What informs parents' decision-making about childhood vaccinations? 2010

Astrid Austvoll-Dahlgren, and Sølvi Helseth
Faculty of Nursing, Oslo University College, Norway. astrid.austvoll-dahlgren@su.hio.no

OBJECTIVE This paper is a report of a study conducted to identify parents' decision-making processes in relation to childhood vaccinations, including barriers and facilitators to searching for information. BACKGROUND Decision-making about childhood vaccinations is complex. Access to the best available evidence and the ability to obtain and understand such information are necessary for effective participation in decision-making. METHODS A grounded theory approach was used, with semi-structured interviews and focus groups with parents (n = 10) and public health nurses (n = 16) conducted in 2008. Data were derived through incident-to-incident and axial coding. RESULTS Being positive towards vaccination and being decided were found to be main barriers to participation and obtaining information; other factors were perceptions about own abilities and capacity. Public health nurses were the parents' most important source of information, but tended to inform to facilitate vaccinations. Issues related to this and being inadequately informed were that some parents expressed low confidence about the decision they had made and uncertainty about their rights and responsibilities in decision-making. CONCLUSIONS Information delivered by public health nurses should not facilitate a specific choice but rather be balanced, explaining the benefits and harms, and accompanied by a qualified recommendation. Useful tools to improve practice may include checklists for shared decision-making and guidelines about trustworthy websites.

UI MeSH Term Description Entries
D007114 Immunization Deliberate stimulation of the host's immune response. ACTIVE IMMUNIZATION involves administration of ANTIGENS or IMMUNOLOGIC ADJUVANTS. PASSIVE IMMUNIZATION involves administration of IMMUNE SERA or LYMPHOCYTES or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). Immunologic Stimulation,Immunostimulation,Sensitization, Immunologic,Variolation,Immunologic Sensitization,Immunological Stimulation,Sensitization, Immunological,Stimulation, Immunologic,Immunizations,Immunological Sensitization,Immunological Sensitizations,Immunological Stimulations,Sensitizations, Immunological,Stimulation, Immunological,Stimulations, Immunological,Variolations
D007223 Infant A child between 1 and 23 months of age. Infants
D007722 Health Knowledge, Attitudes, Practice Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL). Knowledge, Attitudes, Practice
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009524 Newspapers as Topic Publications printed and distributed daily, weekly, or at some other regular and usually short interval, containing news, articles of opinion (as editorials and letters), features, advertising, and announcements of current interest. (Webster's 3d ed) Newspapers as Topics,Topics, Newspapers as
D009664 Norway A country located in northern Europe, bordering the North Sea and the Atlantic Ocean, west of Sweden. The capital is Oslo. Kingdom of Norway
D010290 Parents Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent. Step-Parents,Parental Age,Parenthood Status,Stepparent,Age, Parental,Ages, Parental,Parent,Parental Ages,Status, Parenthood,Step Parents,Step-Parent,Stepparents
D010358 Patient Participation Patient involvement in the decision-making process in matters pertaining to health. Patient Activation,Patient Empowerment,Patient Engagement,Patient Involvement,Patient Participation Rates,Activation, Patient,Empowerment, Patient,Engagement, Patient,Involvement, Patient,Participation Rate, Patient,Participation Rates, Patient,Participation, Patient,Patient Participation Rate
D011637 Public Health Nursing A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs. Nursing, Public Health

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