護理人員對新型流感認知與其施打疫苗之行為

The Relationship between Knowledge and Practice toward the Acceptance of New Flu Vaccine among Nurses

台灣醫護人員在2003年的嚴重急性呼吸症候群（SARS）戰役中，死亡率全球第一位。在面對多變的環境與新興傳染病無法預知的社會裡，護理人員對於新興傳染病的認知與態度，將左右其對病人的照護品質。但是面對高感染率的流感，醫護人員的疫苗施打率卻偏低。本研究探討台灣臨床護理人員對新型流感（H1N1）認知情形與其疫苗注射行為之關聯性。調查護理人員不同的個人因子對新型流感知識與個人在疫苗施打行為等資訊，進一步研究收集護理人員知與行間之差異性與相關性。如何恢復民眾及基層護理人員對施打疫苗的信心，是防疫機構目前最大的課題。本研究證明護理人員認知，會影響其接種疫苗行為，因此從改變第一線臨床護理人員認知做起，將可大幅改善接種疫苗之覆蓋率。建議政府與各級防疫機構，建立完善的疫苗安全性衛教資訊，並廣為宣傳，並要求各級醫院與衛生局（所）提出疫苗接種不良反應的防護機制，以挽回第一線臨床護理人員對疫苗的信心。H1N1有別於之前之流感與禽流感，醫護人員對其認知有限，希望透過此研究，能呼籲疾管局加強平日流行病學之宣導，也呼籲醫護人員在自保與救人的雙重需求下，能多參與防疫單位的宣導與吸取正確知識。

This study is to explore and discuss the relationship between nursing staffs' knowledge, attitude and their actual practice toward receiving the vaccine for H1N1 swine flu. This study finds that fewer than half of the professionally active nurses receive influenza vaccination every year. This study also finds that professionally active nurses with graduate level of education score significantly higher in the knowledge test about the H1N1-New Flu and its vaccine than those from other groups with lower education levels. The results from a path analysis also show a significant association between the education and vaccination acceptance behavior if the score from knowledge test about H1N1 plays as the intervening factor which receives the impact from education level then further transfers it to influence the vaccine acceptance behavior. This study finds that improving the knowledge and attitude toward the H1N1 vaccine among professionally active nurses actually has significant impacts on vaccine acceptance behavior and it further plays a role in improving the vaccination rate. It is suggested that government should provide sufficient educational material to promote the safety of the H1N1 vaccine in the campaign. In addition, this study also finds it helpful if hospitals of all levels and health departments not only systematically report the adverse reactions due to the vaccine injection but also propose effective prevention mechanisms to them. Since H1N1 is different from and more fatal than the general influenza Government needs to promote the epidemiologic concept of disease prevention in their operation, as well as, encourage professionally active nurses and other health workers to participate more in those activities advocating disease prevention and absorb right information. The final knowledge test score in this study was surprisingly low among the nearly five hundred participating professionally active nurses. It may imply an opportunity to enhance the on the job training for those professionally active nurses who provide the primary level of patient care. In general, professionally active nurses working as the front line health practitioners who expose directly to the diseases, bacteria and virus, should have the highest priority to receive the vaccination. A mandatory or financially incentive vaccination policy may be suggested to protect these front line workers. Finally, another important finding is that education level among professionally active nurses affects the knowledge of the disease, and the knowledge level. It further influences the vaccine acceptance behavior. It implies that to promote the acceptance rate of vaccination should start with improving the perception, including knowledge and attitude, of the H1N1-New Flu and its vaccine.