“I think of it as planting seeds”: challenging patient-provider discussions about COVID-19 vaccination: a qualitative study
Notice bibliographique
Résumé
BACKGROUND: Vaccination has been essential in mitigating the worst effects of the COVID-19 pandemic in Canada. Healthcare providers can play a crucial role in promoting COVID-19 vaccination by discussing immunization, addressing patients' questions, and providing them with relevant information. However, some segments of the public remained hesitant towards COVID-19 vaccination during the pandemic, reflecting an information environment crowded with misinformation and political polarization. This study examines challenging clinical discussions that healthcare providers had with patients hesitant about COVID-19 vaccines. It focuses on obstacles to fruitful conversations and strategies to overcome them, which can extend into ongoing vaccine-related conversations outside a pandemic context. METHODS: Researchers conducted individual interviews with ten healthcare providers during the pandemic (January-May 2022) in the province of Manitoba, Canada. Participants were recruited using invitations distributed via professional organizations and networks. The recruited sample included primary care physicians, nurse practitioners, and a specialist provider who had recently discussed the COVID-19 vaccine with patients. Study participants were asked about their challenging conversations regarding the COVID-19 vaccine with patients and how they navigated these experiences. The resulting data were analyzed using NVivo12 to capture and organize salient themes. RESULTS: Healthcare providers reported that COVID-19 vaccines have prompted new forms of vaccine hesitancy and resistance compared to existing vaccines, particularly due to concerns about the integrity of the vaccine (e.g., vaccine novelty, ingredients) or related public policy (i.e., vaccine mandates). Providers reported a significant rise in hostility from patients who were staunchly hesitant and experienced moral injury, burnout, and an emotional toll from witnessing disregard for public health. Participants indicated that they attempted to employ motivational interviewing strategies and shared decision-making and voiced desires for further training in such approaches. Some participants found mixed success with using decision aids or used improvised strategies to facilitate discussions. CONCLUSION: Motivational interviewing and shared decision-making strategies proved valuable to healthcare providers in navigating challenging discussions, addressing/acknowledging patient concerns, and preserving relationships. Healthcare providers need to be better supported with training in these strategies and in navigating the moral/emotional/physical consequences of experiencing a global health crisis in clinical settings.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».