Background: Vaccine hesitancy (VH) and vaccine refusal are increasing globally, posing a significant challenge to public health. This study aimed to evaluate VH and associated factors in parents of children with different chronic conditions, comparing them to a control group of healthy children. Methods: This cross-sectional study included mothers of children aged 6 to 12 years, diagnosed with Autism Spectrum Disorder (ASD), attention deficit hyperactivity disorder (ADHD), type 1 diabetes mellitus (T1DM), congenital heart disease (CHD), congenital hypothyroidism (CH) and Familial Mediterranean Fever (FMF) and healthy children without chronic diseases. The study collected sociodemographic data, and parents completed the Parent Attitudes about Childhood Vaccines (PACV) survey and the Parental Attitude Research Instrument (PARI). Vaccine hesitancy was defined as a PACV score ≥ 50. Results: A total of 1163 participants were included, consisting of 546 children with chronic conditions. The overall VH rate was %14.7. Compared to control group, parents of children with T1DM had 3.3 times higher odds of VH, and parents of children with ASD had 1.8 times higher odds of VH. However, parents of children with CHD had lower odds of VH [OR: 0.38 (95% CI: 0.15–0.97)]. The most common reasons for VH were concerns about vaccine ingredients (40.2%) and fear of adverse events (22.5%). The primary suggested solution was receiving more information from healthcare professionals (33.3%). Factors such as having a child with a chronic condition, personal experience with vaccine adverse events, and reliance on the internet for vaccine information were associated with increased VH, whereas obtaining information from healthcare professionals was linked to lower VH. Higher parental democratic attitudes were associated with lower VH, while increased marital conflict was linked to higher VH. Conclusion: Addressing both informational gaps and psychosocial factors, such as marital conflict and democratic parenting attitudes, can enhance vaccine acceptance. Healthcare professionals should provide personalized guidance and resources to empower parents, enabling them to make informed vaccination decisions for high-risk groups such as children with chronic conditions.

Vaccination is the cheapest, safest, and most successful public health approach to protect children's health and prevent infectious diseases. High vaccination rates ensure community immunity and prevent epidemics. A drop in immunization rates below 95% can lead to outbreaks of vaccine-preventable diseases, particularly measles, as well as increased morbidity and mortality. With the recent emergence of vaccine hesitancy (VH) and vaccine refusal (VR) concepts, especially in developed countries, the number of unvaccinated children is increasing both in our country and around the world. Vaccine hesitancy stems from many personal and environmental reasons, as well as sociocultural, environmental, economic, and political reasons. Lack of information about vaccines, fear of side effects, concerns about vaccine efficacy and safety, the idea that vaccines are harmful, anti-vaccine publications on the internet and social media, belief in natural immunity, and religious reasons are seen as the most common reasons for VH and VR in different studies. Raising awareness in society about the importance and necessity of vaccination, identifying the factors that lead to VH, and producing solutions are among the primary measures to be taken. Healthcare personnel play a very important role in the fight against vaccine hesitancy. It is important to establish good, effective, and trusting communication with vaccine-hesitant parents. Recently, in addition to vaccine refusal cases, the number of families refusing vitamin K and heel blood sampling has been increasing. Vaccine refusal, and refusal of health care services will increase neonatal and childhood morbidity and mortality. Legal measures should be taken to protect the best interests of the child. Valid and reliable scales that evaluate parents' vaccine acceptance and hesitancy will be a source of information in the fight against vaccine hesitancy.

This research study aimed to assess the reliability and validity of the Turkish version of the Vaccine Acceptance Instrument (VAI). The VAI is a 20-item Likert-type scale, with responses ranging across seven points. A systematic approach was followed to translate the scale into Turkish, involving translation, expert panel evaluation, back-translation, and pilot testing. The Vaccine Acceptance Instrument and a sociodemographic data form were used for data collection. The reliability of the scale was tested by test–retest analysis, and its internal reliability was examined by Cronbach’s alpha test. The factor structure was examined using Exploratory Factor Analysis (EFA). Confirmatory Factor Analysis (CFA) was employed to assess the scale’s fit. Overall, 229 participants were included in the study. In test–retest reliability analysis, the intraclass correlation coefficient of the scale was 0.992 (95% CI: 0.987–0.996). The Cronbach’s alpha value of the scale was 0.824. A four-factor structure was determined. The model had an acceptable fit [χ²/df = 380.04/164 (2,317) p < 0.001, CFI = 0.91, GFI = 0.90, AGFI = 0.906, NFI = 0.90, RMSEA = 0.076]. The mean total VAI score was 112.71 ± 17.02. The low education level of the mother, being a housewife, and parents not having the COVID-19 vaccine were statistically significantly associated with a low scale score and low vaccine acceptance (p < 0.05). The Turkish adaptation of the VAI demonstrated satisfactory levels of validity and reliability following rigorous testing.

Objective. Management of type 1 diabetes (T1DM) is quite challenging for both adolescents and their families. In this study, we aimed to translate the 14-item Problem Areas in Diabetes-Teen (PAID-T) scale, which measures variables that influence diabetes distress, to Turkish and investigate the Turkish version’s reliability and validity. Methods. One hundred and ninety-four adolescents with T1DM participated in the study. PAID-T and forms for sociodemographic and diabetes characteristics were used for data collection. The scale’s content validity was checked using the Davis technique. Cronbach’s α was used to analyze the scale’s internal reliability and the test-retest for the scale’s reliability. Exploratory factor analysis (EFA) was utilized to examine the factor structure. The fit of the scale was assessed using confirmatory factor analysis (CFA). Results. Of the participants, 54.6% (n=106) were girls. The content validity index values of the scale items ranged between 0.86 and 1.0. The PAID-T scores of girls and boys were similar. No significant difference was found between PAID-T scores with sociodemographic data and diabetes characteristics (p>0.05). The test-retest correlation coefficient of the scale was found to be 0.952. The three-factor (emotional burden, family and friend distress, and regimen-specific distress) model identified in EFA explained 61.8% of the common variance. Fit analysis was performed using CFA for the three-factor model, which did not show adequate fit (x2/df = 2.402, GFI = 0.822, CFI = 0.815, NFI = 0.727, NNFI = 0.772, RMSEA = 0.118). The Cronbach α value of the scale was 0.864. Conclusion. The Turkish version of the 14-item PAID-T showed moderate validity and strong reliability. Accordingly, it can be used as a reliable measurement tool to assess diabetes stress in adolescents with T1DM.

Objective: The aim of this study was to evaluate the validity and reliability of the Turkish translation of the Parent Diabetes Distress Scale (PDDS). Methods: The PDDS is a 5-point Likert-type scale with 20 items. After obtaining permission from the scale developers, the study commenced. First, a systematic adaptation of the scale into the Turkish language was performed including translation, expert panel review, back translation, and pilot study. Test-retest was applied to 35 participants. After these procedures, data collection was undertaken using the adapted PDDS and a demographic data collection form. The collected data were analyzed for reliability, including stability of the scale with test-retest and internal consistency of the scale (Cronbach's alpha), and validity including construct validity of the scale with confirmatory factor analysis (CFA). Results: The parents of 210 teenagers, aged >11 and <18 years, who had been diagnosed with type 1 diabetes mellitus for at least one year were included. Of these parents, 71.9% (n=151) were mothers and 53.3% (n=112) of the children were girls. The Cronbach's a value was 0.906. The results of the CFA were.2/df=4.406, p2.4 points as "high distress". This showed that the majority of the parents in the study experienced moderate or severe diabetes-related distress. Conclusion: The Turkish version of the PDDS fulfilled the validity and reliability tests at an acceptable level.