Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
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Subjectivity of Parents in Refusal of Childhood Vaccination: A Q-methodology Approach

자녀 예방접종 거부 부모의 주관성: Q 방법론적 접근

  • Received : 2013.04.04
  • Accepted : 2013.07.23
  • Published : 2013.07.31
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Abstract

Purpose: Despite the well-known public health benefits of vaccination, increasing public concern about the safety of childhood vaccinations has led some parents to refuse or hesitate having their children immunized. The purpose of this study was to identify the subjectivity of parents toward refusal of childhood vaccination. Methods: Q-methodology, in which subjective viewpoints are explored and analyzed using a combination of quantitative and qualitative techniques, was used. Thirty-five participants were asked to rank 42 statements on diverse issues of childhood vaccination according to a continuous 9-point scale ranging from -4 for strongly disagree to +4 for strongly agree. Collected data was analyzed using the PC-QUANAL program. Results: The results revealed three discrete groups of parents in the refusal of children's immunization: type I, distrust; type II, concern about side effects, and type III, belief that vaccinations are unnecessary. Conclusion: Special nurse counselors who can provide correct information about vaccination based on the three types should be part of the government policy. Customized education programs to shift viewpoints should be also redeveloped according to the results in this study.

목적 예방접종은 국민건강증진에 많은 기여를 함에도 불구하고 백신의 안정성 문제로 부모는 아동 예방접종을 망설이거나 거부하는 경향이 증가하고 있다. 그러므로 본 연구의 목적은 자녀 예방접종을 실시하고 있지 않은 부모의 주관성을 조사하여 이들의 생각과 태도를 파악한 후 각 유형별 간호중재 프로그램을 개발하는 데 기초자료를 제공하고자 함이다. 방법 예방접종을 거부하는 부모의 주관적인 견해를 알아보기 위해 Q-방법론을 적용하였다. 개별 심층면담 기법과 개방형 질문지, 국내외 문헌 고찰을 통해 42개의 Q 표본을 도출하였으며 소표본 이론을 근거로 35명의 P 표본을 선출한 후 9점 척도에 강제로 분포하도록 Q-sorting 과정을 실행하였다. 강제 분포된 카드의 점수는 1-9점으로 변환하여 점수를 배정한 후 PC-QUANAL 프로그램을 이용하여 분석하였다. 결과 자녀 예방접종 거부에 대한 부모의 태도와 관련된 주관성을 Q 요인 분석한 결과 '예방접종 불신형', '예방접종 부작용 염려형', '예방접종 불필요형' 등의 3개 유형으로 분류되었다. 이들 3개 유형은 전체 변량의 67%를 설명하고 있는데, 제1유형은 54%, 제2유형은 8%, 제3유형은 5%로 나타나 제1유형이 대상자의 주관적인 견해를 가장 많이 설명하고 있었다. 결론 본 연구를 통해 도출된 3개 유형을 토대로 예방접종에 대한 정확한 정보를 제공할 수 있는 간호사로 구성된 전문 상담가를 정부 정책 하에 양성할 필요가 있으며, 예방접종에 대한 부정적인 견해를 전환할 수 있는 각 유형별 맞춤형 교육 프로그램 또한 개발될 필요가 있다.

Keywords

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