Burnet Institute, Melbourne, VIC, 3004, Australia.
La Trobe University, Bundoora, VIC, 3086, Australia.
BMC Public Health. 2022 Mar 18;22(1):536. doi: 10.1186/s12889-022-12907-5.
Hepatitis B is a chronic viral infection, a leading cause of primary liver cancer and identified as a major public health priority by the World Health Organization. Despite a high proportion of people in Australia who have been diagnosed with hepatitis B, significant gaps remain in health care access and in accurate knowledge about hepatitis B. Most people with hepatitis B in Australia were born in China, where the infection has an intergenerational impact with significant social implications resulting from the infection. Understanding how people of Chinese ethnicity with hepatitis B understand and respond to hepatitis B is imperative for reducing morbidity, mortality, and the personal and social impact of the infection.
Qualitative semi-structured interviews with people with hepatitis B of Chinese ethnicity recruited through a specialist service identified the advice people with hepatitis B thought was important enough to inform the experience of people newly diagnosed with hepatitis B. A thematic analysis of the data privileged the lived experience of participants and their personal, rather than clinical, explanations of the virus.
Hepatitis B infection had psychological and physical consequences that were informed by cultural norms, and to which people had responded to with significant behavioural change. Despite this cohort being engaged with specialist clinical services with access to the most recent, comprehensive, and expert information, much of the advice people with hepatitis B identified as important for living with hepatitis B was not based on biomedical understandings. Key suggestions from people with hepatitis B were to form sustainable clinical relationships, develop emotional resilience, make dietary changes, regulate energy, and issues related to disclosure.
The study highlights conflicts between biomedical and public health explanations and the lived experience of hepatitis B among people of Chinese ethnicity in Australia. Beliefs about hepatitis B are embedded within cultural understandings of health that can conflict with bio-medical explanations of the infection. Acknowledging these perspectives provides for insightful communication between health services and their clients, and the development of nuanced models of care informed by the experience of people with hepatitis B.
乙型肝炎是一种慢性病毒感染，是原发性肝癌的主要病因，也是世界卫生组织确定的主要公共卫生重点之一。尽管澳大利亚有很大一部分人被诊断出患有乙型肝炎，但在获得医疗保健方面仍存在显著差距，而且对乙型肝炎的准确认识也存在差距。澳大利亚大多数乙型肝炎患者都出生在中国，在中国，乙型肝炎具有代际影响，感染会产生重大的社会影响。了解乙型肝炎的华裔人群如何理解和应对乙型肝炎，对于降低发病率、死亡率以及感染的个人和社会影响至关重要。
通过专门服务机构招募乙型肝炎的华裔患者进行定性半结构式访谈，确定他们认为对新诊断出乙型肝炎的患者有重要指导意义的建议。对数据进行主题分析，优先考虑参与者的生活经历以及他们对病毒的个人而非临床解释。
乙型肝炎感染会产生心理和生理后果，这些后果受到文化规范的影响，患者会对此做出重大的行为改变。尽管这一人群参与了专门的临床服务，可以获得最新、最全面和最专业的信息，但他们认为对乙型肝炎患者很重要的建议并不基于生物医学的理解。乙型肝炎患者的主要建议是建立可持续的临床关系、培养情绪韧性、改变饮食、调节能量以及与披露相关的问题。
本研究强调了生物医学和公共卫生解释与澳大利亚华裔人群乙型肝炎的生活经历之间的冲突。对乙型肝炎的信念根植于对健康的文化理解之中，可能与感染的生物医学解释相冲突。承认这些观点为卫生服务机构与其客户之间提供了富有洞察力的沟通，并为基于乙型肝炎患者经验的精细护理模式的发展提供了依据。
