Assessment of knowledge, attitudes and practices of physicians in Ankara Atatürk Training and Research Hospital towards vaccination in elderly

Introduction and Objectives:Vaccination is necessary for controlling and eliminating life-threatening infectious diseases together with adequate levels of good hygiene, sanitation, nutrition and clean water.Both in the world and in our country, vaccination is often accepted as an application specific to childhood, and immunization of the elder has been neglected. In this study, it was aimed to reveal the attitudes of the physicians about the elderly immunization, to raise awareness about it and to increase the vaccination rates below the targeted levels. Materials and Methods: 253 voluntary physicians working at Ankara Atatürk Training and Research Hospital were included in the study. Within the scope of the study, a questionnaire containing questions about the sociodemographic data and about the knowledge efficiency, attitudes and behaviors of physicians on vaccination for patients 65 years old and over was administered. For evaluating the data, 24.0 version of SPSS program was used. Pearson chi-square test was used for statistical analysis and P value of less than 0.05 was considered statistically significant. Results: When we look at the knowledge sufficiency evaluationof the physicians about themselves; 61.7% (n:156), 58.1%(n:147), 41.3%(n:104) and 13%(n:33)of them found their knowledge sufficient enoughrespectively for influenza, pneumococcus, tetanus and for zoster. A small proportion of physicians were questioning the vaccination of patients 65 years of age and older. A majority of physicians stated that they knew that influenza and pneumococcal vaccineswere recommended for people 65 years of age or older and nearly half of them stated the same for tetanus vaccination. However, only 40.3%(n:102) and 32%(n:81) of the physicians recommended influenza and pneumococcal vaccinations respectivelyto all patients aged 65 years and older., and also 47.8%(121) offered tetanus vaccination in case of injury. Physicians following the guidelines found themselves more knowledgeable about influenza, pneumococcal and tetanus vaccinations. Physicians also reported that the main barriers for not offering vaccination to the elder were; workload in limited time and giving the first order to acute and chronic medical care rather than preventive care. In our study, a small proportion of physicians have participated in an education about the vaccination of the elder and the majority of physicians stated that they need training on vaccination. Conclusion:It was observed that majority of the physicians did not feel knowledgeable enough on vaccinations recommended for patients over 65 years of age. Few of the participants were interested in the vaccination status of the patients at clinical visits and only a small percentage of them recommended vaccines to patients. It is presumed that physicians' beliefs, trainings, following up the guidelines and self-immunization status are effective on their vaccination behaviors about the patients. Various training sessions to improve and update the medical knowledge of physicians about the elderly vaccination are needed in the future. There is also need for multifaceted activities to change and improve the attitudes and behaviors of physicians. Vaccination rates can be improved by interventionist efforts that support vaccination, such as electronic medical records and reminders (certificate of immunization). Keywords: Aging; elderly; vaccination; immunization; physicians; knowledge; attitude; practices