Department of Medicine, University of Texas Health San Antonio (UT Health San Antonio), San Antonio, TX, USA.
Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA.
J Clin Nurs. 2017 Dec;26(23-24):4605-4612. doi: 10.1111/jocn.13806. Epub 2017 May 23.
To identify support needs of low-income baby boomers recently diagnosed with chronic hepatitis C virus infection.
The U.S. Preventive Services Task Force has endorsed one-time screening of all baby boomers (born 1945-1965) for hepatitis C because 75% of the estimated 2-3 million persons with chronic infection are in this age range. We hypothesised that persons diagnosed by routine screening would have significant psycho-emotional, cognitive and healthcare challenges that need to be met by collaborative care and services from nurses and other healthcare personnel.
Qualitative descriptive study of data from three focus groups with predominantly minority participants (N = 16). Data were analysed using qualitative content analysis, and transcribed data were categorised by three domains in a previously developed model and a new domain identified in this study. Frequencies of unique participants' comments about each theme were calculated.
Elucidated domains were as follows: (i) psycho-emotional effects due to social stigma, shame, fear and dealing with risky behaviours; (ii) social effects due to concerns about infecting others; and (iii) cognitive deficits because of poor understanding about hepatitis C virus infection and its care. A new domain related to health care emerged reflecting the following themes: poor access to care, barriers to costly treatment, and navigating complex care for comorbidities. Despite these challenges, participants strongly endorsed universal baby boomer hepatitis C virus screening.
This study describes psycho-emotional and social challenges of people dealing with a hepatitis C diagnosis which are compounded by poor knowledge and barriers to supportive care.
Nursing and other allied health personnel require structured support programmes to assist older persons diagnosed with hepatitis C with addressing these common challenges with the ultimate goal of achieving a cure.
确定最近被诊断患有慢性丙型肝炎病毒感染的低收入婴儿潮一代的支持需求。
美国预防服务工作组已批准对所有婴儿潮一代(1945-1965 年出生)进行一次性丙型肝炎筛查,因为估计有 200 万至 300 万慢性感染者中有 75%在这个年龄段。我们假设通过常规筛查诊断出的患者将面临重大的心理-情感、认知和医疗保健挑战,需要通过护士和其他医疗保健人员的协作护理和服务来满足。
对来自三个以少数族裔参与者为主的焦点小组(N=16)的数据进行定性描述性研究。使用定性内容分析对数据进行分析,并根据之前开发的模型和本研究中确定的一个新模型对转录数据进行分类。计算了每个主题中独特参与者评论的频率。
阐明的领域如下:(i)由于社会耻辱感、羞耻感、恐惧和处理危险行为而产生的心理-情感影响;(ii)由于担心感染他人而产生的社会影响;以及(iii)由于对丙型肝炎病毒感染及其护理的理解能力差而导致的认知缺陷。出现了一个与医疗保健相关的新领域,反映了以下主题:难以获得医疗服务、昂贵治疗的障碍以及为合并症进行复杂的医疗护理。尽管存在这些挑战,但参与者强烈支持对所有婴儿潮一代进行丙型肝炎病毒筛查。
本研究描述了患有丙型肝炎病毒感染的人在处理诊断结果时面临的心理-情感和社会挑战,这些挑战因知识不足和支持性护理的障碍而更加复杂。
护理和其他相关医疗保健人员需要结构化的支持计划,以帮助被诊断患有丙型肝炎的老年人应对这些常见挑战,最终实现治愈。