Polis Suzanne, Zablotska-Manos Iryna, Zekry Amany, Maher Lisa
Suzanne Polis, MPH (research), BN, RN, is Senior Research Fellow (Nursing), Nursing Research & Practice Development Unit, The Sydney Children's Hospitals Network, Randwick New South Wales, Australia. Iryna Zablotska-Manos, PhD, BSc, is Senior Lecturer, The Kirby Institute, UNSW Australia, Wallace Wurth Building, Sydney NSW, Australia. Amany Zekry, PhD, MBBS, is Associate Professor and Hepatologist, St George Hospital, Department of Gastroenterology, Kogarah, New South Wales, Australia, and St George Hospital Clinical School of Medicine, UNSW, Australia. Lisa Maher, PhD, is Professor and Program Head and NHMRC Senior Research Fellow, Viral Hepatitis Epidemiology and Prevention Program Kirby Institute, UNSW Australia, Wallace Wurth Building, Sydney New South Wales, Australia.
Gastroenterol Nurs. 2017 May/Jun;40(3):239-246. doi: 10.1097/SGA.0000000000000161.
Hepatitis B virus (HBV) antiviral therapies potentially suppress HBV viral load to an undetectable level reducing the risk of progressive liver disease and the development of HBV-related hepatocellular carcinoma. Adherence to antiviral therapies is imperative to achieve and maintain viral suppression. To date, there has been limited research on adherence to HBV therapies. Our study aimed to explore factors influencing adherence to antiviral therapy. A total of 29 participants consented to in-depth qualitative interviews at three outpatient clinics in Sydney, New South Wales, Australia. Interviews were digitally recorded and transcribed. Transcripts were initially classified as adherent or nonadherent and thematic analysis was used to identify dominant themes. Adherent behavior was reported by 59% (n = 17) of participants. Several themes influenced adherence including routine, fear of HBV-related disease progression, clinician-patient communication, treatment knowledge, and forgetfulness. To our knowledge, this is the first qualitative study to explore adherence to HBV antiviral therapy. An interplay of several dominant themes emerged from our data including fear of chronic HBV disease progression, clinician-patient communication, treatment knowledge, routine, and forgetfulness. Study findings have the potential to change nursing clinical practice, especially the way nurses and other clinicians target key HBV treatment messages and education, while monitoring adherence.
乙型肝炎病毒（HBV）抗病毒疗法有可能将HBV病毒载量抑制到检测不到的水平，从而降低进展性肝病的风险以及HBV相关肝细胞癌的发生风险。坚持抗病毒治疗对于实现并维持病毒抑制至关重要。迄今为止，关于HBV治疗依从性的研究有限。我们的研究旨在探讨影响抗病毒治疗依从性的因素。共有29名参与者同意在澳大利亚新南威尔士州悉尼的三家门诊诊所接受深入的定性访谈。访谈进行了数字录音和转录。转录本最初被分类为依从或不依从，并采用主题分析来确定主要主题。59%（n = 17）的参与者报告有依从行为。几个主题影响了依从性，包括日常生活习惯、对HBV相关疾病进展的恐惧、医患沟通、治疗知识以及遗忘。据我们所知，这是第一项探讨HBV抗病毒治疗依从性的定性研究。我们的数据中出现了几个主要主题的相互作用，包括对慢性HBV疾病进展的恐惧、医患沟通、治疗知识、日常生活习惯以及遗忘。研究结果有可能改变护理临床实践，特别是护士和其他临床医生在监测依从性时传达关键HBV治疗信息和进行教育的方式。
