To Inoculate or Not To Inoculate: The Factors that Influence the Decision on Flu Inoculation

Abstract

Objective: Patients' poor adherence to medical advice is a major obstacle to the effective delivery of health care. The present research focuses on how patient preferences and physician preconceptions may affect a patient's decision to comply with a physician's recommendation regarding flu inoculation. Methods:A 2 (physician's recommendation: inoculate/not inoculate) by 3 (participant's a priori attitude: pro/ neutral/against) by 2 (physician's gender: male/female) by 2 (treatment setting: private/public) between-within-subjects design was used. One hundred eight-seven participants were asked to read four scenarios presented in random order, describing the circumstances that occur when visiting a physician who provides information about the possibility of flu inoculation. The participants' a priori attitude toward this inoculation was then assessed. The key outcomes were the decision concerning flu inoculation and the certainty of that decision. Results:In general, the decision on inoculation was negative. The participants who a priori objected to inoculation made a more negative choice than those who had neutral preferences and those who a priori approved of it. Compared with a negative recommendation, a positive recommendation by a physician was associated with a less negative decision. The participants were more certain when deciding against inoculation than in favor of it. Conclusion:A positive physician's recommendation caused the participants' decision on inoculation to become less negative, but this suggestion was not sufficient to change the decision altogether. The participants' a priori preference appeared to be a much more compelling factor in deciding whether to inoculate, and it also affected the conviction of that decision.are no studies investigating the problem of non-adherence of patients to their physicians' recommendation against vaccination; however, this problem can certainly occur in a real-life context [6].Studies examining the causal explanations of patients' adherence often reflect the assumption that a rational decision-making process guides the decision regarding whether to comply. This assumption is also found in the frequently cited Health Belief Model [7,8]. Thus, much of the research is devoted to the identification of the factors suggested by the HBM that affect health behavior. For example, the extent to which people perceive themselves as being in danger of becoming unwell and whether they appreciate how severe the flu can be. In the same vein, the alleged inoculation barriers such as the fear of side effects and discomfort or the cost of the vaccine are very regularly examined [9,10].In contrast, the present research centers on how the expectations of a patient and his/her pre-conceptions of a physician may affect the decision to comply with the recommendation regarding flu inoculation. This focus is implied by two different developments. The first is a change in the patient-physician interaction. The second is a shift in the model that views human decision making as ra...