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.
Alumäe, T., Tilk, O. and Ullah, A. 2018. Advanced rich transcription system for Estonian speech. Front. Artif. Intell. Appl., 307, 1–8.
https://doi.org/10.3233/978-1-61499-912-6-1
Bruni, L., Albero, G., Serrano, B., Mena, M., Gómez, D., Muñoz, J. et al. 2023a. Human Papillomavirus and Related Diseases Report. Estonia. Summary Report 10 March 2023. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre).
https://hpvcentre.net/statistics/reports/EST.pdf (accessed 2023-08-02).
Bruni, L., Albero, G., Serrano, B., Mena, M., Collado, J., Gomez, D. et al. 2023b. Human Papillomavirus and Related Diseases Report. Europe. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre)
www.hpvcentre.net/statistics/reports/XEX.pdf (accessed 2023-08-02).
Cockerham, W. C. 2013. Bourdieu and an update of health lifestyle theory. In Medical Sociology on the Move: New Directions in Theory (Cockerham, W. C., ed.). Springer, Dordrecht, 127–154.
https://doi.org/10.1007/978-94-007-6193-3
Dutta, M. J. 2015. Neoliberal Health Organizing: Communication, Meaning and Politics. Routledge, Oxon.
https://doi.org/10.4324/9781315423531
Estonian Gynaecologists Society. Emakakaela, tupe ja vulva vähieelsete muutuste diagnoosimine, jälgimine ja ravi. HPV-vastase vaktsineerimise soovitused(Guideline for the diag nosis, observation and treatment of pre-cancerous status of cervix, vagina and vulva. Recommendations for HPV vaccination).
https://www.ens.ee/ravijuhendid/gynekoloogia (in Estonian) (accessed 2022-08-02).
Estonian Health Board. 2018. HPV ja vaktsiin – infomaterjal koolide tervishoiutöötajatele (HPV and vaccine: informational material for schools’ healthcare professionals).
https://ta.vaktsineeri.ee/sites/default/files/dok/Nakkushaigused/lugemist/Info_kooli_tervishoid.pdf (in Estonian) (accessed 2022-08-02).
Estonian Health Board. 2019. Kuidas vaktsineerimist läbi viiakse? (How HPV vaccination is organized?)
https://ta.vaktsineeri.ee/uudised/lapsevanematele-oluline-teave-kuidas-toimub-hpv-vastu-vaktsineerimine (in Estonian) (accessed 2022-08-03).
Estonian Health Board. 2021. Information request about the HPV vaccination coverage in Estonia in 2020.
Fries, C. J. 2009. Bourdieu’s reflexive sociology as a theoretical basis for mixed methods research: An application to complementary and alternative medicine. J. Mix. Methods Res., 3(4).
https://doi.org/10.1177/1558689809336660
Håkansson Eklund, J., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J. et al. 2019. “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Educ. Couns., 102(1), 3–11.
https://doi.org/10.1016/J.PEC.2018.08.029
Health Foundation (Great Britain). 2014. Person-centred care made simple: what everyone should know about person-centred care.
https://www.health.org.uk/publications/person-centred-care-made-simple (accessed 2022-08-03).
Johnson-Mallard, V., Darville, G., Mercado, R., Anderson-Lewis, C. and MacInnes, J. 2019. How health care providers can use digital health technologies to inform human papillomavirus (HPV) decision making and promote the HPV vaccine uptake among adolescents and young adults. BioResearch Open Access, 8(1), 84–93.
https://doi.org/10.1089/biores.2018.0051
Kala, L. and Torop, A. 2022. Ämmaemandate ja õdede enesehinnanguline teadlikkus ning arvamused HPV ja HPV- vastase vaktsineerimise osas Eestis (Self-rated knowledge and opinions of midwives and nurses regarding HPV and HPV vaccination in Estonia). Diploma thesis. Tallinn Health Care College, Estonia.
http://dspace.ttk.ee:8080/xmlui/bitstream/handle/123456789/177/Ä5_Kala_Torop.pdf?sequence=1&isAllowed=y
(in Estonian) (accessed 2023-03-27).
Kamolratanakul, S. and Pitisuttithum, P. 2021. Human papillomavirus vaccine efficacy and effectiveness against cancer. Vaccines, 9(12).
https://doi.org/10.3390/vaccines9121413
Lubi, K., Vihalemm, T., Krikmann, Ü., Paju, T. and Taba, P. 2013. “There is no need to tell me too much”: chronically ill patients’ strategies of controlling information inflow. Int. J. Commun. Health, 1, 24–30.
Lubi, K., Vihalemm, T. and Taba, P. 2014. Illness-related information seeking: The case of Parkinson’s disease patients. In Advances in Education Research(Lee, G., ed.). Information Engineering Research Institute, Newark, DE, 98–111.
Lubi, K., Vihalemm, T. and Taba, P. 2016. Patients’ interpretations of CAM-related information: Manoeuvring between patient and consumer positionings. In The Power of the Media in Health Communication (Marinescu, V. and Mitu, B., eds). Routledge, Abingdon, Oxfordshire.
https://doi.org/10.4324/9781315554068
Lupton, D. 2012. Medicine as Culture: Illness, Disease and the Body. 3rd ed. SAGE Publications Ltd, London.
https://doi.org/10.4135/9781446254530
Ministry of Social Affairs. 2021. Rahvastiku tervise arengukava 2020–2030. (Public Health Development Plan 2020–2030).
https://www.sm.ee/rahvastiku-tervise-arengukava-2020-2030 (in Estonian) (accessed 2022-08-03).
Ministry of Social Affairs and National Institute for Health Development. 2021. Vähitõrje tegevuskava 2021–2030 (Cancer Control Action Plan 2021–2030).
https://tai.ee/sites/default/files/2021-05/V%C3%A4hit%C3%B5rje_tegevuskava_2021%E2%80%932030.pdf
(in Estonian) (accessed 2022-08-03).
Nettleton, S. 2013. The Sociology of Health and Illness. 3rd ed. Polity Press, Cambridge.
Rittel, H. W. J. and Webber, M. M. 1973. Dilemmas in a general theory of planning. Policy Sci., 4(2), 155–169.
http://www.jstor.org/stable/4531523 (accessed 2022-08-03).
https://doi.org/10.1007/BF01405730
Rooden, M. 2022. Arendusprojekt „Kooliõdedele suunatud emakakaelavähi ennetamise ja HPV- vaktsineerimise alase koolituskava“ loomine (Development project “Creation of a training plan for cervical cancer prevention and HPV vaccination aimed at school nurses”). Master’s thesis. Tallinn Health Care College, Estonia.
http://194.126.99.106:8080/bitstream/handle/123456789/173/Mag2_Rooden.pdf?sequence=27&isAllowed=y (in Estonian) (accessed 2023-03-27).
Sherman, S. M., Bartholomew, K., Denison, H. J., Patel, H., Moss, E. L., Douwes, J. et al. 2018. Knowledge, attitudes and awareness of the human papillomavirus among health professionals in New Zealand. PLoS ONE, 13(12).
https://doi.org/10.1371/journal.pone.0197648
Trucchi, C., Restivo, V., Amicizia, D., Fortunato, F., Manca, A., Martinelli, D. et al. 2020. Italian health care workers’ knowledge, attitudes, and practices regarding human papillomavirus infection and prevention. Int. J. Environ. Res. Public Health, 17(15), 5278.
https://doi.org/10.3390/ijerph17155278
Varsamaa, M. 2021. Preventing cervical cancer: the potential of digital interventions in supporting parents’ decision-making for human papillomavirus vaccination (Emakakaelavähi ennetamine: digilahenduste võimekus toetada lapsevanemate vaktsineerimisotsuse kujunemist inimese papilloomviiruse vastasel vaktsineerimisel). Master’s thesis. Tallinn University of Technology, Estonia.
https://digikogu.taltech.ee/et/Item/8a1b9695-d91c-44af-a5c7-33d0c7afbcfc (in Estonian) (accessed 2023-03-27).
Vihalemm, T., Keller, M. and Kiisel, M. 2015. From Intervention to Social Change: A Guide to Reshaping Everyday. Routledge, London.
https://doi.org/10.4324/9781315583396
Waller, J., Forster, A., Ryan, M., Richards, R., Bedford, H. and Marlow, L. 2020. Decision-making about HPV vaccination in parents of boys and girls: A population-based survey in England and Wales. Vaccine, 38(5), 1040–1047.
https://doi.org/10.1016/j.vaccine.2019.11.046