Date of Award

1995

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Bachelor of Nursing Honours

Faculty

Faculty of Health and Human Sciences

First Supervisor

Dr Particia Percival

Second Supervisor

Dr Rob Condon

Abstract

In two separate complementary exploratory descriptive studies the cover and timing of vaccine administration to children in the 0-18 month age group in the remote Kimberley Region of Western Australia were quantified, and reasons for delay in vaccine administration were investigated. The adapted PRECEDE model was used to guide the research and to integrate and interpret the findings. Study One: Three separate computer immunisation databases were combined to provide the first validated age-appropriate infant immunisation data in Western Australia. For the first time in WA, the timing of administration of vaccines was investigated, and for the first time in Australia, the timing of vaccine administration to children in different racial groups was investigated. During the first six months of life the overall cover and timing of vaccine administration for the total population appeared to be satisfactory. However, at 12 and 18 months of age, the overall cover decreased and delay increased. The overall vaccine cover for Aboriginal children was significantly lower than that of all other racial groups; and a higher percentage of Aboriginal children experienced delay in administration of all vaccines, at all ages. Study Two: Using a questionnaire to gather data, reasons for delay in vaccine administration were sought from the Kimberley community nurses. The respondents suggested two major reasons for delay: the poor general health of the children and the mobility of the Aboriginal population. The findings indicated that, although limited on-going immunisation education was reported, the community nurses were knowledgeable of childhood immunisation, and administered vaccines to "at-risk" Aboriginal children appropriately. The findings of both studies suggest that, in some areas of the Kimberley Region, the numbers of community nurses were not adequate to cope with a highly mobile client population with multiple health problems. There is an urgent need for: investigation of staffing levels in community health in the Kimberley; the increased involvement of other health agencies in childhood immunisation; as well as culturally-appropriate Research to provide data from Aboriginal health-workers and Aboriginal parents and care-givers on immunisation delay in children in the 0-18 month age group.

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