School nurses’ attitudes and experiences regarding the human papillomavirus vaccination programme in Sweden: a population-based survey

Abstract

BackgroundSweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations. The aim of the present study was to investigate the attitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after its implementation.MethodsData were collected using a web-based questionnaire in the spring of 2013, and 83.1% (851/1024) of nurses responded.ResultsThere were strong associations between the nurses’ education about the HPV vaccine and their perceived knowledge about the vaccine and a favourable attitude towards vaccination (both p < 0.001). School nurses who received a high level of education were more likely to have a positive attitude to HPV vaccination compared with nurses with little education about HPV vaccination (adjusted odds ratio [OR] = 9.8; 95% confidence interval [CI]: 3.797–25.132). Nurses with high perceived knowledge were more likely to have a positive attitude compared with those with a low level of perceived knowledge (OR = 2.5; 95% CI: 1.299–4.955). If financial support from the government was used to fund an additional school nurse, nurses were more likely to have a positive attitude than if the financial support was not used to cover the extra expenses incurred by the HPV vaccination (OR = 2.1; 95% CI: 1.051–4.010). The majority, 648 (76.1%), had been contacted by parents with questions about the vaccine, mostly related to adverse effects. In addition, 570 (66.9%) stated that they had experienced difficulties with the vaccinations, and 337 (59.1%) of these considered the task to be time-consuming.ConclusionsA high level of education and perceived good knowledge about HPV are associated with a positive attitude of school nurses to the HPV vaccination programme. Thus, nurses require adequate knowledge, education, skills and time to address the questions and concerns of parents, as well as providing information about HPV. Strategic financial support is required because HPV vaccination is a complex and time-consuming task.

To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School‐Based Vaccination Program in Sweden

“…In our recent population‐based study regarding school‐nurses attitude to and experiences of the implemented HPV vaccination program we found that almost 8 out of 10 nurses had been contacted by parents who had concerns regarding the vaccine. Most of these questions were related to side effects 39. Therefore, it is not surprising that there was an association between declining the vaccine and beliefs regarding information about HPV.…”

“…Most of these questions were related to side effects. 39 Therefore, it is not surprising that there was an association between declining the vaccine and beliefs regarding information about HPV. These parents were less content with the information they received from the school health service and, to a large extent, listed the Internet as their main source of information.…”

“…Age-appropriate information could be distributed in schools by the school nurse or other health care professionals. 39 We believe that the HBM is useful as it helps to understand the factors associated with the decision to consent to or decline the HPV vaccination. However, it must be emphasized that HBM is a cognitive model and does not consider the emotional aspects regarding parents' decision.…”

Parents' views of including young boys in the Swedish national school-based HPV vaccination programme: a qualitative study

“…Furthermore, the findings in our populationbased study among the providers, the school nurses, indicate a high level of approval for extending the national HPV vaccination programme to also include boys. 20 It needs to be considered that even if a higher vaccine uptake among girls is reached, boys are neither protected on individual level nor on public health level, and a group of males, MSM, would be left unprotected by a female-only programme. Additionally, men who have sex with unvaccinated women from countries with low HPV vaccine uptake are also at risk of HPV infection and HPV-related cancer.…”

Knowledge, attitudes and awareness of the human papillomavirus amongst primary care practice nurses: an evaluation of current training in England

“…Level of HPV knowledge in school nurses, who are responsible for the administration of the HPV vaccine in many countries 32 , is also variable 15,[33][34][35] . HPV knowledge in nurses has been identified as an important precursor for a positive attitude towards the vaccine 33,36 .…”