임신 중 Tdap 접종에 대한 임부들의 인식, 태도 및 행동
Knowledge, Attitude and Practice on Maternal Immunization with Tetanus Toxoid, Reduced Diphtheria Toxoid, and Aellular Pertussis (Tdap) among Pregnant Women
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초록
목적: 임신 중 tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) 접종의 효과 및 안전성에도 불구하고, 아직 국내 임신 중 Tdap 접종률은 낮다. 이에 저자들은 임신 중 Tdap 접종에 대한 임부들의 인식, 태도 및 행동에 대한 조사를 하였다. 방법: 본 연구는 서울 및 경기 소재 대학병원 산부인과를 방문한 임부를 대상으로 개별적인 설문지를 통해 임신 중 Tdap 접종에 대한 인식, 태도 및 행동을 수집한 단면 설문조사다. 결과: 총 184명의 임부들이 설문지 작성을 완료하였다. 이 중 158명(86%)의 임부들은 의사로부터 백일해 및 Tdap 백신에 대한 정보를 안내 받지 못했고, 166명(90%)의 임부들은 임신 중 Tdap 접종의 필요성을 알지 못했다. 현 임신기간 중 Tdap 접종을 하지 않을 것이라고 답한 임부 중 7%만이 백일해 및 백신에 대한 이해를 묻는 5문항 중 3문항 이상 올바르게 답하였다. 로지스틱 회귀분석에서 의사의 추천(adjusted odds ratio [OR], 236.2; 95% confidence interval [CI], 12.6–4,432), 백신이 효과적이라는 믿음(adjusted OR, 40.21; 95% CI, 2.35–687.7), 백신이 안전하다는 믿음(adjusted OR, 19.83; 95% CI, 1.54– 255.9) 등이 Tdap 접종을 결정하는데 유의하게 중요한 요인이었다. 결론: 대부분의 임부들이 Tdap 접종에 대하여 적절하게 안내를 받지 못하거나, 추천받지 못하는 것으로 보인다. 임부들의 Tdap 접종률을 향상시키는 데에 의료기관 종사자에 의해 제공되는 정보가 매우 중요하다.
Abstract
Purpose: Despite effectiveness and safety of maternal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination, Tdap vaccination coverage during pregnancy remains quite low. We assessed the knowledge, attitude and practice on maternal Tdap vaccination among pregnant women. Methods: This study was a cross-sectional survey of pregnant women who visited tertiary obstetrics and gynecologic units in Seoul and Gyeonggi province of Korea. Individual questionnaires were administered to assess knowledge, attitude and practice on maternal immunization with Tdap. Results: The questionnaires were completed by 184 pregnant women; 158 (86%) had not received information from doctors about pertussis and Tdap, and 166 (90%) did not know the need for Tdap vaccination. Only 7% of pregnant women unlikely to receive Tdap vaccine during current pregnancy answered 3 or more of the 5 knowledge-based questions correctly. By logistic regression analysis, recommendation by doctor (adjusted odd ratio [OR], 236.2; 95% confidence interval [CI], 12.6–4,432), belief that the vaccine is effective (adjusted OR, 40.21; 95% CI, 2.35–687.7), and belief that the vaccine is safe (adjusted OR, 19.83; 95% CI, 1.54–255.9) were significantly important factors to respondents' intention to be vaccinated. Conclusions: Most pregnant women seem to be neither recommended nor adequately informed about Tdap vaccination. Information given by health care professionals is very important to increase Tdap coverage among pregnant women.
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