Table 4 Determinants of the professional influencing the discussion of the decision-making process

1

Religion

1a

Orthodox Protestant

Especially when I show them that I know these denominations, they tell more about their deliberations. I think they tell me a lot more than most of my colleagues. (R5, CHC doctor)

They know that I’m a confessor of one of the orthodox Protestant denominations, therefore they come to me with their questions. I can easily go into it, because I feel what the problem is.(R18, GP)

1b

Protestant

They are not talking to someone who knows nothing about it. They have the idea that I can place myself in their shoes and know the terminology. (R1, CHC doctor)

I show them that I’m interested in their background, and I tell them about my Protestant background. Not orthodox, but just Protestant. That makes a difference, they expect that I will understand them. And that’s why they tell me about their considerations. (R4, CHC doctor)

1 c

Other or no religion

Sometimes I ask them: “What is it, that is written in the Bible?” And then I get a phrase that I don’t understand at all. (R12, CHC nurse)

2

Attitude towards parents with religious objections

I don’t have any affinity with their religion. At that moment [during the polio-epidemic] I couldn’t imagine that you refused to have your children vaccinated. I rather got angry than that I tried to understand it. I still don’t understand it, or maybe I don’t want to understand it, that’s also possible. (R17, GP)

The moral dilemma, I can’t relate to that. It is something that doesn’t play a role on my part at all….I can only indicate what we vaccinate for; they have to fight the moral battle themselves. (R8,CHC nurse)

There are always people who don’t accept it. That’s their philosophy of life, and I resigned to it, through the years. It’s their way of thinking and you have to respect it. (R 21, GP)

I find it interesting to learn about their arguments, to talk about it. (R1, CHC doctor)

My approach is to go along with them, I know why they didn’t have their children vaccinated, at least I think I know, and from that point of view I reason why this specific vaccination would be necessary, or not.(R14, GP)

3

Communication skills

This isn’t part of providing sound medical information […]You certainly feel that you would like to do something more, but you don’t know what form to give this. (R6, CHC doctor)

I’m glad if I am able to discuss the subject and get to know why parents decide to vaccinate their children. But I don’t find out why they refuse. That is more difficult. (R4, CHC doctor)