Why do parents refuse childhood vaccination? Reasons reported in Finland.

AIMS: This article examines the reasons for partial and complete refusal of childhood vaccination as reported by parents in Finland. It analyzes perceptions and experiences central in vaccination decisions. METHODS: The analysis is based on 38 in-depth interviews with Finnish parents who have refused all or several vaccines for their children. The interviews were analyzed using qualitative content analysis. RESULTS: Three categories of reasons were identified in the analysis: 1) risks and effects of vaccination - concern about and/or experiences of possible side-effects was the most important reason for avoiding vaccines; 2) distrust - participants did not trust vaccination recommendations made by health officials and medical professionals due to perceived bias in medical research, ties between health officials and the pharmaceutical industry, and personal experiences of (suspected) adverse effects and the way these concerns were received in healthcare institutions; 3) health perceptions and practices - parents supported their vaccination choices with complementary and alternative medicine treatments and alternative health understandings. Many stated that contracting vaccine-preventable illnesses would provide longer lasting and more 'natural' immunity than vaccination, and possibly other health benefits. CONCLUSIONS: A loss of trust in medical and public health actors was central to the process in which parents came to question, contest, and eventually refuse childhood vaccination. The adverse effects of the Pandemrix vaccine in 2009-2010 have been important in leading to distrust and contestation. Distrust may relate to personal experiences of (suspected) adverse effects or to broader concerns over the neutrality of health authorities and the trustworthiness of medical research.

Mentalisation Amongst Maternal and Child Health Nurses Using the Newborn Behavioural Observations With Infant-mother dyads: A Qualitative Study.

PURPOSE: This study explored Maternal and Child Health Nurses' (MCHN) mentalisation processes towards infant-mother dyads when using the Newborn Behavioural Observations (NBO) system in practice. DESIGN AND METHODS: Ten Australian MCHNs (female; aged 31-66 years), who had used the NBO clinically within the last 12 months, were recruited from a database of NBO-trained practitioners. Interpretative phenomenological analysis of one-on-one semi-structured interviews explored MCHNs experiential meaning-making. RESULTS: Analysis of the data produced four main themes: reflections regarding the dyad, personal reflections, reflection into action, and professional identity and future practice. MCHNs reported that the NBO's focus on the pre-verbal infant provided them with an added dynamic to consultations outside of the practitioner-caregiver relationship. Thus, they were able to provide holistic and collaborative relationship support to infant-mother dyads. Emotional satisfaction and pride in profession were also reported; in current literature, these factors have been found to reduce burnout in primary care providers. CONCLUSIONS: The NBO appears to promote practitioner mentalisation, offering MCHNs a framework and confidence to apply infant mental health theory practically. PRACTICE IMPLICATIONS: The NBO offers potential benefits to child and family health nursing practice, and other primary care providers, who offer infant mental health and relationship support as part of their work with families in the first three months. The NBO also provides a means to shift from prescriptive to mentalisation-based, infant-inclusive, and individualised practice.

Effects of Parental Stress, Optimism, and Health-Promoting Behaviors on the Quality of Life of Primiparous and Multiparous Mothers.

BACKGROUND: Parental stress, optimism, and health-promoting behaviors (HPBs) are important predictors of the quality of life (QoL) of mothers. However, it is unclear how strongly these predictors affect the QoL of mothers. It is also unclear if the impact of these predictors on QoL differs between primiparous and multiparous mothers. In this study, we defined primiparous as "bearing young for the first time" and multiparous as "having experienced one or more previous childbirths." OBJECTIVES: The first objective of this study was to examine the relative effect of parental stress, optimism, and HPBs on the QoL of mothers. The second objective was to investigate if the effect of these predictors differed between primiparous and multiparous mothers. METHODS: One hundred ninety-four Australian mothers (n = 87, 44.8% primiparous mothers) participated in an online survey that included the Parental Stress Scale, the Health-Promoting Lifestyle Profile II, the Revised Life Orientation Test, and the Quality of Life Enjoyment and Satisfaction Questionnaire. RESULTS: All predictors (parental stress, optimism, and HPBs) significantly affected the QoL of mothers; higher levels of optimism, greater use of HPBs, and lower parental stress were associated with higher levels of QoL for all mothers. Parity did not affect the relationships. DISCUSSION: This study sheds light on the nature and unique effect of parental stress, optimism, and HPBs on the QoL of mothers.