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      Perception and Performance of Preventive Behaviors for the Pandemic Influenza in Hospital Employees and Outpatients


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          A new strain of the H1N1 subtype of influenza A virus resulted in a pandemic outbreak. In South Korea, cases of pandemic influenza have increased. Therefore, we explored perception or preventive behaviors for this virus in hospital employees and outpatients.

          Materials and Methods

          Data was collected from hospital employees and outpatients at three university hospitals located in Daegu, Gyeongju in South Korea between the 21st and 30th of September, 2009 using a self-administrated questionnaire. We estimated perception by components of The Health Belief Model (HBM), preventive behaviors consisted of avoidance behaviors, and the recommended behaviors by the Korea Center of Disease Control and Prevention (KCDC). Desire for vaccination was identified.


          The 1,837 participants comprised hospital employees (n = 880, 47.9%) and outpatients (n = 957, 52.1%). Of all hospital employees, 491 (55.8%) and 708 (80.5%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Among all outpatients, 490 (51.2%) and 651 (68.0%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Recommended preventative behaviors were adopted by 674 (76.6%) of hospital employees and 631 (65.9%) of outpatients. Vaccination was desired by 479 (54.4%) of hospital employees and 484 (50.6%) of outpatients. Factors influencing preventative behaviors included gender, economic status (for hospital employees) and educational level (for outpatients). All HBM components except perception of barriers were associated with the preventive behaviors in both groups.


          The majority of the surveyed hospital employees and outpatients perceived the benefits of preventive behaviors for pandemic influenza and performed them.

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          Most cited references12

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          Influenza vaccination of healthcare workers.

          To assess factors associated with influenza vaccination of healthcare workers. Cross-sectional survey. University-affiliated Veterans' Affairs medical center. Staff physicians and nurses employed by the medical center. A mailed, self-administered questionnaire. The response rate was 38.0%. The mean age of the respondents was 43.6 years, 71.5% were females, and 26.2% were physicians. Nearly all of the practitioners had daily or weekly contact with elderly or high-risk patients. The influenza vaccination rate of the respondents was 61.2%. More than 50% of vaccine recipients indicated that avoiding illness, protecting patients, and being able to receive the vaccine conveniently and free of charge all were very important factors influencing their decisions to receive the vaccine. Avoiding illness was rated the most important factor by 58.8% of vaccine recipients. Among vaccine nonrecipients, concern about side effects was identified as a very important factor by 36.2% and as the most important factor by 30.9%. Vaccine recipients were significantly more likely than were vaccine nonrecipients to indicate that influenza and its complications are very serious for high-risk patients. They also were more likely to report that the vaccine is very effective, that influenza vaccination is uncommonly associated with side effects, that healthcare workers' risk for contracting influenza is higher than the general public's risk, and that it is very important for healthcare workers to receive the vaccine to decrease risk for transmission to high-risk patients. After stepwise logistic regression, variables independently associated with receipt of vaccine were age, prior receipt of vaccine, being a physician, considering the vaccine to be very effective, believing that systemic side effects are uncommon, and indicating that it is very important for healthcare workers to receive vaccine for the protection of their patients. Many healthcare workers fail to receive influenza vaccine each year. Strategies to improve immunization levels should address concerns about vaccine safety and efficacy, barriers to vaccination including inconvenience and cost, and the reasons for targeting healthcare workers.
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            Prevalence of influenza vaccination and correlates of intention to be vaccinated among Hong Kong Chinese.

            To explore influenza vaccination rates and investigate correlates of intention to be vaccinated among adults attending a Hong Kong outpatient clinic. Descriptive cross-sectional survey. Convenience sample of adults attending outpatient clinic (452 participants). Self-administered written questionnaire including socio-demographic items, health items, influenza vaccination history, and questions based on the Health Belief Model and Predisposing, Reinforcing, and Enabling Causes in Educational Diagnosis and Evaluation framework. The response rate was 78.9%. Of the participants, 27% had been vaccinated in the past year; 51% reported intention to be vaccinated this year. Intention to be vaccinated did not vary according to gender, marital status, occupation, or household income. In adjusted logistic regression analysis, intention to be vaccinated was significantly associated with chronic disease, having received the flu shot in the previous year, perceived susceptibility ("I am likely to get the flu if I do not get a yearly flu shot"), and reinforcing factors ("My family encouraged me to get a flu shot last year" and "My doctor encouraged me to get a flu shot last year"). The government can successfully promote vaccination by educating the public about susceptibility to flu and the benefits of vaccination, by publicizing locations where vaccinations are available, and by having family and physicians encourage patients to be vaccinated.
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              Determinants of adherence to influenza vaccination among inner-city adults with persistent asthma.

              Despite guideline recommendation, influenza vaccination rates among asthmatic patients remain low. The objective of this study was to identify health beliefs associated with vaccination adherence in asthmatic patients. We surveyed 167 adults with persistent asthma undergoing follow-up at a hospital-based clinic. Vaccination beliefs questions were based on the Health Belief Model. Patients who reported receiving influenza immunisation most or every year were considered adherent to vaccination. Overall, 71% of patients were adherent to influenza vaccination. In multivariate analyses, doctor or nurse recommendation (odds ratio [OR]: 14.71, 95% CI 5.40-40.05), the belief that the vaccine protects against influenza (OR: 7.21, 95% CI 2.25-23.10), and the belief that the vaccine could cause a cold (OR: 0.46, 95% CI 0.19-1.13) were independent predictors of adherence. Vaccination beliefs and physician recommendation were associated with influenza vaccination adherence among inner-city asthmatics. Future interventions should target these potentially modifiable factors.

                Author and article information

                Yonsei Med J
                Yonsei Medical Journal
                Yonsei University College of Medicine
                01 January 2011
                30 November 2010
                : 52
                : 1
                : 181-187
                [1 ]Department of Family Medicine, School of Medicine, Dongguk University, Gyeongju, Korea.
                [2 ]Department of Family Medicine, School of Medicine, Kyungpook National University, Deagu, Korea.
                [3 ]Department of Family Medicine, School of Medicine, Keimyung University, Deagu, Korea.
                Author notes
                Corresponding author: Dr. Hwee Soo Jeong, Department of Family Medicine, School of Medicine, Dongguk University, 1090-1 Seokjang-dong, Gyeongju 780-714, Korea. Tel: 82-54-770-8286, Fax: 82-54-770-8378, hweesoo@ 123456yahoo.co.kr
                © Copyright: Yonsei University College of Medicine 2011

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 17 November 2009
                : 16 March 2010
                : 16 March 2010
                Original Article
                Infectious Diseases

                perception,influenza a virus,h1ni subtype,behavior
                perception, influenza a virus, h1ni subtype, behavior


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