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School nurses’ attitudes and experiences regarding the human papillomavirus vaccination programme in Sweden: a population-based survey
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Sexuell och reproduktiv hälsa, Sexual and Reproductive Health)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Sexuell och reproduktiv hälsa, Sexual and Reproductive Health)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Sexuell och reproduktiv hälsa, Sexual and Reproductive Health)
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2014 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 540, 1-9 p.Article in journal (Refereed) Published
Abstract [en]

Background: Sweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, andschool nurses are responsible for managing the vaccinations. The aim of the present study was to investigate theattitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after itsimplementation.Methods: Data were collected using a web-based questionnaire in the spring of 2013, and 83.1% (851/1024) ofnurses responded.Results: There were strong associations between the nurses’ education about the HPV vaccine and their perceivedknowledge about the vaccine and a favourable attitude towards vaccination (both p < 0.001). School nurses whoreceived a high level of education were more likely to have a positive attitude to HPV vaccination compared withnurses with little education about HPV vaccination (adjusted odds ratio [OR] = 9.8; 95% confidence interval [CI]:3.797–25.132). Nurses with high perceived knowledge were more likely to have a positive attitude compared withthose with a low level of perceived knowledge (OR = 2.5; 95% CI: 1.299–4.955). If financial support from thegovernment was used to fund an additional school nurse, nurses were more likely to have a positive attitude thanif the financial support was not used to cover the extra expenses incurred by the HPV vaccination (OR = 2.1; 95% CI:1.051–4.010). The majority, 648 (76.1%), had been contacted by parents with questions about the vaccine, mostlyrelated to adverse effects. In addition, 570 (66.9%) stated that they had experienced difficulties with thevaccinations, and 337 (59.1%) of these considered the task to be time-consuming.Conclusions: A high level of education and perceived good knowledge about HPV are associated with a positiveattitude of school nurses to the HPV vaccination programme. Thus, nurses require adequate knowledge, education,skills and time to address the questions and concerns of parents, as well as providing information about HPV.Strategic financial support is required because HPV vaccination is a complex and time-consuming task.

Place, publisher, year, edition, pages
BioMed Central, 2014. Vol. 14, no 540, 1-9 p.
Keyword [en]
Attitude, Experience, Human papillomavirus, School health, School nurse, Vaccination
National Category
Health Sciences
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-229189DOI: 10.1186/1471-2458-14-540ISI: 000338959600002PubMedID: 24886332OAI: oai:DiVA.org:uu-229189DiVA: diva2:736117
Funder
Swedish Cancer Society, 130744
Available from: 2014-08-05 Created: 2014-08-05 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Prevention of Human Papillomavirus in a school-based setting
Open this publication in new window or tab >>Prevention of Human Papillomavirus in a school-based setting
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to examine beliefs about human papillomavirus (HPV) prevention, especially vaccination, among parents, immigrant women, adolescents and school nurses, and to promote primary prevention among adolescents.

The methods used in the thesis were focus group interviews, individual interviews, a web-based questionnaire, and finally, a randomised controlled intervention study.

The immigrant women were largely in favour of HPV prevention, although barriers, such as logistic difficulties, and cultural or gender norms were found. Parents’ decision concerning vaccination of their daughters depended on several factors. Regardless of their final choice, they made the decision they believed was in the best interest of their daughter. The benefits outweighed the risks for parents choosing to vaccinate while parents declining made the opposite judgement. The majority of the school nurses reported that the governmental financial support given because of the vaccination programme had not been used for the intended purpose. Three out of four nurses had been contacted by parents who raised questions regarding the vaccine; most were related to side effects. The educational intervention had favourable effects on the adolescents’ beliefs regarding HPV prevention, especially among those with an immigrant background. Furthermore, the intention to use condom as well as actual vaccination rates among girls was slightly increased by the intervention.

Trust in the governmental recommendations and the amounts of information given are important factors in the complex decision about HPV vaccination. Attention given to specific needs and cultural norms, as well as the possibility to discuss HPV vaccination with the school nurse and provision of extra vaccination opportunities at a later time are all strategies that might facilitate participation in the school-based HPV vaccination programme. School nurses need sufficient resources, knowledge and time to meet parents’ questions and concerns. The vaccinations are time-consuming and the governmental financial support needs to be used as intended, for managing the vaccination programme. A school-based intervention can have favourable effects on the beliefs and actual actions of young people and may possibly thus, in the long term, decrease the risk for HPV-related cancer.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 85 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1138
Keyword
Human papillomavirus, HPV, vaccination, cervical cancer, school nurse, school health, immigrants, parents, adolescents, belief, attitude, decision, prevention, public health, randomised controlled trial, intervention, focus group interviews, vaccine hesitancy
National Category
Nursing
Research subject
Medical Science; Caring Sciences
Identifiers
urn:nbn:se:uu:diva-263252 (URN)978-91-554-9354-7 (ISBN)
Public defence
2015-11-20, Gustavianum, Auditorium Minus, Akademigatan 3, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Funder
Swedish Cancer Society, 130744
Available from: 2015-10-29 Created: 2015-09-29 Last updated: 2015-11-10

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Grandahl, MariaTydén, TanjaRosenblad, AndreasOscarsson, MarieNevéus, TryggveStenhammar, Christina

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