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CAUSES AND
EFFECT OF NEGATIVE ATTITUDE TO IMMUNIZATION AMONG COUPLES
ABSTRACT
BACKGROUND:
Lack of information has been associated with couples anxiety or concern in a
number of healthcare areas.
OBJECTIVES:
(1) Identify the proportion of parents who agreed, were neutral, and disagreed
that they had access to enough information to make a decision about immunizing
their child; (2) examine how parents who agreed and disagreed differed with
respect to sociodemographic characteristics, and their attitudes about
immunizations, their child’s healthcare provider, immunization
requirements/exemptions, and immunization policymakers; and (3) identify if differences
exist in specific immunization concerns.
METHODS: A
sample of parents with at least one child aged < or =6 years (n=642) was
analyzed using data from the HealthStyles survey conducted during July and
August 2003. Odds ratios and the Mantel-Haenszel chi-square test were used for
analysis.
RESULTS:
Response rate for HealthStyles was 69% (4035/5845). The largest proportion of
parents agreed they had access to enough information (67%) compared to parents
who were neutral (20%) or who disagreed (13%). Compared to parents who agreed,
parents who disagreed were more likely to be less confident in the safety of
childhood vaccines (odds ratio [OR]=5.4, 95% confidence interval [CI]=3.3-8.9),
and to disagree that their child’s main healthcare provider is easy to talk to
(OR=10.3, 95% CI=3.7-28.1). There was a significant linear trend in the
percentage of parents expressing immunization concerns among those who agreed,
were neutral, and who disagreed they had access to enough information
(p<0.05; df=1).
CONCLUSIONS:
While most parents agreed that they had access to enough immunization
information, approximately a third did not. Perceived lack of information was
associated with negative attitudes about immunizations and toward healthcare
providers. Basic information about the benefits and risks of vaccines presented
by a trusted provider could go a long way toward maintaining and/or improving
confidence in the immunization process.
CHAPTER ONE
1.0 INTRODUCTION
Immunization
is recognized as a safe and effective method of preventing disease (National
Advisory Committee on Immunization, 1998); however, not all parents choose to
immunize their children and not all couples choose to maintain or update their
own immunization status. The goal of this thesis is to understand why young
couples (parents or future parents) make the decisions they do and how they
arrive at those decisions. Health scientists need to acquire an understanding
of the experience of people in relation to their environments for the purpose of
increasing their potential for health. Improved health policies may be
developed if we can understand how to serve our populations better as a whole.
It is more useful to put into place policy that will be meaningful and
followed, than blanket statements that do not put the population’s needs first.
This study contributes to a better understanding of the thought processes
behind persons who choose to delay or refuse immunizations irrespective of the
policy environment. The area of immunization is as complex as a mosaic, and
true to this metaphor, every tile of information contributes to the overall
picture while remaining distinct. This thesis is presented as another tile.
Currently in Amuzi community in Obowo L.G.A, mainstream immunization is
voluntary, though strongly encouraged and freely dispensed to all citizens.
Changes are on-going in mandatory immunization policy provincially. Alberta and
Saskatchewan pride themselves in not having moved to mandatory laws due to the
public health delivery systems in place. (Personal communication, P.
Hasselback, January, 2002). As long as most people comply, the herd immunity
remains strong and the risk for developing vaccine reventable diseases remains
low. However, certain groups in the population do not agree with immunization
for a variety of reasons. Some of these reasons include theological
constraints, belief structures that favor “natural” immunity, beliefs that
immunization is dangerous to children, mistrust in pharmaceutical companies and
a belief in alternative health therapies such as provided by naturopaths and
chiropractors.
What about
apathy? Funk and Wagnells (1982) describe this as indifference and lack of
interest. Do couples feel immunization is important? Do they think about it
during their daily lives? What will our future generation of parents do to
contribute to herd immunity when they have never seen the diseases the vaccines
are designed to prevent? What will happen when the next generation feels overly
confident that they will not be touched by these diseases because they are
perceived as a “Third World problem” or when they do not understand the
ramifications of the diseases? Lack of knowledge of our own immune systems in
the general population is high. Because of the complexity of interactions
between anatomical structures and biochemistry most laypersons shrug their
shoulders when asked how basic immunological functions occur.
Policies
encouraging health education may emphasize the importance of citizens taking a
pro-active role in understanding their bodies and what they can do to remain
healthy. In this day of reduced health care budgets more emphasis needs to be
placed on prevention of disease. Immunization is an integral cog to the wheel.
An analysis of this issue indicates a need for more knowledge to guide health
care workers and policy-makers in contributing to immunization.
DESCRIPTION
OF THE PROJECT
The purpose
of this project is to ascertain the beliefs of young couples regarding
immunization for their children or future children.
The overall
objectives of this qualitative study are to:
Determine
the theological constructs of young couples who refuse or delay immunization
among their children or future children for religious beliefs.
Determine
the beliefs of young couples who engage in alternative health practices and
refuse or delay their children’s or future children’s immunizations.
Determine
whether youngcouples (non-parents) are thinking ahead regarding immunization.
Determine if
there are gender differences between perspectives regarding immunization.
Determine if
there are vocational/academic differences between groups regarding
immunization.
Determine
the relationship between various groups who do not immunize regarding their
decision-making.
OBJECTIVES
The main
objective of the study was to deepen our understanding of the knowledge,
attitudes, practices, fears and beliefs about immunization among children.
Specifically the objectives were:
To identify
myths and misconceptions about immunization among couples.
To identify
knowledge, attitudes, practices, fears and beliefs (KAPBF) about childhood immunization.
To determine
motivating and de-motivating factors in parents seeking immunization among
couples.
RESEARCH
QUESTIONS
The aim of
this study was to answer the following research questions in order to describe
and explain:
What are the
theological constructs of young couples who choose not to immunize their
children or future children? What is the relationship between these beliefs and
the young couples’ decision-making regarding immunization?
What are the
beliefs of young couples who engage in alternative health practices and choose
not to immunize their children or future children? What is the relationship
between these beliefs and the young couples’ decision-making regarding
immunization?
What are the
beliefs of young couples who are concerned about vaccine safety and choose not
to immunize their children or future children? What is the relationship between
these beliefs and the young couples’ decision-making regarding immunization?
DEFINITIONS
In the
context of this study, the following theoretical definitions were used:
Understanding
is the process of interpreting, knowing and comprehending the meaning that is
felt, intended and expressed by another (Denzin, 1989, p. 120);
Immunization
is the process of being immunized against a particular disease;
Health care
workers include individuals from the disciplines of medicine, public health,
physical and social science and nursing;
Health
scientists are researchers concerned with aspects of health science and health
care from multiple disciplines of medicine, public health, physical and social
science, education and nursing; and,
Informants
are defined as the people interviewed in this study who provided information
about personal immunization experiences.
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