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A survey of aspirin use and Reye's syndrome awareness among parents.

Morris LA, Klimberg R.

A national telephone survey of 1,155 parents of children 19 years of age and younger solicited patterns of medication use during episodes of childhood flu and chicken pox. During the previous two years, 6 per cent of the parents whose children had chicken pox and 16 per cent of parents whose children had flu administered aspirin. Approximately 12 per cent of the total sample said they would give their child aspirin if their child were to get the flu or chicken pox today. About half (53 per cent) were aware of the contraindication against aspirin use and 40 per cent could spontaneously recall the name Reye's Syndrome (RS). When measured by a recognition test, 84 per cent of the sample said they had heard of RS. People who continued to believe that aspirin was an appropriate medication were more likely to have treated older children. The RS contraindication for aspirin should be emphasized for teenagers in future public informational programs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3777289&dopt=Abstract flu, flu medicine, tamiflu



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Implicit models of illness.

Turk DC, Rudy TE, Salovey P.

This study was designed to be an initial investigation of implicit models of illness, that is, the dimensional structure that organizes an individual's common-sense illness schema. Nurses, college students, and diabetics rated the qualities of two different diseases, one that was personally salient (i.e., flu or diabetes) and one with which they were familiar but did not have direct experience (i.e., cancer), on a 38-item Implicit Models of Illness Questionnaire (IMIQ). An exploratory factor analysis revealed a four-dimensional structure of illnesses composed of Seriousness, Personal Responsibility, Controllability, and Changeability. The stability of this four-dimensional model was established using confirmatory factor analysis to test the fit of this structure to the IMIQ data of another sample of subjects drawn from the same populations. The structure of this implicit model proved stable for judgments of different diseases and across groups of subjects, even though they differed in their physical-health status and occupational roles. The dimensions identified in the present study were compared to those described in other papers. Our dimensions seemed to be both personally and psychologically meaningful. The implications of this preliminary "generic" implicit illness model for future work in the field of health cognition are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3795264&dopt=Abstract flu, flu medicine, tamiflu



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Nosocomial outbreak of influenza virus A (H3N2) infection in a solid organ transplant department.

Malavaud S, Malavaud B, Sandres K, Durand D, Marty N, Icart J, Rostaing L.

Department of Clinical Microbiology, CHU Toulouse-Rangueil, 1, Avenue Jean Poulhes, 31403 Toulouse Cedex 4, France. malavaud.s chu-toulouse.fr.

BACKGROUND: There is a strong body of evidence in favor of influenza virus immunization in solid organ recipients. However, little attention has been devoted to other reservoirs, such as the patients' relatives and, at the time of hospital admission, to the healthcare workers. METHODS: Analysis of the epidemiology of an outbreak of nosocomial influenza A in a solid organ transplant unit. RESULTS: Four cases of influenza A virus infection were reported during a short 4-day outbreak in a 12 single-room transplant unit. None of the patients had been immunized against influenza. Three patients had not been visited by their relatives between admission and influenza infection. Three nurses, among the 27 healthcare workers, presented with clinical flu symptoms at times consistent with nosocomial transmission. CONCLUSIONS: Because the prevention of influenza infection by vaccination warrants a global strategy to target the different reservoirs, we suggest that the modern policy of vaccinating solid organ patients should be extended both to their relatives and to the healthcare workers of transplant units.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11502991&dopt=Abstract flu, flu medicine, tamiflu



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Predicting and understanding influenza vaccination behavior. Alternatives to the health belief model.

Montano DE.

Recent reviews indicate that attempts to validate the Health Belief Model (HBM) have produced only modest support for it and that the HBM may be incomplete in its organization and development as an expectancy-value model. As an alternative, the Fishbein and Triandis models are discussed. The author investigated the utilities of the Fishbein and Triandis models as predictors of behavioral intention and behavior, using obtaining versus not obtaining an influenza vaccination as the health behavior. Eligible participants were patients at high risk for flu complications, registered at the Seattle VA Medical Center's Medical Comprehensive Care Unit (MCCU) clinic. A random sample of 439 patients was selected to participate in a two-wave longitudinal survey in which the Fishbein and Triandis model components were assessed at the beginning of the 1983 flu season, and a measure of flu shot-getting behavior was obtained at the end of the season. Both models accounted for significant and substantial proportions of variance in intentions and behavior. Comparisons of these models revealed that the three-component Triandis Intention model and the overall Triandis model were superior to the Fishbein model in predicting intention and behavior. The potential use of this model for developing interventions is discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3702503&dopt=Abstract flu, flu medicine, tamiflu



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Developing and testing a decision model for predicting influenza vaccination compliance.

Carter WB, Beach LR, Inui TS, Kirscht JP, Prodzinski JC.

Influenza vaccination has long been recommended for elderly high-risk patients, yet national surveys indicate that vaccination compliance rates are remarkably low (20 percent). We conducted a study to model prospectively the flu shot decisions and subsequent behavior of an elderly and/or chronically diseased (at high risk for complications of influenza) ambulatory care population at the Seattle VA Medical Center. Prior to the 1980-81 flu shot season, a random (stratified by disease) sample of 63 patients, drawn from the total population of high-risk patients in the general medicine clinic, was interviewed to identify patient-defined concerns regarding flu shots. Six potential consequences of influenza and nine of vaccination were emphasized by patients and provided the content for a weighted hierarchical utility model questionnaire. The utility model provides an operational framework for (1) obtaining subjective value and relative importance judgments from patients; (2) combining these judgments to obtain a prediction of behavioral intention and behavior for each patient; and, if the model is valid (predictive of behavior), (3) identifying those factors which are most salient to patient's decisions and subsequent behavior. Prior to the 1981-82 flu season, the decision model questionnaire was administered to 350 other high-risk patients from the same general medicine clinic population. The decision model correctly predicted behavioral intention for 87 percent and vaccination behavior for 82 percent of this population and, more importantly, differentiated shot "takers" and "nontakers" along several attitudinal dimensions that suggest specific content areas for clinical compliance intervention strategies.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3949541&dopt=Abstract flu, flu medicine, tamiflu



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Influenza vaccination--knowledge, attitudes, coverage--can they be improved?

Madar R, Repkova L, Baska T, Straka S.

Institute of Epidemiology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia. madar jfmed.uniba.sk

The reasons for low rate of influenza vaccination in Slovakia have been analyzed in selected target groups. In our questionnaire study we focused on the level of knowledge about this vaccination and the attitudes towards it. We selected three target groups: medical students, nurses and printing company workers. The authors as well tried to identify the ways how the flu vaccination coverage could be increased in the future. The questionnaire survey revealed several surprising facts. Though almost all the respondents knew about the existence of influenza vaccine, less than one quarter of them have ever received influenza shot. Despite our expectations that the main source of information about influenza prevention in medical students and nurses would be from their medical and nursing studies, it was shown to be from mass media instead. Even more staggering was the distrust towards the vaccination as a reason for not being vaccinated in a high proportion of both the medical students and the nurses. The majority of medical students would not even want to get a vaccination, even if it were to be provided for free. These results suggest that if we want to improve the low influenza vaccination coverage within the general population of our country, we will have to focus our attention primarily on the professional groups of medical workers and medical and nursing students who should be able to provide the public with the competent advice. Therefore, changing the current negative approach and improving the deficit in knowledge concerning vaccination are the key tasks for all under- as well as postgraduate teachers of medicine and nursing in Slovakia, especially, but not exclusively, of those specialised in public health.(Tab. 3, Fig. 2, Ref. 8).

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15168869&dopt=Abstract flu, flu medicine, tamiflu