Authorization for Donation of Organs and Tissues signed in the above period, 620 (25.34%) of them refused to donate a cornea. Regarding the time trend of corneal donation refusals, the period 2001-2009 was the only one that showed significance, when the 0-11 and 12-19 age groups showed a decreasing trend and that of 60 years or older showed an increasing trend. In the period 2001-2020, the age groups of 20-40, 41-59, and 60 years or older had lower rates of refusal to donate a cornea (48%, 59%, and 73%, respectively). Conclusion The age group is associated with refusal because older individuals had the highest refusal rates.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Obtenção de Tecidos e Órgãos , Família , Córnea , Recusa de Participação , Estudos TransversaisRESUMO
ABSTRACT Objectives: to analyze the trends and factors associated with family refusal of skin donation for transplantation. Methods: this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance. Results: 1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively. Conclusions: there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
RESUMEN Objetivos: analizar la tendencia y los factores asociados al rechazo familiar de la donación de piel para trasplante. Métodos: estudio transversal desarrollado en el Estado de São Paulo con los términos de autorización familiar firmados entre 2001 y 2020. Las variables analizadas fueron: año, edad, sexo, causa del deceso y tipo de institución. Los datos fueron analizados mediante regresión lineal y logística múltiple, con la estimación del Odds Ratio, adoptando p<0,05 como significancia estadística. Resultados: 1.355 individuos rechazaron la donación de piel. La tendencia de rechazos fue decreciente (2001-2009) en los grupos de edad de 0-11 años y de 12-19 años, y creciente en el grupo de ≥60 años. La tendencia siguió siendo decreciente (2010-2020) en el grupo de edad de 0-11 años y creciente en el de 20-40 años. El género masculino y los grupos de edad de 20-40 años, 41-59 años y ≥60 años presentaron, respectivamente, 27%, 34%, 47% y 53% menos probabilidades de rechazo. Conclusiones: es urgente la necesidad de medidas que busquen mitigar el alto número de rechazos asociados a la donación de piel.
RESUMO Objetivos: analisar a tendência e os fatores associados à recusa familiar de doação de pele para transplante. Métodos: estudo transversal desenvolvido no Estado de São Paulo com os termos de autorização familiar firmados entre 2001 e 2020. As variáveis analisadas foram: ano, idade, sexo, causa do óbito e tipo da instituição. Os dados foram analisados por meio de regressão linear e logística múltipla, com o Odds Ratio estimado, adotando-se p<0,05 como significância estatística. Resultados: 1.355 indivíduos recusaram a doação de pele. A tendência de recusas foi decrescente (2001-2009) nas faixas etárias de 0-11 anos e de 12-19 anos e crescente na faixa de ≥60 anos. A tendência permaneceu decrescente (2010-2020) na faixa etária de 0-11 anos e crescente na de 20-40 anos. O sexo masculino e as faixas etárias de 20-40 anos, 41-59 anos e ≥60 anos apresentaram, respectivamente, 27%, 34%, 47% e 53% menores chances de recusa. Conclusões: é urgente a necessidade de medidas que visem atenuar o alto número de recusas associadas à doação de pele.
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Introducción. El virus del papiloma humano tiene una prevalencia del 11.7% en mujeres, siendo la vacunación la estrategia de prevención más efectiva; sin embargo, en México solo se aplica al 14.4% del total de las niñas de 9 a 12 años. Objetivo. Identificar los conocimientos y actitudes de madres de familia en la no aceptación de la vacuna del virus del papiloma humano para sus hijas. Metodología. Estudio cualitativo fenomenológico hermenéutico, con entrevista a seis madres mexicanas quienes no aceptaron la vacuna para sus hijas. Muestreo intencional, se aplicó en el 2021 una guía fundamentada en la revisión de literatura con formato en línea, con transcripción, análisis temático y procesamiento en el software MAXQDA versión 18.2.0. Resultados. Se realizaron entrevistas a madres de entre 30 a 40 años, la mayoría con licenciatura, religión católica y empleadas de institución gubernamental. Se obtuvieron tres categorías centrales: 1) significado del virus del papiloma humano; 2) vacuna del virus del papiloma humano y 3) prevención y promoción de la salud para la vacuna del virus del papiloma humano, con 9 subcategorías que abordan: conocimiento, creencias, desinformación, beneficios, motivación y falta de aceptación de la vacuna. Discusión. Estudios evidencian que la falta de información provoca la no aceptación de la vacuna del virus del papiloma humano, lo que limita la inmunización oportuna en las niñas, coincidiendo con los resultados encontrados. Conclusión. El bajo conocimiento y falta de información confiable afecta a que las madres presenten actitudes negativas de no aceptación de la vacuna del virus del papiloma humano para sus hijas. Las intervenciones de enfermería con información pertinente y de impacto aportarán a un comportamiento saludable individual y familiar.
Introduction. The human papillomavirus has a prevalence of 11.7% among women, and vaccination is the most effective prevention strategy; however, in Mexico it is only applied to 14.4% of all girls between 9 and 12 years of age. Objective. To identify the knowledge and attitudes of Mexican mothers in the non-acceptance of the human papillomavirus vaccine for their daughters. Methodology. Qualitative hermeneutic phenomenological study, with interviews with six Mexican mothers who did not accept the vaccine for their daughters. Purposive sampling, a guide based on the literature review was applied in 2021 with online format, transcription, thematic analysis and processing in MAXQDA software version 18.2.0. Results. Interviews were conducted with mothers between 30 and 40 years of age, most of whom had a bachelor's degree, were Catholic and were employed by government institutions. Three core categories were obtained: 1) meaning of human papillomavirus; 2) human papilomavirus vaccine; and 3) prevention and health promotion for human papillomavirus vaccine, with 9 subcategories addressing: knowledge, beliefs, misinformation, benefits, motivation, and lack of acceptance of the vaccine. Discussion. Studies show that lack of information leads to non-acceptance of the human papillomavirus vaccine, which limits timely immunization of girls, coinciding with the results found. Conclusion. Limited knowledge and lack of reliable information affect the negative attitudes of mothers who refuse the human papillomavirus vaccine for their daughters. Nursing interventions with relevant and impactful information will contribute to healthy individual and family behaviors.
Introdução. O papilomavírus humano tem uma prevalência de 11.7% em mulheres, sendo a vacinação a estratégia de prevenção mais eficaz; no entanto, no México, apenas 14.4% do total de meninas de 9 a 12 anos são vacinadas. Objetivo. Identificar o conhecimento e as atitudes das mães quanto à não aceitação da vacina contra o papilomavírus humano por suas filhas. Metodologia. Estudo hermenêutica fenomenológico qualitativo, com entrevistas com seis mães mexicanas que não aceitaram a vacina para suas filhas. Amostragem intencional, foi aplicado em 2021 um guía baseado na revisão de literatura em formato online, com transcrição, análise temática e processamento no software MAXQDA versão 18.2.0. Resultados. Foram realizadas entrevistas com mães entre 30 e 40 anos, a maioria com graduação, religião católica e funcionárias de instituição governamental. Foram obtidas três categorias centrais: 1) significado do papilomavírus humano; 2) vacina contra o papilomavírus humano e 3) prevenção e promoção da saúde para a vacina contra o papilomavírus humano, com 9 subcategorias que abordam: conhecimento, crenças, desinformação, benefícios, motivação e falta de aceitação da vacina. Discussão. Estudos mostram que a falta de informação leva à não aceitação da vacina contra o papilomavírus humano, o que limita a imunização oportuna nas meninas, coincidindo com os resultados encontrados. Conclusão. O baixo conhecimento e a falta de informações confiáveis afetam as atitudes negativas das mães em relação à não aceitação da vacina contra o papilomavírus humano para suas filhas. Intervenções de enfermagem com informações relevantes e impactantes contribuirão para um comportamento saudável individual e familiar.
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Vacinas contra Papillomavirus , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa Qualitativa , Recusa de Vacinação , Promoção da SaúdeRESUMO
RESUMO A decisão vacinal de profissionais de saúde tem sido observada em diferentes países, devido ao seu comportamento de hesitação frente à vacinação contra a Covid-19, que pode interferir no controle da pandemia. Pretendeu-se identificar os fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 em publicações de julho de 2020 a julho de 2022. Foi realizada uma revisão integrativa da literatura nas bases de dados PubMed, Scopus, Web of Science e Cinahl. Das 439 publicações, foram escolhidos 35 artigos para análise. As características sociodemográficas da decisão vacinal revelaram que profissionais não médicos, principalmente enfermeiros, apresentaram maior hesitação. O estudo revelou fatores associados à hesitação vacinal, tais como: dúvidas sobre a eficácia das vacinas e o processo de produção, insegurança pela escassez de estudos, medo dos efeitos colaterais e informações veiculadas em mídias sociais. Em relação à aceitação e à recomendação vacinal, ressaltam-se a vacinação prévia contra a influenza, a confiança na eficácia das vacinas e o receio pelo risco de contágio por Covid-19. A identificação dos fatores associados à decisão vacinal de profissionais de saúde contra a Covid-19 foi estratégica em relação à ampliação da cobertura vacinal, tanto para a proteção da saúde dos profissionais quanto para a da população.
ABSTRACT The vaccine decision of health professionals has been observed in different countries, due to their hesitation behavior in the face of vaccination against COVID-19, which can interfere with the control of the pandemic. It was intended to identify the factors associated with the vaccination decision of health professionals against COVID-19 in publications from July 2020 to July 2022. An Integrative Literature Review was carried out in PubMed, Scopus, Web of Science and CINAHL databases. Of the 439 publications, 35 articles were chosen for analysis. The sociodemographic characteristics of the vaccine decision revealed that non-medical professionals, mainly nurses, had greater vaccine hesitancy. The study revealed factors associated with vaccine hesitancy, such as: doubts about the effectiveness of vaccines and the production process, insecurity due to lack of studies, fear of side effects and information conveyed on social media. Regarding vaccine acceptance and recommendation, prior vaccination against influenza, confidence in the effectiveness of vaccines and fear of the risk of contagion by COVID-19 stand out. Identifying the factors associated with the vaccination decision of health professionals against COVID-19 was strategic in relation to expanding vaccination coverage, both to protect the health of professionals and the population.
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OBJECTIVE: The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. METHODS: A cross-sectional survey was conducted in parents 6-18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. RESULTS: Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). CONCLUSIONS: In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series.
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Vacinação , Vacinas , Feminino , Humanos , Lactente , Guatemala , Estudos Transversais , Imunização , Pais , Atitude , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
Abstract Objective: To evaluate the behavior of VCR and VCH, per municipality and per vaccines offered at the NVC, to identify priority areas for intervention. Methods: Descriptive study of a time series, using secondary data and accompanied by a narrative review of the literature evaluating VCR and VCH. Vaccines offered to children under one year and to those aged one year in the pre-pandemic period of COVID-19 (2015 to 2019) were selected and compared to those offered during the pandemic period (2020 and 2021 ). Results and discussions: The decrease in VCR and VCH is a process that precedes the COVID-19 pandemic but was intensified during this period. In 2021, the VCR was around 70% for most vaccines. This phenomenon encompasses the entire country; however, it is more intense in the states/municipalities located in the north and northeast regions, suggesting greater difficulty in accessing health services. Conclusion: Low and heterogeneous VCR requires the adoption of practices that were previously implemented, establishing partnerships with governmental and non-governmental institutions, with adequate communication, active search for non-compliance and non-adherence to the regular vaccination program, adopting intra- and extramural vaccination strategies, to reverse the current situation and reduce the risk of recurrence of diseases that have been already controlled and eliminated.
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Objetivos: Determinar la predisposición a recibir esta vacuna contra SARS-CoV-2. Materiales y métodos: Se aplicó un diseño observacional de corte transversal en la población adulta del Paraguay entre mayo y octubre 2022. se aplicó el cuestionario de Kotta et al previamente validado, el cual fue difundido por redes sociales. Resultados: Se incluyeron 303 encuestados, con edad media 34 ± 12 años y predominio del sexo femenino (64,0%). En la muestra, 51,8% padeció COVID-19 y 97,3% ya recibió al menos una dosis de la vacuna. Se detectó que 58,4% aceptada la vacuna, 17,8% vacilaba en recibirla y 23,7% la rechazaba. La aceptación fue más frecuente en los varones (p 0,05). Conclusión: En el momento epidemiológico de disponibilidad universal de la vacuna y habiendo aún sujetos afectados por COVID-19, el rechazo a la misma fue 23,7%.
Objectives: To determine the predisposition to receive this vaccine against SARS-CoV-2. Materials and methods: An observational cross-sectional design was applied in the adult population of Paraguay between May and October 2022. The previously validated questionnaire of Kotta et al was applied, which was disseminated through social networks. Results: 303 respondents were included, with a mean age of 34 ± 12 years and predominance of the female sex (64.0%). In the sample, 51.8% suffered from COVID-19 and 97.3% have already received at least one dose of the vaccine. It was detected that 58.4% accepted the vaccine, 17.8% hesitated to receive it and 23.7% rejected it. Acceptance was more frequent in males (p 0.05). Conclusion: At the epidemiological moment of universal availability of the vaccine and with subjects still affected by COVID-19, rejection of it was 23.7%.
Assuntos
SARS-CoV-2 , COVID-19 , Vacinas , Inquéritos e Questionários , Dosagem , Objetivos , MétodosRESUMO
Vaccination coverage against Human Papillomavirus (HPV) is low compared with uptake of other vaccines in many countries, including Brazil. The aim of this study was to examine the main reasons provided by parents or guardians of a target population that did not have the first dose of HPV vaccine in a small rural Brazilian municipality, and to verify the factors associated with the reasons for non-vaccination. This is a cross-sectional study with interviews based on the Health Belief Model (HBM), conducted with parents and guardians of 177 unvaccinated children or adolescents. The outcome of interest was the main reason for not vaccinating the child/adolescent. The exposure factors of interest were knowledge about HPV and its prevention as well as sociodemographic characteristics. The main justifications for not vaccinating were lack of information (62.2%), fear or refusal (29.9%), and logistical issues (7.9%). The justifications associated with adolescents' sex, fear, or refusal were mentioned by 39.3% (95% CI: 28.8-50.6%) of parents or guardians of girls and by 21.5% (95% CI: 13.7-31.2%) of parents or guardians of boys. The main barrier to HPV vaccination is lack of information. Further training of health professionals in clarifying the benefits of vaccination and differentiating the risks between boys and girls could encourage uptake.
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OBJECTIVE: To evaluate the behavior of VCR and VCH, per municipality and per vaccines offered at the NVC, to identify priority areas for intervention. METHODS: Descriptive study of a time series, using secondary data and accompanied by a narrative review of the literature evaluating VCR and VCH. Vaccines offered to children under one year and to those aged one year in the pre-pandemic period of COVID-19 (2015 to 2019) were selected and compared to those offered during the pandemic period (2020 and 2021). RESULTS AND DISCUSSIONS: The decrease in VCR and VCH is a process that precedes the COVID-19 pandemic but was intensified during this period. In 2021, the VCR was around 70% for most vaccines. This phenomenon encompasses the entire country; however, it is more intense in the states/municipalities located in the north and northeast regions, suggesting greater difficulty in accessing health services. CONCLUSIONS: Low and heterogeneous VCR requires the adoption of practices that were previously implemented, establishing partnerships with governmental and non-governmental institutions, with adequate communication, active search for non-compliance and non-adherence to the regular vaccination program, adopting intra- and extramural vaccination strategies, to reverse the current situation and reduce the risk of recurrence of diseases that have been already controlled and eliminated.
Assuntos
COVID-19 , Vacinas , Criança , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Cobertura Vacinal , Brasil/epidemiologia , Fatores de Tempo , VacinaçãoRESUMO
Background and Purpose: The negative attitude towards vaccines for coronavirus disease (COVID-19) has motivated the adaptation of instruments for this specific purpose. However, details of the reliability and validity of these scales are unknown. The study aimed to evaluate some indicators of the reliability and validity of the Spanish version of the Attitude towards COVID-19 Vaccines Scale. Methods: A validation study was carried out with 1,136 students of emerging age (18 and 29 years) from a Colombian university; 65.5% were female. Cronbach's alpha and McDonald's omega were calculated for reliability, and exploratory and confirmatory factor analyzes for validity. Additionally, the gender differential item functioning (DIF) was estimated with Kendall's tau b. Results: The Spanish version of Attitude towards COVID-19 Vaccines Scale showed high internal consistency (Cronbach's alpha of .94 and McDonald's omega of .95), a one-dimensional structure with acceptable goodness-of-fit indicators (CFI = .94, TLI = .91, and SRMR = .04), and non-gender DIF (Kendall's tau b between .02 and .06). Conclusions: The Spanish version of the Attitude towards COVID-19 Vaccines Scale presents some appropriate reliability and validity indicators among university emerging adults. These findings should be explored in samples with other characteristics.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Humanos , Feminino , Adolescente , Adulto Jovem , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , COVID-19/prevenção & controle , Estudantes , PsicometriaRESUMO
A emergência na produção de vacinas justifica-se devido ao número de óbitos provocados pela síndrome respiratória e a necessidade para que seja realizado o controle desses casos e suas formas graves. Em concomitância com o avanço da imunização da população, observou-se que o movimento social de Hesitação Vacinal (HV), caracterizado pela recusa ou atraso em aceitar a vacinação, tem tomado proporção mundial nos últimos anos, apoiando-se em questionamentos referentes principalmente sobre a eficácia e segurança dos imunizantes. Diante disso, ressalta-se a importância da discussão sobre individualidade versus coletividade e compreender as justificativas que estão associadas ao processo de HV da COVID-19. Este estudo tem por objetivo analisar o processo de HV contra a COVID-19 no Brasil, na perspectiva da visão de quem hesita. Trata-se de um estudo exploratório descritivo, de característica qualitativa, e abordagem por amostra não probabilística do tipo snowball (Bola de neve). A metodologia utiliza cadeias de referências para construir a sua população amostral, os sujeitos da pesquisa são indivíduos que tenham porventura hesitado em tomar qualquer um dos imunobiológicos contra a COVID-19 que atualmente são oferecidos pelo Programa Nacional de Imunização, serem maior de 18 anos, residirem no território geográfico do Rio Grande do Norte, e terem aceitado participar da pesquisa assinando o Termo de Consentimento Livre e Esclarecido TCLE. Para a análise de conteúdo, utilizou-se a técnica do Discurso do Sujeito Coletivo, descrita por LEFEVRE & LEFEVRE, elaborada a partir da Teoria das Representações Sociais. Os resultados preliminares foram organizados de forma sistematizada, onde caracterizou-se socioeconomicamente os sujeitos participantes da pesquisa, foram elencadas categorias de acordo com o sentido das ideias centrais para compreender o indivíduo enquanto ser social a respeito do processo de hesitação vacinal da COVID-19, sendo elas: Vivências e experiências sobre a pandemia e a doença COVID-19; As percepções sobre da vacina a COVID-19 e vacinação; Justificativas associadas a hesitação vacinal contra a COVID-19 e outros fatores relacionados. Evidenciando achados a respeito dessas perspectivas, os principais apontamentos encontrados associados ao processo de hesitação vacinal se relacionam a motivos variados: imposição da imunização, desconfiança dos efeitos do imunobiológico, desinformação, medo das reações, teorias da conspiração, influência política e a infodemia. Portanto, sabendo que a escolha em se vacinar vai além de um critério individual, torna-se necessário que os formadores de políticas de saúde dialoguem sobre estratégias que reforcem a segurança, necessidade, eficácia e importância da vacina para todos (AU).
The emergence of vaccine production is justified by the number of deaths caused by the respiratory syndrome, and the need to control these cases and their severe forms. Concomitantly with the advancement of immunization of the population, it was observed that the social movement of vaccine hesitation characterized by refusal or delay in accepting vaccination has taken on worldwide proportions in recent years, based on questions referring mainly to the efficacy and safety of immunizers. In view of this, it is important to discuss individuality versus collectivity, and to understand the justifications that are associated with the COVID-19 vaccine hesitancy process. This study aims to analyze the vaccine hesitation process against COVID-19 in Brazil, from the perspective of those who hesitate. This is a descriptive exploratory study, with a qualitative characteristic, and a snowball-type non-probabilistic sample approach. The methodology uses chains of references to build its sample population research subjects will be individuals who may have hesitated to take any of the immunobiologicals against COVID-19 that are currently offered by the National Immunization Program, be over 18 years old, reside in the geographic territory of Rio Grande do Norte, and have accepted participate in the research by signing the Term of Free and Informed Consent TCLE, the content analysis used the Collective Subject Discourse technique, described by LEFEVRE & LEFEVRE, based on the Theory of Social Representations. The preliminary results were organized in a systematic way, where the subjects participating in the research were socioeconomically characterized, we listed categories according to the meaning of the central ideas to understand the individual as a social being regarding the process of vaccine hesitation of COVID-19, being them: Experiences and experiences about the pandemic and the COVID-19 disease; Perceptions about the COVID-19 vaccine and vaccination; Justifications associated with vaccine hesitancy against COVID-19 and other related factors. Evidencing findings regarding these perspectives, the main notes found associated with the vaccine hesitation process are related to various reasons, namely: immunization imposition, distrust of the effects of immunobiologicals, misinformation, fear of reactions, conspiracy theories, political influence and the infodemic. Therefore, knowing that the choice to be vaccinated goes beyond an individual criterion, it becomes necessary for health policy makers to dialogue about strategies that reinforce the safety, need, efficacy and importance of the vaccine for everyone (AU).
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Recusa de Vacinação , COVID-19/transmissão , Hesitação Vacinal , Promoção da Saúde , Brasil/epidemiologia , Pesquisa QualitativaRESUMO
RESUMO Objetivo: analisar, nas produções científicas, os motivos que levam pais e familiares de crianças à hesitação vacinal no contexto do controle das doenças imunopreveníveis. Método: revisão integrativa utilizando os seguintes recursos informacionais: Scientific Eletronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem, Índice Bibliográfico Español en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online e Cummulative Index to Nursing and Allied Health Literature. Foi utilizado recorte temporal de 2016 a 2021. Resultados: Vinte e quatro artigos compuseram a amostra final, e emergiram duas categorias: Des(conhecimento) sobre vacinas; e In(decisão) e estilo de vida. Conclusão: esse estudo contribui para a prática profissional, incentivando as gestões das unidades de saúde a estabelecerem estratégias de intervenções com os hesitantes. A recusa vacinal ou o atraso na vacinação devem ser considerados por esses profissionais uma janela de oportunidade para aproximação com os pais e familiares.
ABSTRACT Objective: to analyze, in scientific productions, the reasons that lead parents and family members of children to vaccine hesitancy in the context of control of immunopreventable diseases. Method: integrative review using the following informational resources: Scientific Electronic Library Online, Latin American and Caribbean Literature on Health Sciences, Nursing Database, Índice Bibliográfico Español en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online, and Cumulative Index to Nursing and Allied Health Literature. A time cut-off from 2016 to 2021 was used. Results: Twenty-four articles comprised the final sample, and two categories emerged: Un(knowledge) about vaccines; and In(decision) and lifestyle. Conclusion: this study contributes to professional practice, encouraging health units' managements to establish strategies for interventions with the hesitant. Vaccine refusal or delay in vaccination should be considered by these professionals a window of opportunity to approach parents and family members.
RESUMEN Objetivo: analizar, a través de la producción científica, los motivos que llevan a países y familias de niños a la vacilación vacunal en el contexto de la lucha contra las enfermedades inmunoprevenibles. Método: revisión integradora utilizando los siguientes recursos informativos: Scientific Eletronic Library Online, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Nursing Database, Índice Bibliográfico Español en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online y Cumulative Index to Nursing and Allied Health Literature. Se utilizó un marco temporal de 2016 a 2021. Resultados: Veinticuatro artículos constituyeron la muestra final, y surgieron dos categorías: Des(conocimiento) sobre vacunas; e In(decisión) y estilo de vida. Conclusión: este estudio contribuye a la práctica profesional, animando a las direcciones de las unidades sanitarias a establecer estrategias de intervención con las personas indecisas. El rechazo o el retraso en la vacunación deben ser considerados por estos profesionales como una ventana de oportunidad para acercarse a los padres y familiares.
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ABSTRACT Objectives: to synthesize scientific evidence on vaccine hesitancy in children under five years of age and its associated factors. Methods: a scoping review, conducted according to the methodological structure proposed by the JBI. Searches were carried out in the Latin American and Caribbean Center on Health Sciences Information, Scientific Electronic Library Online and PubMed databases, including gray literature. Studies in English, Spanish and Portuguese were included, without temporal delimitation. Editorials, studies that did not address vaccine hesitancy in children under five years of age and were not aligned with the objective and research question were excluded. The sample consisted of 18 articles. Results: misinformation, concern about adverse effects, distrust about efficacy, affliction regarding administration simultaneously, and insecurity in relation to the laboratories were the reported reasons. Conclusions: strategies are needed to combat the lack of information about immunobiological agents, as misinformation was the main factor in parents' vaccine hesitation.
RESUMEN Objetivos: sintetizar la evidencia científica sobre la reticencia vacunal en menores de cinco años y sus factores asociados. Métodos: revisión de alcance, realizada según la estructura metodológica propuesta por el JBI. Las búsquedas se realizaron en el Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud, Scientific Electronic Library Online y PubMed, incluida la literatura gris. Se incluyeron estudios en inglés, español y portugués, sin delimitación temporal. Se excluyeron editoriales, estudios que no abordaran la reticencia vacunal en menores de cinco años y que no estuvieran alineados con el objetivo y pregunta de investigación. La muestra estuvo compuesta por 18 artículos. Resultados: la desinformación, la preocupación por los efectos adversos, la desconfianza en la eficacia, la angustia por la administración simultánea y la inseguridad por los laboratorios fueron los motivos informados. Conclusiones: se necesitan estrategias para combatir la falta de información sobre inmunobiológicos, ya que la desinformación fue el principal factor en la duda vacunal de los padres.
RESUMO Objetivos: sintetizar evidências científicas sobre hesitação vacinal em crianças menores de cinco anos e seus fatores associados. Métodos: revisão de escopo, conduzida conforme a estrutura metodológica proposta pelo JBI. Realizaram-se buscas nas bases Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde, Scientific Electronic Library Online e PubMed, incluindo literatura cinzenta. Foram incluídos estudos em inglês, espanhol e português, sem delimitação, temporal. Foram excluídos editoriais, estudos que não abordaram hesitação vacinal em menores de cinco anos e não estiveram alinhadas com o objetivo e questão de pesquisa. A amostra foi composta por 18 artigos. Resultados: desinformação, preocupação com efeitos adversos, desconfiança sobre eficácia, aflição quanto à administração simultaneamente e insegurança em relação aos laboratórios foram os motivos relatados. Conclusões: são necessárias estratégias de combate à carência de informações acerca dos imunobiológicos, pois a desinformação foi o fator principal na hesitação vacinal dos pais.