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Influenza is a contagious but preventable disease, which can have severe complications. If the virus is not treated in time, it can cause hospitalization or even death. To stop the infection from spreading among people, doctors use the preventive way, and that is called vaccination. However, the lack of understanding of vaccines and how exactly they work is interfering with the proper implementation of precautionary measures (Srivastav et al., 2019).
People are not educated enough on the subject and are anxious about what a vaccine can do to the immune system. However, several Hong Kong researchers like Leung et al. (2017) are confident that educated patients are more likely to increase the vaccination rate. This paper will focus on analyzing their article “Impact of Patient Education on Influenza Vaccine Uptake Among Community-Dwelling Elderly: A Randomized Controlled Trial”. The analysis will be conducted according to Rapid Critical Appraisal Checklist for a Randomized Clinical Trial (Melnyk & Fineout-Overholt, 2005, p. 51).
Review of the study
The main purpose of this study is to determine the performance of a short face-to-face educational session between the doctor and the patient. The authors believe that the information may motivate the patients to make a well-informed and balanced decision, thus increasing the influenza vaccination rate among people up to 75 years old (Thomas & Lorenzetti, 2018). The search was conducted with the help of medical students who approached patients in General Out-patient Clinics. They invited them to participate in the study, which means that random assignment was not concealed from the individuals.
After giving written consent, patients were divided according to their gender and if they received the influenza vaccination in the previous 2 years. Out of 529 patients, 265 were placed into the experimental group, and 243 were put in the control group (Leung et al., 2017).
Subjects and providers were not blind to the study group. Then investigators gave each patient in the intervention group a personal 3-minute verbal session about the outcomes of the influenza vaccine. Patients in the control group have not received an educational session but could access information from other sources like the Internet or nurses. From this information it can be concluded that the researchers selected an appropriate control group of adults similar on variables, the subjects were not assigned randomly into groups. However, subjects in the group were not analyzed individually.
The essential goal was to figure out the number of patients who decided to get an influenza vaccination within three days after their educational session. To record the results of the experiment, nursing stations provided lists of people who got vaccinated. The study does not elaborate on instruments used to measure the outcomes. The trial indicated that in three days, a pamphlet and a short educational session increased the vaccination rate from 25.0% in the control group to 33.6% in the intervention group (Leung et al, 2017), thus making the NNT of 11.6.
Such results are also compatible with previous randomized experiments, where doctors and nurses used personal interventions, which created moderate advances in influenza vaccination rates (Chan et al., 2015). The results from other randomized trials seem to show even less productivity (Wong et al., 2016). Nevertheless, even with the help of educational materials, the vaccination uptake was still low, revealing the discrepancy between what was planned and the results.
While the research and report seem to be thoughtfully done, and the results demonstrated the importance of spreading awareness about vaccines, the study does not fully solve the problem. The results of the intervention were not up to what was expected. The researchers consider that the main reasons were such limitations as social biases and the 3-day follow-up period. They suggest that because of such limitations, some people may have been feeling pressured to make a deliberate decision to get an influenza vaccine. Nevertheless, such a method of education is feasible in a clinical setting because of its affordability and can help in caring for patients. Therefore, it can be suspected that patients may benefit from the information given by their medical staff and increase the vaccination rate.
Chan, S. S., Leung, D. Y., Leung, A. Y., Lam, C., Hung, I., Chu, D & Lam, T. H. (2015). A Nurse-delivered brief health education intervention to improve pneumococcal vaccination rate among older patients with chronic diseases: a cluster randomized controlled trial. International Journal of Nursing Studies, 52(1), 317-324.
Leung, K. C., Mui, C., Chiu, W. Y., Ng, Y. Y., Chen, M. H., Ho, P. H., Pang, H. H. (2017). Impact of patient education on influenza vaccine uptake among community-dwelling elderly: A randomized controlled trial. Health Education Research, 32(5), 455-464.
Melnyk, B. M., & Fineout-Overholt, E. (2005). Rapid critical appraisal of randomized controlled trials (RCTs): An essential skill for evidence-based practice (EBP). Pediatric Nursing, 31(1), 50-2.
Srivastav, A., Lu, P. J., Santibanez, T., Amaya, A., Dever, J., Stanley, M., Williams, W. (2019). Influenza vaccination hesitancy among adults. Proceedings of APHA’s 2019 Annual Meeting and Expo, Philadelphia, PA: American Public Health Association.
Thomas R. E., Lorenzetti D. L. (2018). Interventions to increase influenza vaccination rates of those 60 years and older in the community. Web.
Wong, V. W. Y., Fong, D. Y. T., Lok, K. Y. W., Wong, J. Y. H., Sing, C., Choi, A. Y. Y., Tarrant, M. (2016). Brief education to promote maternal influenza vaccine uptake: A randomized controlled trial. Vaccine, 34(44), 5243-5250.