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Challenges and opportunities of a new HPV immunization program: Perceptions among swedish school nurses
Uppsala universitet, Vårdvetenskap.ORCID iD: 0000-0002-5837-8263
Uppsala universitet, Vårdvetenskap.
Uppsala universitet, Institutionen för kvinnors och barns hälsa. (Internationell kvinno- & mödrahälsovård/Essén)
Uppsala universitet, Institutionen för kvinnors och barns hälsa. (Socialpediatrisk forskning/Sarkadi)
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2011 (English)In: Vaccine, ISSN 0264-410X, E-ISSN 1873-2518, Vol. 29, 4576-4583 p.Article in journal (Refereed) Published
Abstract [en]

Aim To investigate school nurses’ perceptions of HPV immunization, and their task of administering the vaccine in a planned school-based program in Sweden. Method: Data were collected through five focus group interviews with school nurses (n = 30). The interviews were recorded, transcribed verbatim and analyzed using content analysis.

Findings The theme Positive attitude to HPV immunization despite many identified problems and challenges summarizes the results. The school nurses saw the program as a benefit in that the free school-based HPV immunization program could balance out social inequalities. However, they questioned whether this new immunization program should be given priority given their already tight schedule. Some also expressed doubts regarding the effect of the vaccine. It was seen as challenging to obtain informed consent as well as to provide information regarding the vaccine. The nurses were unsure of whether boys and their parents should also be informed about the immunization.

Conclusion Although some positive aspects of the new HPV immunization program were mentioned, the school nurses primarily identified problems and challenges; e.g. regarding priority setting, informed consent, culture and gender. In order to achieve a good work environment for the school nurses, and obtain a high coverage rate for the HPV immunization, these issues need to be taken seriously, be discussed and acted upon.

Place, publisher, year, edition, pages
2011. Vol. 29, 4576-4583 p.
Keyword [en]
HPV, Vaccination, School nurses, Focus groups, Dilemmas, Gender
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:rkh:diva-1064DOI: 10.1016/j.vaccine.2011.04.054PubMedID: 21549793OAI: oai:DiVA.org:rkh-1064DiVA: diva2:750156
Available from: 2011-05-14 Created: 2014-09-26 Last updated: 2015-08-10Bibliographically approved
In thesis
1. Introduction of School-Based HPV Vaccination in Sweden: Knowledge and Attitudes among Youth, Parents, and Staff
Open this publication in new window or tab >>Introduction of School-Based HPV Vaccination in Sweden: Knowledge and Attitudes among Youth, Parents, and Staff
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to provide a better understanding of knowledge, attitudes, consent, and decision-making regarding Human papillomavirus (HPV) vaccination, seen from the perspectives of concerned parties – high school students, school nurses, and parents.

Two quantitative studies were performed: one descriptive cross-sectional study and one quasi-experimental intervention study. Qualitative studies using focus group interviews and individual interviews were also performed.

High school students’ knowledge about HPV and HPV prevention was low but their attitudes toward HPV vaccination were positive. An educational intervention significantly increased the students’ knowledge regarding HPV and HPV prevention. Their already positive attitudes toward condom use and HPV vaccination remained unchanged. The students wanted to receive more information about HPV from school nurses. The school nurses were also positive to HPV vaccination but identified many challenges concerning e.g. priorities, obtaining informed consent, culture, and gender. They saw an ethical dilemma in conflicting values such as the child’s right to self-determination, the parents’ right to make autonomous choices on behalf of their children, and the nurse’s obligation to promote health. They were also unsure of how, what, and to whom information about HPV should be given. Parents, who had consented to vaccination of their young daughters, reasoned as follows: A vaccine recommended by the authorities is likely to be safe and effective, and the parents were willing to do what they could to decrease the risk of a serious disease for their daughter. Fear of unknown adverse events was overweighed by the benefits of vaccination. Parents also saw the school nurse as an important source of HPV information.

Conclusions: Positive attitudes toward HPV vaccination despite limited knowledge about HPV, are overarching themes in this thesis. School nurses have a crucial role to inform about HPV prevention. It is important that the concerned parties are adequately informed about HPV and its preventive methods, so that they can make an informed decision about vaccination. A short school-based intervention can increase knowledge about HPV among students. From a public health perspective, high vaccination coverage is important as it can lead to a reduced number of HPV-related disease cases. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 62 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 962
Keyword
Human papillomavirus, HPV, cervical cancer, vaccination, condom use, adolescents, school-nurses, parents, knowledge, attitudes, intervention
National Category
Medical Ethics Nursing
Research subject
Medical Science
Identifiers
urn:nbn:se:rkh:diva-1060 (URN)978-91-554-8836-9 (ISBN)
Public defence
2014-02-21, Gustavianum, Auditorium Minus, Akademigatan 3, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2014-09-26 Created: 2014-09-26 Last updated: 2015-08-10Bibliographically approved

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