Proceedings of the Estonian Academy of Sciences (Aug 2023)

Implementation of person-centredness under structural constraints: a case of HPV vaccination

  • Kadi Lubi,
  • Merilin Varsamaa,
  • Liis Kala,
  • Agnessa Torop,
  • Kaire Sildver,
  • Mare Rooden

DOI
https://doi.org/10.3176/proc.2023.3.12
Journal volume & issue
Vol. 72, no. 3
pp. 303 – 312

Abstract

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Person-centredness is claimed to be one of the aims of healthcare, placing the person at the centre of healthcare (services). However, individual responsibility is expected and stressed in the implementation with limited structural support. This has led to the situation where despite the availability of HPV vaccination as the most beneficial preventive method, the coverage for girls aged 12–14 is below the recommended (>70%) rate. The objective of the research was to analyse structural constraints experienced by parents and service providers of the target group of girls regarding HPV vaccination under the circumstances of a global pandemic. Qualitative methods were used, namely in-depth interviews (n = 18) with nurses and midwives and three focus group interviews (n = 13) with parents of girls aged 12–14 years, as well as thematic textual analysis with the combination of inductive and deductive analysis methods. The research was granted ethical permission. The results outline that for parents the main challenge is the ability to find relevant supportive information for decision-making. For nurses, the challenge is to find appropriate ways to counsel and support parents and girls. The study revealed the lack of a country-wide strategy as one of the weak links in supporting the continuation of necessary preventive activities despite the external situation. Also, the skills of counselling and development of innovative communicative and educational digital tools that are target group specific yet also country- and culture-specific should be improved, as this may lead to more person-centred healthcare service for cervical cancer prevention.

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