Parental regret regarding children's vaccines-The correlation between anticipated regret, altruism, coping strategies and attitudes toward vaccines

The Decision-Making Process regarding Ovarian Tissue Cryopreservation in Girls with Turner Syndrome by Patients, Parents, and Healthcare Providers: A Mixed-Methods Study

INTRODUCTION

Ovarian tissue cryopreservation (OTC) has proven to be effective in other patient groups, but the effectiveness in girls with Turner syndrome (TS) is still unclear. Guidelines for counselling about OTC in TS are lacking. The aim of this study was to gain insight into the experiences of patients, parents, and healthcare providers with the decision-making process regarding OTC in girls with TS.

METHODS

Within a year after counselling, a survey was sent to 132 girls with TS and their parents. Furthermore, focus groups were conducted with (1) gynaecologists with subspeciality reproductive medicine, (2) paediatric endocrinologists, (3) parents of girls aged 2-12, and (4) parents of girls aged 13-18. Transcripts were analysed using a thematic analysis approach.

RESULTS

The response rate of the survey was 45%. Of the survey respondents, 90% appreciated counselling regarding their future parenting options and considered it an addition to existing healthcare. Girls with TS and their parents indicated that the option of OTC raised hope for future genetic offspring and instantly made them feel that their only option was to seize this opportunity. Gynaecologists and paediatricians found it challenging to truly make families grasp a realistic perspective of OTC in girls with TS.

DISCUSSION AND CONCLUSION

Offering young girls with TS the possibility of fertility preservation in an experimental setting raised high hopes and led to challenges for healthcare providers in ensuring a considered decision. The appropriate moment for counselling should be tailored to the individual and discussed with patient, parents, and paediatrician.

Vaccinated kindergartens: A community-based bottom-up initiative addressing vaccine hesitancy in Israel

BACKGROUND

Vaccine hesitancy (VH) has grown over recent decades. While most of the strategies implemented to cope with VH are top-down interventions, the present article focuses on a unique community-based bottom-up initiative conducted in Israel: Mehusgan-the vaccinated kindergarten.

OBJECTIVE

The objective of the study was to learn about the vaccinated kindergarten initiative: its implementation, benefits, and challenges as well as its broader potential impact.

METHODOLOGY

During 2020, we conducted 13 semi-structured in-depth interviews with parents, kindergarten teachers and managers, and physicians.

FINDINGS

The interviews revealed that parents are encouraged to complete the vaccination program as recommended; additional kindergartens join the initiative; and additional kindergartens become vaccinated.

CONCLUSIONS

Mehusgan is a unique and growing initiative that leads to vaccinated kindergartens and, therefore, contributes to public health. This case study can encourage other community-based bottom-up initiatives that seek to raise vaccination rates.

Understanding the psychosocial determinants of Italian parents' intentions not to vaccinate their children: an extended theory of planned behaviour model

OBJECTIVE

This study aimed to identify the psychosocial factors involved in Italian parents' intentions not to vaccinate their children. For this purpose, we used an extended version of the Theory of Planned Behaviour, which included both proximal and distal factors influencing intention not to vaccinate children.

DESIGN

Participants included 447 Italian parents, each completed an online questionnaire, which measured intention not to vaccinate children, attitude toward not vaccinating, subjective norms, perceived behavioural control, anticipated regret, negative attitude toward vaccines, risk perception, trust in healthcare institutions, trust in science and religious morality.

RESULTS

Results showed that attitude toward not vaccinating was strongly associated with intention not to vaccinate children. Furthermore, attitude toward not vaccinating was associated with negative attitude toward vaccines, which in turn was affected by all the distal factors considered (risk perception, trust in healthcare institutions, trust in science, religious morality). Finally, negative attitude toward vaccines fully mediated the effect of the distal factors on attitude toward not vaccinating children.

CONCLUSION

These findings provide support for the validity of the proposed extended TPB model in explaining parents' intention not to vaccinate children. Theoretical and practical implications, in terms of understanding and promoting vaccination behaviour, are discussed.

Resources for assessing parents' vaccine hesitancy: a systematic review of the literature

The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.

The patient-physician relationship: an account of the physician's perspective

BACKGROUND

The issue of patient-physician relationships in general, and particularly the trust of patients in their primary care physician has gained much interest in academia and with practitioners in recent years. Most research on this important topic, however, focused on how patients view the relationship and not how the physicians see it. This research strives to bridge this gap, with the resolution of leading to an improved appreciation of this multifaceted relationship.

METHODS

A survey of 328 actively practicing physicians from all four health maintenance organizations (HMOs) in Israel resulted in a hierarchical formation of components, indicating both the relative as well as absolute importance of each component in the formation of the patient-physician relationship. The sample conducted was a convenience one. Methodologically, we used two different complementary methods of analysis, with the primary emphasis on the Analytic Hierarchical Processing (AHP), a unique and advanced statistical method.

RESULTS

The results provide a detailed picture of physicians' attitudes toward the patient-physician relationship. Research indicates that physicians tend to consider the relationship with the patient in a rather pragmatic manner. To date, this attitude was mostly referred to intuitively, without the required rigorous investigation provided by this paper. Specifically, the results indicate that physicians tend to consider the relationship with the patient in a rather pragmatic manner. Namely, while fairness, reliability, devotion, and serviceability received high scores from physicians, social interaction, friendship, familial, as well as appreciation received the lowest scores, indicating low priority for warmth and sociability in the trust relationship from the physician's perspective. The results showed good consistency between the AHP results and the ANOVA comparable analyses.

CONCLUSIONS

In contrast to patients who traditionally stress the importance of interpersonal skills, physicians stress the significance of the technical expertise and knowledge of health providers, emphasizing the role of competence and performance. Physicians evaluate the relationship on the basis of their ability to solve problems through devotion, serviceability, reliability, and trustworthiness and disregard the "softer" interpersonal aspects such as caring, appreciation, and empathy that have been found to be important to their patients. This illustrates a mismatch in the important components of relationship building that can lead to a loss of trust, satisfaction, and repeat purchase.

POLICY IMPLICATIONS

We study the impact physicians' incentives have on the tangible relationship and discuss the significance of physician-patient relationship on satisfaction with the health service given. As a result policies leading to a more dynamic role must be given to the patient, who being well informed by the physician, can help in the decision making process. Policy schemes need to be implemented as a way of changing physicians' behavior, forcing them to better construct and utilize this dyadic relationship.