Journal of Preventive Medicine and Public Health

Original Articles

Knowledge, Attitudes, Barriers and Uptake Rate of Influenza Virus Vaccine Among Physicians in Jordan: A Multicentric Cross-sectional Study: Munir Abu-Helalah, Tarek Rashad Gharibeh, Mohammad Al-Hanaktah, Hussam Alshraideh, Raghad Mahmoud Darweesh, Maria Alshurman, Lekaa Ja’far Al Mughrabi F, Yaqeen Ja’far Al Mughrabi F, Neveen Ghanem; J Prev Med Public Health. 2025;58(5):484-495. Published online June 3, 2025; DOI: https://doi.org/10.3961/jpmph.24.776

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Abstract Summary PDF Supplementary Material: Objectives
Seasonal influenza poses significant global health challenges, with healthcare professionals (HCPs) particularly vulnerable due to frequent exposure to infected patients. Influenza vaccination is a proven method to reduce morbidity and mortality. Despite recommendations by health authorities, vaccination uptake among HCPs remains suboptimal globally and within Jordan. This study aimed to assess knowledge, attitudes, barriers, and influenza vaccine uptake among physicians in Jordan.
Methods
A cross-sectional study was conducted from March 2023 to June 2023 involving 389 physicians from Ministry of Health facilities across Jordan. A structured and validated questionnaire was used to collect demographic data, vaccination history, and insights guided by the health belief model. Multivariate logistic regression analyses were performed to identify predictors of vaccine uptake and patient vaccination practices.
Results
The influenza vaccination rate during the 2022-2023 season was 47%. Vaccination uptake was associated with factors such as age, geographic location, professional designation, and training. Vaccinated physicians demonstrated better knowledge and more favorable attitudes toward vaccination. Common barriers included misconceptions about personal risk, concerns over vaccine efficacy, and forgetting to vaccinate. Physicians who received training were more likely to recommend vaccination to patients.
Conclusions
The low vaccination rate among Jordanian physicians highlights the need for targeted educational interventions and policies to address misconceptions and barriers. Improving influenza vaccination uptake among HCPs is critical to enhancing patient confidence, reducing transmission, and improving public health outcomes.; Summary

Key Message
"Despite recommendations by health authorities, vaccination uptake among HCPs remains suboptimal in Jordan and globally. This study aimed to assess knowledge, attitudes, barriers, and influenza vaccine uptake among physicians in Jordan. A cross-sectional study was conducted from March 2023 to June 2023 involving 389 physicians from the Ministry of Health, Jordan. The influenza vaccination rate during the 2022-2023 season was 47%. Common barriers included misconceptions about personal risk, concerns over vaccine efficacy, limited training, and forgetting to vaccinate. The low vaccination rate among Jordanian physicians highlights the need for targeted educational interventions and policies to address misconceptions and barriers."

Probability of Early Retirement Among Emergency Physicians: Jaemyeong Shin, Yun Jeong Kim, Jong Kun Kim, Dong Eun Lee, Sungbae Moon, Jae Young Choe, Won Kee Lee, Hyung Min Lee, Kwang Hyun Cho; J Prev Med Public Health. 2018;51(3):154-162. Published online May 17, 2018; DOI: https://doi.org/10.3961/jpmph.18.079

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Objectives
Early retirement occurs when one’s job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction.
Methods
A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram.
Results
Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors.
Conclusions
To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.

Summary

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Special Article

How to Improve Influenza Vaccination Rates in the U.S.: Byung-Kwang Yoo; J Prev Med Public Health. 2011;44(4):141-148. Published online July 29, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.4.141

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Abstract PDF

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities.

This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

Summary

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English Abstracts

A Study of Factors Related to Korean Physicians' Trust in the Government: On the Target for Board Members of Physicians' Associations.: Sunhee Lee, Gunmo Yang, Juhyun Seo, Juhye Kim; J Prev Med Public Health. 2010;43(5):411-422.; DOI: https://doi.org/10.3961/jpmph.2010.43.5.411

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Abstract PDF

OBJECTIVES
This study aims to investigate the factors related to Korean physicians' trust in the government. METHODS: We used structured questionnaires that were composed of multidimensional scales for each of the various categories. RESULTS: The recognition levels of trust of the government by Korean physicians were not high, and they ranged from 3.6 to 4.8 for ten scales. The factors related to trust in the government were categorized into seven factors on the basis of a factor analysis. On the regression analysis, a positive relationship was found between "the individual propensity to trust" and trust in the government, while a negative relationship was found between "the recognition level regarding the government as an authoritarian power" and trust in the government. "Confidence about participation in the policy process" as internal efficacy and "belief in governmental ability and motivation toward public demand" as external efficacy also showed a strong positive relationship with trust in the government. CONCLUSIONS: From these results, we can draw the conclusion that making efforts to improve the recognition level of trust in the government among physicians is an important policy task. To increase the trust level, participation of physicians in the policy process in various ways and open communication between the physicians'associations and the government should be facilitated.

Summary

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The Relationship between Trust in Healthcare System and Health Examination Participation
Baek-Geun Jeong, In-Kyoung Hwang, Hae-Sook Sohn, Kwang-Wook Koh, Tae-Ho Yoon, Jeong-Hun Lim
Journal of agricultural medicine and community health.2010; 35(4): 395. CrossRef

The Levels of Psychosocial Stress, Job Stress and Related Factors of Medical Doctors Practicing at Local Clinics.: Moon Kuk Kang, Yune Sik Kang, Jang Rak Kim, Baek Geun Jeong, Ki Soo Park, Sin Kam, Dae Yong Hong; J Prev Med Public Health. 2007;40(2):177-184.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.177

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Abstract PDF

OBJECTIVES
This study was conducted to investigate the levels of psychosocial stress, job stress and their related factors among medical doctors practicing at local clinics. METHODS: A survey using a self administered questionnaire was administered to 1,456 doctors practicing at private clinics via post for 2 months (2006. 1 - 2006. 3). Psychosocial stress, job stress,demographic factors, job related factors and health related behaviors were investigated. Among the eligible study population, the respondents were 428 doctors (29.4%). RESULTS: The average scores of psychosocial stress and job stress were 2.19 and 3.13, respectively. The levels of psychosocial stress and job stress were statistically lower in older respondents, those who worked shorter or who were more satisfied with their job, and those with higher socioeconomic status. The level of psychosocial stress was related with smoking status, drinking status and exercise. The level of job stress was related with smoking status and exercise. In multiple linear regression analysis using psychosocial stress as a dependent variable, age, working hours per day, job satisfaction and perception on socioeconomic status were significant independent variables. In analysis using job stress as a dependent variable, age, working hours per day and job satisfaction were significant independent variables. CONCLUSIONS: Stress affects the doctor-patient relationship, productivity and overall health level of people. Therefore, it is important to manage and relieve the stress of doctors. It is suggested that more advanced studies on stress level and related factors and ways to improve the stress and health related behaviors of medical doctors should be conducted.

Summary

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Keon Kim, Sunhwa Lee, Yoon Hee Choi
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Yune Sik Kang
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Mind-Body Approach in the Area of Preventive Medicine: Focusing on Relaxation and Meditation for Stress Management
Yunesik Kang
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The Work Related Psychosocial Factor and Disease among Health Professional
Sang Baek Koh
Journal of the Korean Medical Association.2010; 53(6): 467. CrossRef
Job Satisfaction, Subjective Class Identification and Associated Factors of Professional Socialization in Korean Physicians
Hyung-Gon Yoon, Seok-Jun Yoon, In-Kyoung Hwang, Yeong-Bae Mun, Hee-Young Lee
Journal of Preventive Medicine and Public Health.2008; 41(1): 30. CrossRef

Original Articles

Smoking Status and Smoking Cessation Activity among Physicians in a Community.: So Yeon Ryu, Ki Soon Kim, Myung Gun Kang, Hyung Cheol Park, Jin Sun Kim; Korean J Prev Med. 2003;36(3):271-278.

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Abstract PDF: OBJECTIVES
The purposes of this study were to assess the smoking status, knowledge and attitude related to smoking and smoking cessation activity of the physicians in a community, and to identify their predictors of smoking cessation activity. METHOD: All physicians employed by various health facilities in a community were surveyed using a structured questionnaire. Of the physicians surveyed, 523 (69.6%) returned completed questionnaires. RESULTS: The smoking rate of physicians was 29.3% (34.2% in males, 3.6% in females) and the knowledge and attitude scores to smoking were 22.5+/-2.4 and 65.4+/-6.9, respectively. The self-efficacy score was 3.4+/-1.0 and the smoking cessation activity score was 65.4+/-6.9. The smoking cessation activity was statistically significant with working place, specialty, knowledge and attitude to smoking and self-efficacy. In stepwise multiple regression, smoking cessation activity was predicted by doctors' working place, specialty, attitudes related to smoking issues, and self-efficacy of counseling knowledge and skills. CONCLUSION: Physicians need to participate routinely and actively in smoking cessation activity. For doctors to effectively counsel and intervene in patients regarding smoking cessation, it is essential to integrate education on smoking cessation intervention into curricula in formal education and to offer continuing education including smoking cessation intervention.; Summary

Geographical distribution of physician manpower by specialty and care level.: Seung Hum Yu, Sang Hyuk Jung, Byung Yool Cheon, Tae Yong Shn, Hyohn Joo Oh; Korean J Prev Med. 1993;26(4):661-671.

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Abstract PDF: In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.; Summary

Recognition and attitude to fundtional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city.: Moo Sik Lee, Nung Ki Yoon, Suk Kwon Suh, Jae Yong Park; Korean J Prev Med. 1993;26(1):1-19.

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Abstract PDF: Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered failure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is successful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical insurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician preferred pros and 17.7 percent cons ,but 38 percent of practicing pharmacist preferred pros and 45.5 percent cons. And pharmacist know better the content of functional division between physician and pharmacist, practicing emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist preferred generic name (44.0%, 89%) mostly, but physician preferred brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the governmental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the government should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.; Summary

English Abstracts

Mortality among Medical Doctors Based on the Registered Cause of Death in Korea 1992-2002.: You Cheol Shin, Jae Heon Kang, Cheol Hwan Kim; J Prev Med Public Health. 2005;38(1):38-44.

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Abstract PDF: OBJECTIVE
To compare the mortality rate of Korean medical doctors to that of the general Korean population for the period 1992-2002. METHODS: The membership records of the Korean Medical Association were linked to the 1992-2002 death certificate data of Korea's National Statistical Office using 13-digit unique personal identification numbers. The study population consisted of 61, 164 medical doctors with a follow-up period of 473, 932 person-years. Standardized mortality ratios (SMRs) were calculated to compare cause-specific mortality rates of medical doctors to those of the general population. RESULTS: We confirmed 1, 150 deaths at ages from 30 to 75 years from 1 January 1992 to 31 December 2002. The SMR for all-cause of death was 0.47 (95% CI : 0.44~0.50). The SMRs for smoking-related diseases such as cerebrovascular accidents and chronic obstructive pulmonary disease were smaller than the SMR of all-cause of death. However, the SMRs for colorectal and pancreatic cancers were not significantly lower than those of the general population. Transport accidents and suicides accounted for 72% (94 of 131) of external causes of death. The SMR for suicide was 0.51 (95% CI : 0.38~0.68). CONCLUSIONS: The mortality rate of South Korean medical doctors was less than 50% that of the general population of South Korea. Cause-specific analysis showed that mortality rates in leading causes of death were lower among medical doctors although differences in mortality rates between medical doctors and the general population varied with the causes of death. These health benefits found among medical doctors may be attributable to the lower level of health damaging behaviors (e.g., lower smoking rates) and better working conditions.; Summary

Factors Influencing Antibiotics Prescribing of Primary Health Physicians in Acute Upper Respiratory Infections.: Nam Soon Kim, Soong Nang Jang, Sun Mee Jang; J Prev Med Public Health. 2005;38(1):1-8.

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Abstract PDF: OBJECTIVES
To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). METHODS: We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. RESULTS: We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). CONCLUSION: These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.; Summary

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