READ- With new information continually emerging, professional nurses must be equipped to critique scholarly literature and discern its value for practice. “A systematic review of studies that
measure parental vaccine attitudes and beliefs in childhood vaccination” is a quantitative scholarly nursing article related to my PICOT question. Throughout this article, I have determined its strengths, limitations, and potential application.

The purpose of this article is to show the examination of how parental attitudes and beliefs towards childhood vaccinations are measured in questionnaires through a systematic review of the literature. The research design used is of a descriptive nature. The data for this quantitative study was collected by means of a key bibliographic database to search got relevant articles. The information from the article includes the method of recruitment and the location and type of participants, the number of participants recruited as well as the number of whom which completed the study, the vaccine or set of vaccines of relevance to the study, and details of the questions used to measure attitudes and beliefs about vaccination including any description of behavioral theories used to inform the questionnaire design, and whether the questions were taken directly or adapted from existing instruments. The titles, abstracts, or executive summaries found through the search strategy were screened independently by two authors to determine if they were relevant to the review. The full text of those articles that appeared to meet the inclusion criteria were retrieved and reviewed for relevance independently
by the same two authors. The reference lists of all included items were searched to identify any additional items for inclusion. The search was limited to key words and between specific dates to keep all results recent and relevant. Data extracted from each study was grouped by study type and study characteristics including sample size, recruitment method, and location. The initial search strategy returned 41,570 titles and abstracts. Out of the beginning number of 41,570, only 116 met the inclusion criteria and were used for the official study. Sample sizes
across all 116 included studies ranged from 49 to 12,259 participants. Parental attitudes and beliefs about childhood vaccines in general were studied. Thirty-four countries were represented in the included studies, with the most common country being the United States.

The quantitative study concludes that perceptions of susceptibility, severity, benefit and barriers, cues to action and self-efficacy are all concerns for parents. A strength of this study is in the results. Practitioners must understand the WHY behind vaccination hesitancy or refusal in order to improve upon them. The results conclude that there is hesitancy and refusal due to the general concerns of parents. There were several limitations to the review approach
and conduct. The first limitation was that the geographical distribution of the studies. Some of the studies were not in the appropriate language needed in order for the subject to understand and answer the questionnaire correctly. Also, parental beliefs and attitudes towards influenza vaccination often differ from routine childhood vaccinations. For parents who are hesitant on the influenza vaccine, but not necessarily all other vaccinations, they may have answered based off of their concerns on the influenza vaccine and not been specific, grouping all vaccinations with their influenza shot hesitancy.

Although the article does not directly offer recommendations regarding potential application for future practice, one can conclude from the results that practitioners must allow an opportunity for parents to express their concerns, and providing guidance and answers to their concerns or questions. Knowledge is power. Practitioners must provide the information needed to parents on vaccination safety and their necessity in order for the parents to feel empowered in making the best, safest choices for their children.

INSTRCUTIONS- Add substantive dialogue that is collaborative in nature. Asks questions, offers new insights, applications, perspectives, information, or implications for practice. use clear and concise language in an organized manner following rules of English grammar, spelling, syntax, and punctuation. 1 paragraph