HEATHER FLETT

1
What are the experiences of parents living in
Halton regarding childhood immunisations?

• HEATHER FLETT
• BN (HONS), RGN, PGDIP SCPHN, RHV
• Heather.flett_at_hsthpct.nhs.uk
• HCRC, Caldwell Road, Widnes, WA8 7GD
• 0151-495-5016

2
Summary

• Clinical Importance and Background
• Previous Research
• Aims and Objectives
• Sample and Setting
• Data Collection
• Data Analysis
• Limitations
• Conclusions and Recommendations
• Questions

3
Clinical Importance and Background

• Significant public health area
• Non attendance at immunisation clinic can reduce
  herd immunity
• MMR vaccine
• Changes to the National Immunisation Schedule
• Changes to the Health Visiting Role

4
Previous Research
Past and current research Gaps in Knowledge
No standardised format of giving patients immunisation information (Gagnon and Bryanton, 2009). No standards for Immunisation Information.
Mothers perspectives of immunisations (Gagnon and Bryanton, 2009 Tarrant and Thomson, 2008 Wroe, Turner and Salkovskis, 2004) and Austin, Campion-Smith and Ward, 2008). Fathers Perspectives.
Families living in affluent areas (Tarrant and Thomson, 2008 and Bedford and Lansley, 2006). Families living in deprived areas.
Majority of Children had fully complete immunisation statuses (Tarrant and Thomson, 2008 Bedford and Lansley, 2006) and Austin, Campion- Smith and Ward, 2008). Children with incomplete immunisation statuses.
Children had an average age of 3 years (majority of the childhood immunisation schedule already completed) (Gagnon and Bryanton, 2009 Tarrant and Thomson, 2008 Wroe, Turner and Salkovskis 2004 Bedford and Lansley, 2006 Gelline, Maiback and Marcuse, 2000 and Austin, Campion-Smith and Ward 2008). Children within the age range appropriate to the National Childhood Immunisation Programme.
5
Aims and Objectives

• Aim
• To explore the lived experiences of childhood
  immunisations from parents living in a deprived
  area.
• Objectives
• The objectives will be based around the HBM and
  are as follows
• To discover the influences on the parents
  decision making choices with regard to childhood
  immunisations (cue to action).
• To investigate parents personal experiences of
  childhood immunisations (perceptions and
  modifying actions, demographic, sociopsycho and
  structural variables, perceived seriousness and
  susceptibility).

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Data Collection

Inclusion Criteria Exclusion Criteria
Participants from a locally deprived area.
Parents perceptions.
Children's age range between eight weeks and five years (pre-school child). Children over the age of five years (school aged child).
Registered at local General Practitioners.
5 parents children who have had attendance at immunisation clinic.
5 parents children who have had non attendance at immunisation clinic twice. Safeguarding/Child Protection Plan as to Trust policy (DH, 2008b)
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Van Manens Interpretative Phenomenology and
Health Belief Model

• Lived Space
• Lived Body
• Lived Time
• Lived Other

(Rosenstock, 1966)
Van Manen (1990)
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Data Analysis

• Lived body/ Perceptions and modifying factors
• Trust
• Past perceptions, current views and Influence.
• Lived Space/Demographic, Sociopsycho and
  Structural variables.
• Support
• Reliance, Expectations of the health
  professionals role and Experiences at clinic.
• Lived Time/ Perceived seriousness and
  susceptibility
• Conflict and Reliability
• Knowledge and external reliability.
• Lived Other/Cue to action
• Awareness
• Access of information, Responsibility and Social
  Factors.

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Limitations

• Generalisability
• Ethics
• Recruitment

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Conclusions and Recommendations

• Structured immunisation information and external
  sources
• Current ways of working (grey area)
• Opportunistic immunising
• Suspended list
• Immunisation documentation
• Profile

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Questions??

• Heather.flett_at_hsthpct.nhs.uk
• HCRC, Kingsway Team, WA8 7GD
• 0151-495-5016

12
References

• Austin, H., Campion-Smith. C., Thomas. S.,
  Ward. W. (2008). Parents difficulties with
  decisions about childhood immunisation. Community
  Practitioner. 81 (10), 32- 35.
• Bedford, H., Lansley, M. (2006). Information on
  Childhood Immunisation parents views. Community
  Practitioner. 79, 8.
• Department of Health. (2008b). The Child Health
  Promotion Programme Pregnancy and the first five
  years of life. London The Stationary Office.
• Gagnon, A. J., Bryanton, J. (2009). Postnatal
  parental education for optimizing infant general
  health and parent-infant relationships (Review).
  The Cochrane Collaboration. John Wiley Sons.
• Gellin, B. G., Maibach, E. W. Marcuse, E. K.
  (2000). Do parents understand Immunizations? A
  National Telephone Survey. Pediatrics, 106 (5),
  1097- 1102.
• Rosenstock, I. M. (1966). Why people use health
  services. Millbank Memorial Fund Quarterly.44, 94
  124.
• Tarrant, M., Thomson, N. (2008). Secrets to
  success A qualitative study of perceptions of
  childhood immunisations in a highly immunized
  population. Journal of Paediatrics and Child
  Health. 44, 541- 547.
• Van Manen, M. (1990). Researching Lived
  Experience Human science for an action sensitive
  pedagogy. Ontario Althouse Press.
• Wroe, A. L., Turner, N., Salkovskis, P. M.
  (2004). Understanding and predicting parental
  decisions about early childhood immunisations.
  Health Psychology. 23 (1), 33- 41.