Empathy in vaccination counselling: a survey on the impact of a three-day residential course

Empathy competence and future specialty among medical residents in Japan: a nationwide cross-sectional study

Empathy is essential for physicians to provide patient-centered care. Nevertheless, the degree to which empathy varies among medical residents based on their desired future specialty remains undetermined. This nationwide cross-sectional study compared empathy levels (Jefferson Scale of Empathy, JSE) of 824 year one and two postgraduate residents in Japan by intended medical specialty, individual characteristics, and training and working environment characteristics. Empathy levels were compared with applicants for general medicine, which emphasizes patient-centeredness. The highest mean JSE and the highest percentage of women residents were observed in general medicine (M = 109.74; SD = 14.04), followed by dermatology (M = 106.64; SD = 16.90), obstetrics and gynecology (M = 106.48; SD = 14.31), and pediatrics (106.02; SD 12.18). Residents interested in procedure-centered departments (e.g. ophthalmology, orthopedics) garnered lower JSE scores. Multivariate regression revealed that future general medicine candidates achieved the highest JSE scores ([Formula: see text] = 6.68, 95% CI 2.39-10.9, p = 0.002). Women achieved significantly higher JSE scores than men ([Formula: see text] = 2.42, 95% CI 0.11-4.73, p = 0.041). The results have implications for empathy training and postgraduate education strategy in different clinical specialties.

Empathy training for service employees: A mixed-methods systematic review

Following the surge for empathy training in service literature and its increasing demand in service industries, this study systematically reviews empirical papers implementing and testing empathy training programs in various service domains. A mixed-methods systematic review was performed to identify and describe empathy training programs and discuss their effectiveness in service quality, service employees' well-being, and service users' satisfaction. Included papers met those eligibility criteria: qualitative, quantitative, or mixed-methods study; one training in empathy is identifiable; described training(s) developed for or tested with service employees dealing with service users. We searched health, business, education, and psychology databases, such as CINAHL, Medline ABI/Inform Global, Business Source Premier, PsycINFO, and ERIC. We used the Mixed-Method Assessment Tool to appraise the quality of included papers. A data-based convergent synthesis design allowed for the analysis of the data. A total of 44 studies published between 2009 to 2022 were included. The narrative presentation of findings was regrouped into these six dimensions of empathy training programs: 1) why, 2) who, 3) what, 4) how, 5) where, and 6) when and how much. Close to 50% of studies did not include a definition of empathy. Four main empathic competencies developed through the training programs were identified: communication, relationship building, emotional resilience, and counseling skills. Face-to-face and group-setting interventions are widespread. Our systematic review shows that the 44 papers identified come only from health services with a predominant population of physicians and nurses. However, we show that the four empathic skills identified could be trained and developed in other sectors, such as business. This is the first mixed-methods, multi-disciplinary systematic review of empathy training programs in service research. The review integrates insights from health services, identifies research limitations and gaps in existing empirical research, and outlines a research agenda for future research and implications for service research.

The AIMS approach: regulating receptivity in patient-provider vaccine conversations

The World Health Organization named vaccine hesitancy a leading global health threat of modern time. Addressing this public health issue requires a multi-front strategy, one such strategic effort is training health care professionals to respond to reluctant patients/caregivers or those who refuse vaccines. AIMS (Announce, Inquire, Mirror, and Secure) is designed to help HCPs engaged in more productive conversations with patients/caregivers to secure trust, a key behavior leading to higher vaccination rates.

Vaccine hesitancy educational tools for healthcare providers and trainees: A scoping review

In the era of vaccine hesitancy, highlighted by the current SARS-CoV2 pandemic, there is an acute need to develop an approach to reduce and address apprehension towards vaccinations. We sought to map and present an overview of existing educational interventions for healthcare providers (HCPs) on strategies to engage in effective vaccine discussion. We applied the Joanna Briggs Institute methodology framework in this scoping review. We searched five relevant databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS) and grey literature through the Google search engine using keywords and subject headings that were systematically identified. We identified 3384 citations in peer-reviewed literature and 41 citations in grey literature. After screening for our inclusion criteria, we included 28 citations from peer reviewed literature and 16 citations from grey literature for analysis. We identified a total of 41 unique education interventions. Interventions were available from multiple disciplines, training levels, clinical settings, and diseases/vaccines. Interventions predominantly centered around two foci: knowledge sharing and communication training. Most interventions identified from peer-reviewed literature were facilitated and were applied with multiple modes of delivery. Interventions from grey literature were more topical and generally self-directed. We identified several gaps in knowledge. Firstly, accessibility and generalizability of interventions was limited. Secondly, distribution of interventions did not adequately address nursing and pharmacy disciplines, and did not cover the breadth of medical specialties for whom vaccine discussions apply. Thirdly, no interventions addressed self monitoring and the clinicians' recognition and management of emotions during difficult conversations. There is a need to address this gap and provide available, credible and comprehensive educational interventions that will support our healthcare providers in effective communication with vaccine hesitant patients.

Pandemic response in Alaska: Preparing pharmacists to lead vaccination efforts

BACKGROUND

Despite the established efficacy of vaccines, many Alaskans choose not to be vaccinated, citing safety and efficacy concerns. Vaccine hesitancy, consistently ranked among the top 10, is one of most addressable global health threats. The main objective of this paper is to provide an overview of the steps taken by our team to help identify and address vaccine hesitancy by identifying unmet training needs and engaging pharmacists, pharmacy interns, and technicians in the development of tailored vaccine hesitancy education to improve vaccine confidence and vaccination rates among all Alaskans.

METHODS

To determine the unmet training needs that contributed to vaccine hesitancy, an assessment survey was developed and administered to pharmacists across the state.

RESULTS

An expert panel, composed of pharmacists across the state, was convened to review survey results and to establish a scalable health care provider training program. Adult-learning strategies and real-world examples were used to address pharmacist identified factors contributing to vaccine hesitancy and provide more tailored training to pharmacists and technicians in Alaska to help address factors contributing to vaccine hesitancy in patients that may be extending the pandemic.

CONCLUSION

Pharmacy professionals are well positioned to respond to emerging threats, but more training and practice opportunities are required to get comfortable addressing vaccine hesitancy with established communication strategies.

Vaccine Hesitancy in Japan: From a Perspective on Medical Uncertainty and Trans-Scientific Theory

The development and dissemination of vaccines has made immunization possible and has led to the successful control and eradication of various infectious diseases in many parts of the world. However, even when vaccines that are said to be "effective" are offered, a certain number of people do not receive them, and this has become a problem known as "vaccine hesitancy". ItThe reason of "Vaccine hesitancy" is pointed out that there is not only because of the risk of contracting infectious diseases if they are not vaccinated, but also because of the lack of a collective immunity system. Vaccines are an effective means of acquiring immunity, but no matter how highly effective vaccines are developed, if the vaccination rate does not exceed a certain number, "herd immunity", which means that the risk of person-to-person transmission is reduced when a significant portion of the population becomes immune to, cannot be acquired. Therefore, how to increase the vaccination rate of the population is a major public health challenge. This paper reviews previous studies on "vaccine hesitancy" in Japan and analyzes people's hesitancy in terms of negative "rumors" about vaccines, risk perception of vaccine side effects, and sense of burden when receiving vaccinations. Then, the author will examine that the background of "vaccine hesitancy" is not only distrust of vaccines and risk perception of side effects, but also distrust of those who provide and promote vaccinations, such as medical professionals, government, and public administration. By using medical uncertainty which shows there are many unknowns and uncertainties in medicine and trans-scientific theory which indicates there are areas that science cannot answer this paper argues that the problem of "vaccine hesitancy" can be reduced if medical professionals and governments show sincere empathy and attitude toward victims of adverse vaccine reactions and those who hesitate to vaccinate.

Vaccine Hesitancy in Japan: From a Perspective on Medical Uncertainty and Trans-Scientific Theory

The development and dissemination of vaccines has made immunization possible and has led to the successful control and eradication of various infectious diseases in many parts of the world. However, even when vaccines that are said to be "effective" are offered, a certain number of people do not receive them, and this has become a problem known as "vaccine hesitancy". Why is vaccine hesitancy a problem? It has been pointed out that the reason is not only because of the risk of contracting infectious diseases if they are not vaccinated, but also because of the lack of a collective immunity system. Vaccines are an effective means of acquiring immunity, but no matter how highly effective vaccines are developed, if the vaccination rate does not exceed a certain number, herd immunity cannot be acquired. Therefore, it is said that how to increase the vaccination rate of the population is a major public health challenge. Hence, the large number of people who do not receive vaccinations due to "vaccine hesitancy" is problematic. This paper reviews previous studies on "vaccine hesitancy" in Japan and analyzes people's hesitancy in terms of negative "rumors" about vaccines, risk perception of vaccine side effects, and sense of burden when receiving vaccinations. Then, I will examine that the background of "vaccine hesitancy" is not only distrust of vaccines and risk perception of side effects, but also distrust of those who provide and promote vaccinations, such as medical professionals, government, and public administration. By using medical uncertainty and trans-scientific theory, this paper argues that the problem of "vaccine hesitancy" can be reduced if medical professionals and governments show sincere empathy and attitude toward victims of adverse vaccine reactions and those who hesitate to vaccinate.

A Behavioral analysis of nurses' and pharmacists' role in addressing vaccine hesitancy: scoping review

The purpose of this review was to identify, characterize, and map the existing knowledge on a) nurses' and pharmacists' perceived barriers and enablers to addressing vaccine hesitancy among patients; and b) strategies or interventions for nurses and pharmacists to address vaccine hesitancy in their practice. Our comprehensive search strategy targeted peer-reviewed and grey literature. Two independent reviewers screened papers and extracted data. We coded narrative descriptions of barriers and enablers and interventions using the Behavior Change Wheel. Sixty-six records were included in our review. Reported barriers (n = 9) and facilitators (n = 6) were identified in the capability, opportunity and motivation components. The majority of the reported interventions were categorized as education (n = 47) and training (n = 26). This current scoping review offers a detailed behavioral analysis of known barriers and enablers for nurses and pharmacists to address vaccine hesitancy and interventions mapped onto these behavioral determinants.

Post-Marketing Active Surveillance of Adverse Reactions Following Influenza Cell-Based Quadrivalent Vaccine: An Italian Prospective Observational Study

Since the influenza season 2018/19, the Italian Ministry of Health recommended a dose of cell-based quadrivalent vaccine (Flucelvax Tetra) for HCWs (healthcare workers), because this vaccine seemed more efficacious in the prevention of AH3N2 virus. Due to the lack of pre-registration data, the safety profile of this new vaccine must be investigated in post-marketing surveillance. The aim of our study is to evaluate, through a post-marketing active surveillance program developed during the 2019/20 influenza season, any Adverse Events Following Immunization (AEFIs) that happened in the 7 days after immunization with Flucelvax Tetra. The study was carried out in a sample of HCWs of Policlinico General University-Hospital (Apulia, South Italy). AEFIs were classified as ‘serious’ or ‘not serious’ according to the WHO (World Health Organization) guidelines; the WHO causality assessment algorithm was applied to classify serious AEFIs. A total of 741 HCWs were enrolled, and 430 AEFIs (reporting rate: 58.0 (95%CI: 54.4–61.6) × 100 enrolled) were recorded. Of these, 429 of 430 (99.8%; reporting rate: 57.8 (95%CI: 54.2–61.5) × 100 enrolled) were classified as not serious and one (0.2%; reporting rate: 0.13 (0.03–0.75) × 100 enrolled) was classified as serious. Local reactions were the adverse reaction reported most frequently (88%); regarding the serious AEFI, causality assessment excluded the causal link with the administration of the vaccine. All the AEFIs resolved without sequelae. Flucelvax Tetra showed a profile of high safety. Due to their characteristics of greater sensitivity than passive surveillance, active surveillance programs can be useful in defining the safety profiles of a given vaccine/drug in certain population subgroups.

The Role of Emotional Competences in Parents' Vaccine Hesitancy

The role of parents’ emotional competencies on vaccine hesitancy and decision making has been seldom examined. Two studies investigated the relationship between parents’ attitudes towards childhood vaccines and self-reported behavior (Study 1) and between parents’ emotional competence and attitudes towards vaccines (Study 2). In Study 1, predictors of temporal, partial, or complete vaccine refusal (having voluntarily postponed/forgone some/all vaccines) were examined in 2778 parents. In Study 2, psychological predictors of the attitude towards vaccines were examined in 593 parents, using the Profile of Emotional Competence and the valence of mental images spontaneously associated with the term “vaccine”. In Study 1, attitudes were aggregated in three independent factors (concerns about vaccine safety; diseases prevented by vaccines; and naturalistic views) that independently predicted vaccine refusal. In Study 2, a significant mediational analysis showed a positive indirect effect of intrapersonal emotional competences on attitudes towards vaccines, through mental images associated with the word “vaccine”. Parents’ intrapersonal emotional competences affected all dimensions of attitudes towards vaccines, suggesting that being able to manage, identify, and recognize one’s own emotions is central to vaccine acceptance. These findings suggest that intervention strategies, rather than stressing the pro-social benefits of vaccinating, should focus on aspects related to one’s own emotions.

Healthcare Workers Training Courses on Vaccinations: A Flexible Format Easily Adaptable to Different Healthcare Settings

Since 2017, Italy has expanded the compulsory vaccination from 4 to 10 for those aged 0 to 16 years. Because of the great organizational effort required for the immunization services, minor attention was given to the vaccinations not included among the mandatory ones. This situation led to a real difficulty in harmonizing the vaccination procedures even inside a single region. In the Lazio region, the Laboratory of Vaccinology of the University of Rome Tor Vergata established a working group to create a new training model for healthcare professionals. The course program proposed an update of three vaccinations which are not mandatory but actively offered. It included the same part of scientific updating and a variable part based on local experiences. A specific anonymous questionnaire on knowledge and attitude was administered. The study aimed to propose a general format of training courses for vaccination centers adaptable to the individual local health units (ASLs) and to evaluate through questionnaires. The results show differences in knowledge and attitudes toward non-mandatory vaccinations among the ASLs of Lazio, confirming the usefulness of a support to make knowledge and procedures homogeneous. This model could be adapted to any healthcare setting and exported to other services.

Adverse Events Following Measles-Mumps-Rubella-Varicella Vaccination and the Case of Seizures: A Post Marketing Active Surveillance in Puglia Italian Region, 2017-2018

Since 2012, the Italian Ministry of Health has recommended to improve the surveillance of adverse events following the measles-mumps-rubella-varicella (MMRV) tetravalent vaccine that was provided in the official immunization schedule of some Italian regions for children during the second year of life. This recommendation was based on data from some surveys that showed an additional risk of seizure following the administration of this vaccine. Responding to the Ministry commitment, the Puglia Region launched, from May 2017 to November 2018, a post-marketing active surveillance program of adverse events following MMRV immunization (AEFIs). Immunized children (second year of life) were enrolled on a voluntary basis, AEFIs diaries were used, and their parents were interviewed 25 days after the immunization. There were 2540 children enrolled; 2149/2540 (84.6%) completed the post-vaccination follow-up. Of these, 992 AEFIs were registered with a reporting rate of 46.2 × 100 doses: 883/992 (89.0%) AEFIs were not serious, while 109/992 (11.0%) were serious. For serious AEFIs, the evaluation of causality assessment was performed using the algorithm proposed by the World Health Organisation (WHO): 82/109 consistent causal associations to MMRV immunization were detected (reporting rate of consistent AEFIs: 3.8 × 100 follow-up). All serious AEFIs consistently associated with immunization resulted completely resolved at the follow-up. The reporting rate of seizure consistently associated with immunization was 0.05 × 100, lower than data previous published in the literature that did not report the causality assessment. Because no emerging signals were detected, our data from the active surveillance program confirmed the safety profile of the MMRV vaccine.