Maternal Care Providers' Barriers Regarding Influenza and Pertussis Vaccination During Pregnancy in Catalonia, Spain.

Objective Maternal care providers (MCPs), obstetrician-gynaecologists and midwives are uniquely placed to increase maternal vaccination acceptance. We aimed to assess their knowledge, attitudes and practices regarding influenza and pertussis vaccination during pregnancy. Methods We conducted an online survey among MCPs working at "Attention to Sexual and Reproductive Health" (ASSIR) Units in Catalonia region. The survey included questions about current recommendations of influenza and pertussis immunization during pregnancy, reasons for not routinely recommending vaccination and several strategies to increase vaccination uptake. Results A total of 194 MCPs completed the survey, 178 (91.8%) were female and 145 (70%) were midwives. Only 61 (31.4%) stated they vaccinated themselves annually against influenza with a significant lower uptake among midwives (26.9%) than obstetrician-gynaecologists (44.9%) (p = 0.03). Overall, 53.6% of MCPs knew influenza vaccine was indicated during first trimester but only 43.3% stated they prescribed it. Almost all MCPs (98.5%) knew pertussis vaccine was recommended and 97.4% stated they prescribed it. The most important vaccination barrier found was the concern related to vaccine adverse events (25.9%) and more midwives than obstetrician-gynaecologists expressed this concern (30.8 vs. 10%) (p = 0.02). The most popular strategies were: including vaccine recommendations in the pregnancy booklet (93.8%) and receiving vaccination training (92.3%). In the adjusted analysis, the only factor significantly associated with MCPs' prescription of influenza vaccine during second/third trimester was having been vaccinated themselves (odds ratio 3.70, 95% confidence interval 1.3-13.2). Conclusions for Practice Implementation of practical tools, continuous training and clear definition of responsibilities regarding vaccination among MCPs may have a significant impact on maternal vaccination coverage.

Elementos diferenciales entre mujeres inmigrantes y mujeres autóctonas respecto al maltrato / Differential features between immigrant and autochthonous women in psychic mistreatment

A fin de conocer los elementos diferenciales entre mujeres autóctonas e inmigrantes con maltrato psíquico actual (MPA) en cuanto a incidencia, antecedentes, tipo de maltrato y sintomatología diferencial, se ha realizado el presente estudio. Método: Análisis comparativo sobre un estudio descriptivo, transversal realizado en 159 mujeres (34 emigradas) atendidas de forma consecutiva en dos PASSIR de Barcelona. Análisis estadístico: paquete SPSS versión 11.0. Comparación con la prueba de la x2, y medianas con la t de Student. Riesgo alfa de 0,05 para una precisión de ±0,07 unidades porcentuales. Resultados: Se detectan diferencias significativas en MPA en las mujeres inmigrantes y autóctonas en función de: a) incidencia de MPA en el 29,4% de las mujeres inmigrantes frente al 10,4% de las autóctonas (p = 0,011); b) historia de maltrato anterior (de cualquier tipo) en el 55,9% de las mujeres emigradas frente al 35,2% del resto (p = 0,02), y c) los síntomas principales de las mujeres con MPA inmigrantes son desconfianza (38,2%) y confusión (35,3%) frente al 16 y el 16,8%, respectivamente, de las autóctonas. Conclusiones: Ante una demanda de atención psicológica hay una mayor probabilidad de encontrar una situación de MPA en el colectivo de mujeres inmigrantes. Más desconfianza y confusión en las mujeres inmigrantes con MPA puede relacionarse con un pasado recurrente de maltrato y agravado por el impacto del proceso migratorio (AU)

The purpose of this study was to determine differential elements among autochthonous and immigrant women experiencing current psychic mistreatment (PM) in terms of incidence, antecedents, type of mistreatment and differential symptomatology. Method: We performed a descriptive cross-sectional comparative study in 159 women (34 immigrants) consecutively attending two sexual and reproductive health programs in Barcelona. Statistical analysis was performed using the SPSS package version 11.0. Comparisons were made using the x2 test and Student's t test. An alpha risk of 0.05 for a precision of ±0.07 percentage units was employed. Results: Significant differences in PM were detected in immigrant and autochthonous women: 1. The incidence of PM was 29.4% in immigrant versus 10.4% in autochthonous women (p = 0.011). 2. A history of previous mistreatment (of any type) was found in 55.9% of immigrant women versus 35.2% of Spanish-born women (p = 0.02). 3. The main symptom in immigrant women experiencing PM was distrust (38.2%) and confusion (35.3%) as contrasted with 16% and 16.8 % respectively in autochthonous women. Conclusions: In women seeking psychological help, there is a higher probability of finding PM in immigrants. The greater presence of distrust and confusion among immigrant women experiencing PM could be related to recurrent past mistreatment and be aggravated by the impact of immigration (AU)