Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Research Instrument
- Respondents’ vaccination intention and vaccination status: in the first and second survey period, the respondents were only asked if they would be vaccinated if the vaccine was available (response options: yes/I do not know/no). In the third survey period, the respondents were asked whether they were already vaccinated (response options yes/no) and about their intention to be vaccinated (response options yes/not sure/no).
- Psychological burden: the feeling thermometer (FT) was used to assess the psychological burden, i.e., one’s own experience of physical, emotional, psychosocial burden, and the burden of everyday life during the last 7 days. Respondents had to assess these on a continuous visual scale from 0 (no burden) to 10 (extremely strong burden). The FT provides a summary score that investigators use under the expected utility and information theory, and it has shown good properties for the measurement of health-related quality of life (HRQL). The results suggest moderate reliability of clinical marker states’ ratings for the FT [40,41].
- Anxiety: The generalized anxiety disorder 7-item, GAD-7 [35], was used. The GAD-7 consists of seven questions based in part on the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition) criteria for GAD and reflects the frequency of symptoms during the preceding 2-week period; for each symptom queried, it provides the following response options: “not at all”, “several days”, “over half the days”, and “nearly every day”, and these are scored 0, 1, 2, or 3, respectively (Cronbach’s alpha = 0.92). The GAD-7 scores range from 0 to 21, with higher scores indicating progressively higher levels of anxiety (0–4 = minimal anxiety, 5–9 = mild anxiety, 10–14 = moderate anxiety, and 15–21 = severe anxiety). When used as a screening tool, further evaluation is recommended when the score is 10 or greater. Using the threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% [42,43].
- Perceived infectability and germ aversion: The perceived vulnerability to disease questionnaire, PVDQ, developed by Duncan et al. [44], was adapted to be more reflective of the current reality [45], and a 15-item self-report on a 7-point scale response (with endpoints labeled as “strongly disagree” and “strongly agree”) was used. It measures two factors: perceived infectability (assesses beliefs in one’s own susceptibility to infectious diseases, e.g., “If an illness is going around, I will get it”; seven items) (Cronbach’s alpha = 0.87), and germ aversion (assesses emotional discomfort in contexts where disease-causing germs might be transmitted, e.g., ”It really bothers me when people sneeze without covering their mouth”; eight items) (Cronbach’s alpha = 0.74) [38]. In our study, Cronbach’s alpha showed lower internal consistency of these scores (0.68 and 0.56, respectively).
2.4. Statistical Analysis
3. Results
3.1. Analysis of Factors Influencing Vaccination Intention in Different Survey Periods
3.2. Comparison of Respondents Who Were Already Vaccinated and Respondents Who Expressed Their Intention to Be Vaccinated in the Third Survey Period
3.3. Level of Anxiety and Vaccination Intention
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Survey Period | I | II | III | Difference between Samples: Chi-Square (p) | |
---|---|---|---|---|---|
Period | 13 March 2020–14 March 2020 | 13 April 2020–8 May 2020 | 7 March 2021–26 May 2021 | ||
No. of respondents (N) | 7764 | 313 | 154 | ||
No. of health care workers | 851 | 86 | 145 | ||
Gender N (%) | Female | 742 (87.2%) | 75 (87%) | 125 (86.8%) | 0.947 |
Education N (%) | Secondary school | 357 (41.7%) | 46 (52.9%) | 67 (46.2%) | 0.149 |
Graduate | 362 (42.3%) | 26 (29.9%) | 60 (41.4%) | ||
Postgraduate | 137 (16.0%) | 15 (17.2%) | 18 (12.4%) | ||
Age N (%) | >29 years | 198 (23.7%) | 33 (38.8%) | 37 (25.5%) | 0.051 |
30–45 years | 420 (50.4%) | 35 (41.2%) | 70 (48.3%) | ||
>46 years | 216 (25.9%) | 17 (20.0%) | 38 (26.2%) | ||
Alone | 71 (8.3%) | 6 (6.9%) | 15 (10.3%) | 0.006 * | |
Living arrangements (%) | Living with partner/children | 570 (66.5%) | 60 (69.0%) | 74 (51.0%) | |
Living with elderly | 216 (25.2%) | 21 (24.4%) | 56 (38.6%) |
Survey Period | Vaccination Intention Not Declared N (%) | Vaccination Intention Declared N (%) | Already Vaccinated N (%) | Total N |
---|---|---|---|---|
I | 526 (61.4%) | 331 (38.6%) | - | 857 |
II | 49 (56.3%) | 38 (43.7%) | - | 87 |
III | 39 (26.9%) | 61 (42.1%) | 45 (31.0%) | 145 |
Period I | Period II | Period III | p (ANOVA) | Bonferroni Post-Hoc Test Significance: Periods (p) | |
---|---|---|---|---|---|
Number of cases | 857 | 87 | 145 | ||
Perceived infectability | 3.45 ± 1.02 | 3.22 ± 1.11 | 3.61 ± 0.89 | 0.015 * | II-III (0.012) |
Germ aversion | 4.97 ± 1.01 | 4.89 ± 1.04 | 4.69 ± 0.76 | 0.007 * | I-III (0.005) |
GAD-7 | 4.59 ± 5.16 | 4.62 ± 5.36 | 3.89 ± 4.57 | 0.296 | |
Psychological burden | 4.66 ± 2.51 | 4.13 ± 2.74 | 4.04 ± 2.65 | 0.009 * | I-III (0.021) |
Phase | Factor | B | Sig. (p) | Odds Ratio (95%CI) |
---|---|---|---|---|
I | Perceived infectability | 0.144 | 0.065 | 1.16 (0.99–1.35) |
Germ aversion | 0.128 | 0.092 | 1.14 (0.98–1.32) | |
GAD 7 (≥10) | 0.497 | 0.030 | 1.64 (1.05–2.58) | |
Education (secondary school) | 0.032 | 1 (ref) | ||
Education (graduate) | 0.178 | 0.286 | 1.20 (0.86–1.66) | |
Education (postgraduate) | 0.584 | 0.009 | 1.79 (1.16–2.78) | |
Living alone | 0.783 | 1 (ref) | ||
Living with partner/children | 0.067 | 0.810 | 1.07 (0.62–1.85) | |
Living with elderly | −0.056 | 0.854 | 0.95 (0.52–1.72) | |
Psychological burden (≥8) | 0.111 | 0.632 | 1.12 (0.71–1.76) | |
Age ≤ 29 years | 0.737 | 1 (ref) | ||
Age 30–45 years | 0.012 | 0.950 | 1.01 (0.70–1.47) | |
Age ≥46 years | 0.145 | 0.501 | 1.16 (0.76–1.77) | |
II | Perceived infectability | 0.011 | 0.962 | 1.01 (0.65–1.58) |
Germ aversion | 0.111 | 0.657 | 1.12 (0.69–1.82) | |
GAD 7 (≥10) | 1.103 | 0.230 | 3.01 (0.50–18.25) | |
Education (secondary) | 0.359 | 1 (ref) | ||
Education (graduate) | 0.307 | 0.595 | 1.36 (0.44–4.21) | |
Education (postgraduate) | 1.226 | 0.153 | 3.41 (0.63–18.35) | |
Living alone | 0.217 | 1 (ref) | ||
Living with partner/children | 1.773 | 0.186 | 5.89 (0.43–81.70) | |
Living with elderly | 0.865 | 0.547 | 2.38 (0.14–39.64) | |
Psychological burden (≥8) | −1.276 | 0.268 | 0.28 (0.03–2.66) | |
Age ≤29 years | 0.302 | 1 (ref) | ||
Age 30–45 years | 0.196 | 0.734 | 1.22 (0.39–3.78) | |
Age ≥46 years | 1.168 | 0.131 | 3.22 (0.71–14.65) | |
III | Perceived infectability | 0.966 | 0.001 | 2.63 (1.52–4.55) |
Germ aversion | 0.484 | 0.094 | 1.62 (0.92–2.86) | |
GAD 7 (≥10) | 0.476 | 0.588 | 1.61 (0.29–9.01) | |
Education (secondary school) | 0.046 | 1 (ref) | ||
Education (graduate) | 0.928 | 0.056 | 2.53 (0.98–6.54) | |
Education (postgraduate) | 2.232 | 0.050 | 9.32 (1.00–87.03) | |
Living alone | 0.560 | 1 (ref) | ||
Living with partner/children | −0.983 | 0.290 | 0.37 (0.06–2.31) | |
Living with elderly | −0.866 | 0.330 | 0.42 (0.07–2.40) | |
Psychological burden (≥8) | 0.749 | 0.373 | 2.11 (0.41–11.00) | |
Age ≤29 years | 0.003 | 1 (ref) | ||
Age 30–45 years | 1.246 | 0.042 | 3.48 (1.05–11.55) |
Vaccinated | Intended to Be Vaccinated | ANOVA (p) | |
---|---|---|---|
Number of cases | 45 | 61 | |
Perceived infectability | 3.42 ± 0.93 | 4.00 ± 0.83 | 0.001 * |
Germ aversion | 4.72 ± 0.82 | 4.76 ± 0.62 | 0.751 |
GAD-7 | 2.47 ± 3.32 | 4.57 ± 5.64 | 0.028 * |
Psychological burden | 3.47 ± 2.73 | 4.26 ± 2.70 | 0.139 |
Survey Period | Factor | B | Sig. (p) | Odds Ratio (95%CI) |
---|---|---|---|---|
III | Perceived infectability | −0.824 | 0.010 | 0.44 (0.24–0.82) |
Germ aversion | −0.320 | 0.366 | 0.73 (0.36–1.45) | |
GAD7 ≥ 10 | −1.449 | 0.193 | 0.23 (0.07–2.08) | |
Education (secondary school) | 0.267 | 1 (ref) | ||
Education (graduate) | 0.362 | 0.541 | 1.44 (0.45–4.58) | |
Education (postgraduate) | 1.223 | 0.106 | 3.40 (0.77–14.96) | |
Living alone | 0.470 | 1 (ref) | ||
Living with partner/children | −0.767 | 0.411 | 0.47 (0.08–2.89) | |
Living with elderly | −0.135 | 0.887 | 0.87 (0.14–5.56) | |
Psychological burden ≥ 8 | −1.523 | 0.153 | 0.22 (0.03–1.76) | |
Age ≤ 29 years | 0.029 | 1 (ref) | ||
Age 30–45 years | 2.004 | 0.035 | 7.42 (1.15–47.94) | |
Age ≥ 46 years | 2.573 | 0.008 | 13.11 (1.97–87.10) |
Survey Period | Level of Anxiety | N | Vaccination Intention Not Declared (%) | Vaccination Intention Declared (%) | Already Vaccinated (%) | Chi-Square (p) |
---|---|---|---|---|---|---|
I | Minimal (0–4) | 537 | 65.9% | 34.1% | 0.001 * | |
Mild (5–9) | 192 | 57.8% | 42.2% | |||
Moderate (10–14) | 64 | 50.0% | 50.0% | |||
Severe (15–21) | 64 | 45.3% | 54.7% | |||
Total | 857 | 61.4% | 38.6% | |||
II | Minimal (0–4) | 53 | 58.5% | 41.5% | 0.838 | |
Mild (5–9) | 19 | 47.4% | 52.6% | |||
Moderate (10–14) | 8 | 62.5% | 37.5% | |||
Severe (15–21) | 7 | 57.1% | 42.9% | |||
Total | 87 | 56.3% | 43.7% | |||
III | Minimal (0–4) | 96 | 20.8% | 40.6% | 38.5% | 0.006 * |
Mild (5–9) | 33 | 45.5% | 33.3% | 21.2% | ||
Moderate (10–14) | 10 | 40.0% | 60.0% | 0.0% | ||
Severe (15–21) | 6 | 0.0% | 83.3% | 16.7% | ||
Total | 145 | 26.9% | 42.1% | 31.0% |
Survey Period | Pearson Correlation Coefficient between Anxiety and Other Psychological Scores: | ||||
---|---|---|---|---|---|
Group of Respondents | N | Psychological Burden | Perceived Infectability | Germ Aversion | |
I | Vaccination intention not declared | 526 | 0.539 ** | 0.374 ** | 0.072 |
Vaccination intention declared | 331 | 0.545 ** | 0.236 ** | 0.133 * | |
II | Vaccination intention not declared | 49 | 0.679 ** | 0.004 | 0.097 |
Vaccination intention declared | 38 | 0.600 ** | 0.254 | 0.108 | |
III | Vaccination intention not declared | 39 | 0.419 ** | −0.508 ** | 0.333 * |
Vaccination intention declared | 61 | 0.479 ** | 0.163 | −0.089 | |
Already vaccinated | 43 | 0.590 ** | −0.131 | −0.282 |
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Globevnik Velikonja, V.; Verdenik, I.; Erjavec, K.; Kregar Velikonja, N. Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic. Vaccines 2022, 10, 1983. https://doi.org/10.3390/vaccines10121983
Globevnik Velikonja V, Verdenik I, Erjavec K, Kregar Velikonja N. Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic. Vaccines. 2022; 10(12):1983. https://doi.org/10.3390/vaccines10121983
Chicago/Turabian StyleGlobevnik Velikonja, Vislava, Ivan Verdenik, Karmen Erjavec, and Nevenka Kregar Velikonja. 2022. "Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic" Vaccines 10, no. 12: 1983. https://doi.org/10.3390/vaccines10121983
APA StyleGlobevnik Velikonja, V., Verdenik, I., Erjavec, K., & Kregar Velikonja, N. (2022). Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic. Vaccines, 10(12), 1983. https://doi.org/10.3390/vaccines10121983