Maximising influenza vaccination uptake among older people

Older adults aged 65 years and over are particularly vulnerable to seasonal influenza as their immune system is weaker than that of younger adults. The influenza vaccination helps to reduce influenza severity and the incidence of complications, but a range of factors can affect uptake among older people. These factors can be categorised as follows: the system of vaccination; influenza vaccination mistrust and fear of side-effects; health beliefs and behaviours; and other factors. Various interventions to maximise influenza vaccination uptake among older people in the community have been identified, including: interventions to increase community demand, enhance access and improve influenza vaccination among community nurses, as well as provider or system-based interventions and societal interventions. Community nurses have been found to have a positive influence on influenza vaccination uptake and should continue to promote the benefits of influenza vaccination to their patients who are 'persistent decliners'.

Seasonal influenza vaccination knowledge, risk perception, health beliefs and vaccination behaviours of nurses

The relationship between knowledge, risk perceptions, health belief towards seasonal influenza and vaccination and the vaccination behaviours of nurses was explored. Qualified nurses attending continuing professional education courses at a large London university between 18 April and 18 October 2010 were surveyed (522/672; response rate 77·7%). Of these, 82·6% worked in hospitals; 37·0% reported receiving seasonal influenza vaccination in the previous season and 44·9% reported never being vaccinated during the last 5 years. All respondents were categorized using two-step cluster analyses into never, occasionally, and continuously vaccinated groups. Nurses vaccinated the season before had higher scores of knowledge and risk perception compared to the unvaccinated (P<0·001). Nurses never vaccinated had the lowest scores of knowledge and risk perception compared to other groups (P<0·001). Nurses' seasonal influenza vaccination behaviours are complex. Knowledge and risk perception predict uptake of vaccination in nurses.

Development and testing of an instrument to assess nurses' knowledge, risk perception, health beliefs and behaviours related to influenza vaccination

AIMS AND OBJECTIVES

To develop an instrument to measure nurses' knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours and evaluate its construct validity and internal consistency reliability.

BACKGROUND

Although instruments to assess predictors of nurses' vaccination behaviours have been developed, their validity and reliability have not been reported.

DESIGN

Instrument development and initial validity and reliability testing.

METHODS

The instrument was developed drawing on a literature review and expert consultation and was refined through pilot work. A cross-sectional survey using a revised version of the instrument was conducted among a convenience sample of 520 registered nurses (response rate 77.4%). Cronbach's alpha coefficient was calculated to determine internal consistency of the sub-scale in the instrument. Principal components analysis with varimax rotation was carried out to evaluate the instrument's construct validity and examine its internal structure.

RESULTS

Cronbach's alpha coefficients for the three newly developed scales ranged from 0.70-0.76. Principal components analysis produced a good fit and confirmed the internal design of the instrument. In the seasonal influenza knowledge sub-scale four factors explained 44.8% of the total variance; in the H1N1 knowledge sub-scale two factors explained 44.7% of the total variance. Three factors in the risk perception scale contributed 50.5% of the total variance and two factors in the vaccination behaviours scale contributed 62.1% of the total variance.

CONCLUSIONS

An instrument has been developed to assess nurses' knowledge, risk perception and health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The instrument was valid and reliable for the setting where it was used.

RELEVANCE TO CLINICAL PRACTICE

This instrument could be used to assess nurses' knowledge, risk perception, health beliefs towards influenza and influenza vaccination and their vaccination behaviours. The three newly developed scales could also be used independently to measure variables influencing nurses' vaccination practices.