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Knowledge, attitudes, risk perception of influenza and influenza vaccination among final year nursing students in Singapore: an exploratory study


In Singapore, Influenza causes about 600 deaths (out of 15,000) affecting people who are over 65 years old ('Ministry of Health: FAQs', 2014). Influenza vaccination benefits health-care workers (HCWs) and reduces influenza-related morbidity and mortality in high-risk patients. However, only 25% of student nurses have reported having received seasonal or H1N1 vaccination [1].


To explore the relationship among final year nursing students’ knowledge, risk perception, health beliefs and their influenza vaccination behaviours and uptake in Singapore.

Study design

This study utilised a non-experimental, cross-sectional exploratory quantitative study design.


Convenience sampling was used to recruit 868 final year nursing students in Singapore from October 2013 to January 2014. Two survey forms were used to collect data: (i) Participants’ Demographic Information sheet and (ii) King’s Nurses Influenza Vaccination Questionnaire (KNIVQ).


Student nurses’ vaccination rates were 15.7% for Seasonal Influenza vaccine and 5.4% for Influenza A (H1N1) vaccine. Findings revealed a relationship between vaccination uptake rates and knowledge and risk perception and student nurses’ perceived health locus of control (p<0.05). The results also described the different level of student nurses’ vaccination behaviours and their vaccination recommendation to patients. Vaccinated student nurses were also more likely to recommend the Influenza vaccine to their patients in the future.


The findings provide valuable input enabling policy makers develop measures to improve influenza vaccination awareness and take-up rates among students, encouraging them to be patient advocates regarding importance of influenza vaccination for health prevention and promotion.

Disclosure of interest

None declared.


  1. Hunt C, Arthur A: Student nurses' reasons behind the decision to receive or decline influenza vaccine: a cross-sectional survey. Vaccine. 2012, 30 (40): 5824-5829. 10.1016/j.vaccine.2012.07.027.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Leong, R. Knowledge, attitudes, risk perception of influenza and influenza vaccination among final year nursing students in Singapore: an exploratory study. Antimicrob Resist Infect Control 4 (Suppl 1), P19 (2015).

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