Association between Psychological Flexibility and Health Beliefs in the Uptake of Influenza Vaccination among People with Chronic Respiratory Diseases in Hong Kong

Abstract

It is common for elderly people and those with such chronic disorders as respiratory diseases to suffer severe complications from influenza, a viral infection. The voluntary uptake of vaccination is vital to the effectiveness of influenza prevention efforts. The Health Belief Model (HBM) is the most commonly used framework in the field of vaccination behavior to explain the decision that people make to accept or refuse vaccination. In addition, psychological flexibility is considered helpful in causing people to be open to adopting new practices that are consistent with their values. This study examined the role of psychological flexibility and health beliefs in predicting the uptake of influenza vaccination among people in Hong Kong. Eligible participants were Hong Kong permanent residents aged 18 years or above with a history of chronic respiratory diseases (CRD). A convenience sample of 255 patients was recruited to participate in a cross-sectional survey in which HBM components and factors of psychological flexibility were assessed. The following variables were found to be significant predictors of vaccination: age, smoking status, comorbidity, previous hospitalization, perceived susceptibility, perceived severity, and psychological flexibility. Enhancing psychological flexibility might be a potential new direction for motivating people to accept influenza vaccination.

Barriers of Influenza Vaccination Intention and Behavior – A Systematic Review of Influenza Vaccine Hesitancy, 2005 – 2016

“…In line with this, the cognitive parameters of risk perception were frequently identified as significant barriers, i.e. perceiving the likelihood of getting the disease as low (HCP 4/117 [ 43 , 73 – 75 ]; Pregnant 1/35 [ 76 ]; Elderly 1/62 [ 77 ]; Public 9/191 [ 68 , 72 , 78 – 84 ]) and perceiving the severity of the disease as low (HCP 8/117 [ 44 , 85 – 91 ]; Pregnant 3/35 [ 92 – 94 ]; Chronic 3/45 [ 58 , 95 , 96 ]; Children 2/18 [ 97 , 98 ]; Elderly 4/62 [ 96 , 99 – 101 ]; Public 16/191 [ 65 , 71 , 72 , 81 , 83 , 99 , 102 – 111 ]). Additionally, perceiving oneself as less susceptible to the disease decreased the uptake of the influenza vaccine in 23 studies (HCP 4/117 [ 42 , 112 – 114 ]; Pregnant 3/35 [ 115 – 118 ]; Chronic 1/45 [ 95 ]; Children 1/18 [ 119 ]; Elderly 1/62 [ 99 ]; Public 11/191 [ 99 , 107 , 108 , 120 – 128 ]).…”

“…Several studies have found that unhealthy lifestyles have a negative impact on vaccine uptake, such as alcohol consumption (Chronic 1/45 [ 321 ]; Public 3/191 [ 345 – 347 ]) and smoking habits (Pregnant 3/35 [ 296 – 298 ]; Chronic 11/45 [ 95 , 249 , 321 , 325 , 348 – 354 ]; Elderly 9/62 [ 346 , 350 , 355 – 361 ]; Public 9/191 [ 317 , 346 , 347 , 361 – 366 ]). However, smoking was also a promoter in some cases (HCP 1/117 [ 367 ]; Public 3/191 [ 72 , 192 , 368 ]), and alcohol consumption did not reveal a clear picture in the reviewed studies (Pregnant 1/35 [ 297 ]; Elderly 1/62 [ 346 ]; Public 2/191 [ 346 , 365 ]).…”

“…Individuals who interact less frequently with the healthcare system, e.g. fewer doctor visits [ 61 ] or hospitalizations in a given timeframe [ 95 ], had a lower likelihood of getting vaccinated (Pregnant 2/35 [ 324 , 398 ]; Chronic 12/45 [ 95 , 249 , 290 , 294 , 321 , 325 , 349 , 350 , 352 , 353 , 399 , 400 ]; Children 5/18 [ 119 , 401 – 404 ]; Elderly 21/62 [ 59 , 251 , 300 , 302 , 322 , 350 , 356 – 358 , 375 , 376 , 390 , 405 – 413 ]; Public 13/191 [ 61 , 255 , 304 , 347 , 405 , 414 – 421 ]). In line with these findings, not having a regular source of care (e.g.…”

A Multiyear Model of Influenza Vaccination in the United States

“…How influential is a person’s trust in information from the health care system, personal doctors, pharmaceutical companies, government, or social media? How significant a factor is a person’s anxiety about vaccination infection [ 34 ] or fear of hypodermic needles [ 19 ]?…”

“…An influenza-induced fever is common and usually lasts two to four days [ 3 , 34 ]. Millions of people fall ill to influenza every year in the United States and recover in a few days [ 15 ].…”