title: Factors effecting influenza vaccination uptake among health care workers: a multi-center cross-sectional study.
abstract: BACKGROUND
  The present study aimed to identify factors affecting vaccination against influenza among health professionals.
  
  
  METHODS
  We used a multi-centre cross-sectional design to conduct an online self-administered questionnaire with physicians and nurses at state and foundation university hospitals in the south-east of Turkey, between 1 January 2015 and 1 February 2015. The five participating hospitals provided staff email address lists filtered for physicians and nurses. The questionnaire comprised multiple choice questions covering demographic data, knowledge sources, and Likert-type items on factors affecting vaccination against influenza. The target response rate was 20 %.
  
  
  RESULTS
  In total, 642 (22 %) of 2870 health professionals (1220 physicians and 1650 nurses) responded to the questionnaire. Participants' mean age was 29.6 ± 9.2 years (range 17-62 years); 177 (28.2 %) were physicians and 448 (71.3 %) were nurses. The rate of regular vaccination was 9.2 % (15.2 % for physicians and 8.2 % for nurses). Increasing age, longer work duration in health services, being male, being a physician, working in an internal medicine department, having a chronic disease, and living with a person over 65 years old significantly increased vaccination compliance (p < 0.05). We found differences between vaccine compliant and non-compliant groups for expected benefit from vaccination, social influences, and personal efficacy (p < 0.05). Univariate analysis showed differences between the groups in perceptions of personal risks, side effects, and efficacy of the vaccine (p < 0.05). Multivariate analysis found that important factors influencing vaccination behavior were work place, colleagues' opinions, having a chronic disease, belief that vaccination was effective, and belief that flu can be prevented by natural ways.
  
  
  CONCLUSIONS
  Numerous factors influence health professionals' decisions about influenza vaccination. Strategies to increase the ratio of vaccination among physicians and nurses should consider all of these factors to increase the likelihood of success.
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey. asma_asma2000@yahoo.de.
authors.forename: Süheyl
authors.initials: S
authors.lastname: Asma
authors.affiliation: Department of Family Medicine, Yeditepe University Faculty of Medicine, İnönü Mahallesi, Kayışdağı Cad., 26 Ağustos Yerleşimi, Kadıköy, İstanbul, 34755, Turkey.
authors.forename: Hülya
authors.initials: H
authors.lastname: Akan
authors.affiliation: Department of Family Medicine, Mersin University Faculty of Medicine, Çiftlikköy Kampusu, Mersin, 33343, Turkey.
authors.forename: Yücel
authors.initials: Y
authors.lastname: Uysal
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey.
authors.forename: A Gürhan
authors.initials: AG
authors.lastname: Poçan
authors.affiliation: Department of Family Medicine Sütçü İmam University Faculty of Medicine, Avşar Kampüsü, Kahramanmaraş, 46100, Turkey.
authors.forename: Mustafa Haki
authors.initials: MH
authors.lastname: Sucaklı
authors.affiliation: Department of Family Medicine, Mustafa Kemal University Faculty of Medicine, Ürgen Paşa Mh, Hatay, 31030, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Yengil
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Gereklioğlu
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Korur
authors.affiliation: Department of Family Medicine, Mersin University Faculty of Medicine, Çiftlikköy Kampusu, Mersin, 33343, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Başhan
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey.
authors.forename: A Ferit
authors.initials: AF
authors.lastname: Erdogan
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey.
authors.forename: A Kürşat
authors.initials: AK
authors.lastname: Özşahin
authors.affiliation: Department of Family Medicine, Başkent University Faculty of Medicine, Bağlıca Kampüsü Eskişehir Yolu 20. km Bağlıca, Ankara, 06810, Turkey.
authors.forename: Altuğ
authors.initials: A
authors.lastname: Kut
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014421:Turkey; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Healthcare workers; Influenza; Vaccination behavior