Restricted accessResearch articleFirst published online 2026-1
Role of Illness Perception in Explanation of Influenza Vaccination Intention and Behavior in Patients With Cardiovascular Disease: A Cross-Sectional Survey
To investigate the impact of illness perception and its three measures on vaccination in patients with cardiovascular disease (CVD), and the importance of each influencing factor.
Design
A cross-sectional survey.
Setting
This study was conducted in two large comprehensive medical institutions in Jiangsu Province, China.
Sample
602 eligible patients with CVD were recruited from cardiovascular departments.
Measures
A self-administered questionnaire with feasible reliability and validity was used to investigate the demographic characteristics and illness perception.
Analysis
Binary logistic regression analyses were performed using intention (total population) and behavior (willing population) as dependent variables and illness perception and its three measures as independent variables. Furthermore, the importance of the variables was ranked using a random forest model.
Results
Illness perception in patients with CVD negatively influences vaccination intention (OR = 0.560, 95%CI: 0.496.0.633, P < 0.001) and actual vaccination behavior (OR = 0.780, 95%CI: 0.675, 0.900, P < 0.001). In the order of importance of the influencing factors, illness perception was dominant. Among the specific measures of illness perception, cognitive response and emotional response were more important than illness comprehensibility.
Conclusions
This study identified a negative association between illness perception (across all three measures and both influenza vaccination intention and behavior. Assessing the level of illness perception in patients can help identify those who are reluctant to receive the vaccine. The association between illness perception and vaccine hesitancy should be considered when developing future intervention strategies for influenza vaccine hesitancy in patients with CVD.
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