Massah Omid, Effatpanah Mohammad, Moradi Afsaneh, Salehi Mohammad, Farhoudian Ali, Karami Zahra
PhD Student, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Psychiatrist, Assistant Professor, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran , Iran.
Addict Health. 2017 Fall;9(4):229-236.
Untreated Hepatitis C Virus (HCV) has been reported among many Iranian female methadone patients. However, few of them report receiving HCV treatment. The present study is the first research from western Asia that explored the barriers to receiving HCV treatment among a group of Iranian female HCV-infected methadone patients.
This qualitative study was conducted in four main methadone treatment clinics in Tehran, Iran, in November 2016. Overall, fifty-six untreated HCV-infected women and eight clinicians from HCV and methadone treatment services were interviewed. Women either had not received HCV treatment or received HCV treatment but left it. Data were analyzed using NVivo software. This was based on the grounded theory of Strauss and Corbin.
Barriers to receiving HCV treatment included factors related to individuals and factors related to the system. Individual factors included the perception that untreated HCV infection was not a serious health concern, family responsibilities, and self-perceived discrimination against HCV-infected women. System-related factors included the lack of referral from methadone treatment staff, and a long distance between HCV treatment centers and methadone treatment centers. Interviews with the health professionals also confirmed the women' self-reports.
The results of this research confirm the necessity of providing HCV education and the delivery of comprehensive care for this group in methadone treatment clinics. Other services such as staff education and HCV treatment services at methadone treatment centers are suggested.
在许多伊朗女性美沙酮患者中已报告存在未经治疗的丙型肝炎病毒(HCV)感染情况。然而,其中很少有人报告接受过HCV治疗。本研究是西亚地区第一项探讨一组感染HCV的伊朗女性美沙酮患者接受HCV治疗障碍的研究。
这项定性研究于2016年11月在伊朗德黑兰的四个主要美沙酮治疗诊所进行。总共采访了56名未经治疗的HCV感染女性以及来自HCV和美沙酮治疗服务机构的8名临床医生。这些女性要么未接受过HCV治疗,要么接受过HCV治疗但中途放弃。使用NVivo软件对数据进行分析。这是基于施特劳斯和科尔宾的扎根理论。
接受HCV治疗的障碍包括个人因素和系统因素。个人因素包括认为未经治疗的HCV感染并非严重的健康问题、家庭责任以及自我感觉对HCV感染女性存在歧视。系统相关因素包括美沙酮治疗工作人员未进行转诊,以及HCV治疗中心与美沙酮治疗中心之间距离较远。对卫生专业人员的访谈也证实了这些女性的自我报告。
本研究结果证实有必要在美沙酮治疗诊所为该群体提供HCV教育并提供全面护理。建议开展其他服务,如工作人员培训以及在美沙酮治疗中心提供HCV治疗服务。