医护人员对家长疫苗犹豫不决的话语建构:多重道德的故事。

IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Qualitative Health Research Pub Date : 2024-12-01 Epub Date: 2024-06-16 DOI:10.1177/10497323241245646
Esther Lermytte, Piet Bracke, Melissa Ceuterick
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引用次数: 0

摘要

医疗保健专业人员是疫苗相关信息的可信来源,因此他们在解决对疫苗犹豫不决的家长的担忧方面发挥着至关重要的作用。越来越多的证据表明,医疗保健专业人员在处理家长疫苗接种犹豫这一敏感话题时面临着复杂的问题,因为他们要在自己对疫苗和具体情况的担忧与机构和社会的疫苗接种压力之间取得平衡。此外,健康选择(如家长对儿童疫苗接种的选择)往往与道德化联系在一起。鉴于以患者为中心的护理文献强调与对疫苗犹豫不决的家长进行有效沟通,因此考虑医护人员对家长疫苗犹豫不决的解释非常重要。因此,深入了解医护人员如何理解儿童疫苗接种并将其道德化,有助于我们理解道德化如何直接出现在他们与犹豫不决的家长的沟通中。本研究利用批判性社会心理学框架进行话语分析,分析了在比利时佛兰德斯对医疗保健专业人员进行的 39 次半结构式访谈,并介绍了医疗保健专业人员就家长疫苗接种犹豫不决问题所阐述的话语模式。研究结果阐明了医护人员如何通过构建五种不同的解释剧目,即 "好 "或 "坏 "的养育剧目、自由选择剧目、个人风险-收益剧目、公共卫生剧目和可及性剧目,在其关于疫苗犹豫的叙述中延续或抵制道德话语。我们的研究强调了医疗保健专业人员在就疫苗犹豫不决进行协商时所经历的复杂性,因为他们对疫苗犹豫不决的理解受到了现有道德困境和围绕健康与养育的主流话语的影响,并对其起到了促进作用。
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Healthcare Professionals' Discursive Constructions of Parental Vaccine Hesitancy: A Tale of Multiple Moralities.

Healthcare professionals play a crucial role in addressing the concerns of vaccine-hesitant parents since they form a trusted source for vaccine-related information. An increasing body of evidence suggests that healthcare professionals are faced with complexities when navigating the sensitive topic of parental vaccine hesitancy, as they balance their own vaccine- and context-specific concerns with institutional and societal pressures to vaccinate. Furthermore, health choices, such as parental choices for childhood vaccination, are often linked to moralisation. Given the emphasis on effective communication with vaccine-hesitant parents in the patient-centred care literature, it is important to consider healthcare professionals' interpretations of parental vaccine hesitancy. Hence, a deeper understanding of how healthcare professionals make sense of, and moralise, childhood vaccination can help us understand how moralisation might appear in their communication with hesitant parents (in)directly. Drawing on a critical social-psychological framework for discourse analysis, this study analyses 39 semi-structured interviews with healthcare professionals in Flanders, Belgium, and presents the discursive patterns articulated by healthcare professionals on parental vaccine hesitancy. The findings elucidate how healthcare professionals perpetuate, or resist, moral discourse in their accounts of vaccine hesitancy by constructing five different interpretative repertoires, that is, a "good" or "bad" parenting repertoire, a freedom of choice repertoire, an individual risk-benefit repertoire, a public health repertoire, and an accessibility repertoire. Our study highlights the complexities healthcare professionals experience in negotiating vaccine hesitancy, as their understandings of vaccine hesitancy are affected by, and contribute to, existing moral dilemmas and dominant discourses surrounding health and parenting.

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来源期刊
CiteScore
6.80
自引率
6.20%
发文量
109
期刊介绍: QUALITATIVE HEALTH RESEARCH is an international, interdisciplinary, refereed journal for the enhancement of health care and to further the development and understanding of qualitative research methods in health care settings. We welcome manuscripts in the following areas: the description and analysis of the illness experience, health and health-seeking behaviors, the experiences of caregivers, the sociocultural organization of health care, health care policy, and related topics. We also seek critical reviews and commentaries addressing conceptual, theoretical, methodological, and ethical issues pertaining to qualitative enquiry.
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