Illness representations on pneumonia and pneumococcal vaccination uptake among community-living Chinese people with high-risk conditions aged ≥65 years --- a population-based study

Abstract

This study investigated the associations between illness representations of pneumonia and pneumococcal vaccination (PV) uptake among a group of community-living aging adults having at least one high-risk condition for severe invasive pneumococcal diseases (IPD). A total of 750 community-living Chinese-speaking individuals aged ≥65 y completed a random telephone survey. This study was based on 483 participants having at least one high-risk condition for severe IPD. The Illness Representation Questionnaire-Revised (IPQ-R) measured four dimensions of illness representations. These dimensions included timeline (whether pneumonia is believed to be acute/chronic), consequences (severity of pneumonia), treatment control (whether pneumonia is under volitional control), and emotional response (anger, guilty, or shame). Using PV uptake (among all participants) and behavioral intention to take up PV (among unvaccinated participants) as the dependent variables, logistic regression models were fitted. Among all participants (n = 483), 17.8% reported PV uptake; 18.6% of unvaccinated participants (n = 397) intended to take up two doses of free PV in the next year. After adjustment for significant background variables, participants who perceived more severe consequences of pneumonia (adjusted odds ratios, AOR: 1.18, 95%CI: 1.01, 1.40) and belief that treatment can control pneumonia (AOR: 1.41, 95%CI: 1.25, 1.58) reported higher PV uptake. Perceived pneumonia to be chronic (AOR: 1.44, 95%CI: 1.16, 1.78), belief that treatment can control pneumonia (AOR: 1.25, 95%CI: 1.12, 1.40) and having negative emotions related to pneumonia (AOR: 1.17, 95%CI: 1.09, 1.25) were positively associated with behavioral intention to take up PV. Results confirmed that illness representations were associated with PV-related behaviors.