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规范的患者教育可提高弱势群体对丙型肝炎的认知。

Formal patient education improves patient knowledge of hepatitis C in vulnerable populations.

机构信息

Department of Medicine, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110, USA.

出版信息

Dig Dis Sci. 2011 Jan;56(1):213-9. doi: 10.1007/s10620-010-1455-3. Epub 2010 Oct 24.

Abstract

BACKGROUND

Hepatitis C (HCV) knowledge is limited in injection drug users (IDU). Vulnerable populations including IDUs are disproportionally affected by HCV. Effective HCV education can potentially reduce disparity in HCV prevalence and its outcome in this population.

AIM

This study aimed to assess the impact of formal HCV education and factors associated with improved HCV knowledge in the vulnerable population.

METHODS

Over 18 months, 201 HCV-infected patients underwent a 2-h standardized education and completed demographic and pre- and post-education questionnaires.

RESULTS

Patient characteristics were: 69% male, mean age 49±10, 49% White (26% AA, 10% Latino), 75% unemployed, 83% high school education and above, 64% were IDU, and 7% were HIV co-infected. On multivariate analysis, baseline knowledge scores were higher in patients with at least a high school education (coef 7.1, p=0.045). Baseline knowledge scores were lower in African Americans (coef -12.3, p=0.004) and older patients (coef -0.7, p=0.03). Following HCV education, the overall test scores improved significantly by 14% (p=0.0001) specifically in the areas of HCV transmission (p=0.003), general knowledge (p=0.02), and health care maintenance (p=0.004). There was a high compliance with liver specialty clinic attendance following education.

CONCLUSIONS

Formal HCV education is effective in improving HCV knowledge. Although White race, younger age, and higher education were predictors of having more HCV knowledge prior to education, all patients independent of racial background had a significant improvement in their knowledge after education. Therefore, promoting effective HCV education among vulnerable populations may be an important factor in reducing the disparities in HCV disease.

摘要

背景

丙型肝炎(HCV)知识在注射吸毒者(IDU)中有限。弱势群体,包括 IDU,不成比例地受到 HCV 的影响。有效的 HCV 教育可能会减少该人群中 HCV 流行率及其结果的差异。

目的

本研究旨在评估正规 HCV 教育的影响以及与脆弱人群 HCV 知识提高相关的因素。

方法

在 18 个月的时间里,201 名 HCV 感染患者接受了 2 小时的标准化教育,并完成了人口统计学、教育前后问卷。

结果

患者特征为:69%为男性,平均年龄 49±10,49%为白人(26%为非裔美国人,10%为拉丁裔),75%失业,83%具有高中以上学历,64%为 IDU,7%为 HIV 合并感染。多元分析显示,基线知识评分在至少具有高中以上学历的患者中较高(系数 7.1,p=0.045)。非裔美国人(系数-12.3,p=0.004)和年龄较大的患者(系数-0.7,p=0.03)的基线知识评分较低。接受 HCV 教育后,总体测试分数显著提高了 14%(p=0.0001),特别是在 HCV 传播(p=0.003)、一般知识(p=0.02)和医疗保健维护(p=0.004)领域。教育后,肝脏专科诊所的就诊率很高。

结论

正规 HCV 教育可有效提高 HCV 知识。尽管白种人、年轻和高教育程度是教育前 HCV 知识较多的预测因素,但所有患者,无论种族背景如何,在教育后知识水平均有显著提高。因此,在弱势群体中推广有效的 HCV 教育可能是减少 HCV 疾病差异的一个重要因素。

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