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      Psychological determinants of influenza vaccination

      research-article
      Author(s): , ,
      Publication date (Electronic):
      Journal: BMC Geriatrics
      Publisher: BioMed Central
      Keywords: Psychology, Perceived stress, Self-esteem, Influenza vaccination

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          Abstract

          Background

          Previous studies investigated the determinants of individuals’ decision to vaccinate against influenza primarily focusing on social as well as certain proximal determinants, for example, behavioral beliefs. Thus, so far, the analysis of psychological factors as determinants of influenza vaccination was mainly limited to beliefs, attitudes or perceptions that were directly related to influenza vaccination and its perceived impact. However, considering general psychological factors, like general self-efficacy, optimism or subjective well-being, might further enhance the understanding of why certain people vaccinate while others do not. The aim was to investigate the relationship between various general psychological factors and older people’s decision to vaccinate against seasonal flu.

          Methods

          The data of individuals aged 60 or older ( n = 5037; in 2014) were used from the Germany Ageing Survey. The data were collected in face-to-face interviews and in self-administered questionnaires. They include questions on the use of influenza vaccination and the psychological factors of optimism, self-efficacy, self-esteem, perceived stress, self-regulation, life satisfaction, and negative affect as well as positive affect. The psychological determinants of regular influenza vaccination were investigated using multiple logistic regressions.

          Results

          53.2% of all participants were regular users of influenza vaccination. There were significant bivariate correlations of all cited psychological factor with influenza vaccination except for life satisfaction and negative affect. After controlling for numerous potential socio-demographic, morbidity- and lifestyle-related confounders, regular influenza vaccination was still positively associated with lower levels of self-esteem and a higher level of perceived stress.

          Conclusions

          There are significant associations of general individual psychological constructs with the decision to vaccinate against influenza. Future research might determine the impact of psychological factors on the decision to vaccinate in longitudinal research designs. This might be helpful to understand the causal mechanisms behind this relationship, which could help to design interventions that increase vaccination rates in certain target groups.

          Electronic supplementary material

          The online version of this article (10.1186/s12877-017-0597-y) contains supplementary material, which is available to authorized users.

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          Most cited references38

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          The development of instruments to measure the work disability assessment behaviour of insurance physicians

          Romy Steenbeek, Antonius JM Schellart, Henny PG Mulders … (2011)
          Background Variation in assessments is a universal given, and work disability assessments by insurance physicians are no exception. Little is known about the considerations and views of insurance physicians that may partly explain such variation. On the basis of the Attitude - Social norm - self Efficacy (ASE) model, we have developed measurement instruments for assessment behaviour and its determinants. Methods Based on theory and interviews with insurance physicians the questionnaire included blocks of items concerning background variables, intentions, attitudes, social norms, self-efficacy, knowledge, barriers and behaviour of the insurance physicians in relation to work disability assessment issues. The responses of 231 insurance physicians were suitable for further analysis. Factor analysis and reliability analysis were used to form scale variables and homogeneity analysis was used to form dimension variables. Thus, we included 169 of the 177 original items. Results Factor analysis and reliability analysis yielded 29 scales with sufficient reliability. Homogeneity analysis yielded 19 dimensions. Scales and dimensions fitted with the concepts of the ASE model. We slightly modified the ASE model by dividing behaviour into two blocks: behaviour that reflects the assessment process and behaviour that reflects assessment behaviour. The picture that emerged from the descriptive results was of a group of physicians who were motivated in their job and positive about the Dutch social security system in general. However, only half of them had a positive opinion about the Dutch Work and Income (Capacity for Work) Act (WIA). They also reported serious barriers, the most common of which was work pressure. Finally, 73% of the insurance physicians described the majority of their cases as 'difficult'. Conclusions The scales and dimensions developed appear to be valid and offer a promising basis for future research. The results suggest that the underlying ASE model, in modified form, is suitable for describing the assessment behaviour of insurance physicians and the determinants of this behaviour. The next step in this line of research should be to validate the model using structural equation modelling. Finally, the predictive value should be tested in relation to outcome measurements of work disability assessments.
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            Effectiveness of influenza vaccine in the community-dwelling elderly.

            Kristin L. Nichol, James Nordin, David Nelson … (2007)
            Reliable estimates of the effectiveness of influenza vaccine among persons 65 years of age and older are important for informed vaccination policies and programs. Short-term studies may provide misleading pictures of long-term benefits, and residual confounding may have biased past results. This study examined the effectiveness of influenza vaccine in seniors over the long term while addressing potential bias and residual confounding in the results. Data were pooled from 18 cohorts of community-dwelling elderly members of one U.S. health maintenance organization (HMO) for 1990-1991 through 1999-2000 and of two other HMOs for 1996-1997 through 1999-2000. Logistic regression was used to estimate the effectiveness of the vaccine for the prevention of hospitalization for pneumonia or influenza and death after adjustment for important covariates. Additional analyses explored for evidence of bias and the potential effect of residual confounding. There were 713,872 person-seasons of observation. Most high-risk medical conditions that were measured were more prevalent among vaccinated than among unvaccinated persons. Vaccination was associated with a 27% reduction in the risk of hospitalization for pneumonia or influenza (adjusted odds ratio, 0.73; 95% confidence interval [CI], 0.68 to 0.77) and a 48% reduction in the risk of death (adjusted odds ratio, 0.52; 95% CI, 0.50 to 0.55). Estimates were generally stable across age and risk subgroups. In the sensitivity analyses, we modeled the effect of a hypothetical unmeasured confounder that would have caused overestimation of vaccine effectiveness in the main analysis; vaccination was still associated with statistically significant--though lower--reductions in the risks of both hospitalization and death. During 10 seasons, influenza vaccination was associated with significant reductions in the risk of hospitalization for pneumonia or influenza and in the risk of death among community-dwelling elderly persons. Vaccine delivery to this high-priority group should be improved. Copyright 2007 Massachusetts Medical Society.
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              Life-management strategies of selection, optimization, and compensation: measurement by self-report and construct validity.

              Alexandra M. Freund, Paul Baltes (2002)
              The authors examined the usefulness of a self-report measure for elective selection, loss-based selection. optimization, and compensation (SOC) as strategies of life management. The expected 4-factor solution was obtained in 2 independent samples (N = 218, 14-87 years; N = 181, 18-89 years) exhibiting high retest stability across 4 weeks (r(tt) = .74-82). As expected, middle-aged adults showed higher endorsement of SOC than younger and older adults. Moreover, SOC showed meaningful convergent and divergent associations to other psychological constructs (e.g., thinking styles, NEO) and evinced positive correlations with measures of well-being which were maintained after other personality and motivational constructs were controlled for. Initial evidence on behavioral associations involving SOC obtained in other studies is summarized.
              Article 0 comments Cited 166 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Jens-Oliver Bock: j.bock@uke.de
                André Hajek:
                ORCID: http://orcid.org/0000-0002-6886-2745
                a.hajek@uke.de
                Hans-Helmut König: h.koenig@uke.de
                Journal
                Journal ID (nlm-ta): BMC Geriatr
                Journal ID (iso-abbrev): BMC Geriatr
                Title: BMC Geriatrics
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2318
                Publication date (Electronic): 29 August 2017
                Publication date PMC-release: 29 August 2017
                Publication date Collection: 2017
                Volume: 17
                Electronic Location Identifier: 194
                Affiliations
                ISNI 0000 0001 2180 3484, GRID grid.13648.38, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, , University Medical Center Hamburg-Eppendorf, ; Martinistraße 52, 20246 Hamburg, Germany
                Author information
                http://orcid.org/0000-0002-6886-2745
                Article
                Publisher ID: 597
                DOI: 10.1186/s12877-017-0597-y
                PMC ID: 5576319
                PubMed ID: 28851282
                SO-VID: 9ec9501d-78d4-493b-ab70-2bf55de28bc8
                Copyright © © The Author(s). 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 8 December 2016
                Date accepted : 23 August 2017
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                ScienceOpen disciplines: Geriatric medicine
                Keywords: psychology,perceived stress,self-esteem,influenza vaccination
                Data availability:
                ScienceOpen disciplines: Geriatric medicine
                Keywords: psychology, perceived stress, self-esteem, influenza vaccination

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