Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
PLoS One. 2022 Dec 12;17(12):e0272401. doi: 10.1371/journal.pone.0272401. eCollection 2022.
Little is known about the emotional experience and benefits of undertaking direct acting antiviral (DAA) treatment for hepatitis C. A better understanding of individual treatment outcomes can inform acceptable treatment delivery and promotion. We aimed to explore participant-perceived emotional benefits and transformations throughout DAA treatment among people who inject drugs, who were initiating treatment.
Participants were recruited from either a community based clinical trial or community health clinics. Semi structured interviews were conducted with each participant before, during and following treatment. Interviews focussed on treatment perceptions, physical and mental wellbeing and modifiable health behaviours. Interviews were recorded, transcribed verbatim and thematically analysed. Participant and cohort matrices were produced to assess at which time point themes were present and whether themes changed or remained stable over time.
This paper presents analysis from 19 participants interviewed between 2017-2019. Most participants were male, with no or mild fibrosis. At baseline, all but one participant had injected drugs in the past month. Three themes relating to the emotional wellbeing and behaviour change described a common treatment experience; 'hopes for better wellbeing', 'lifting the weight' and 'closing the chapter'. Participants were hopeful treatment would improve their emotional wellbeing. Hopes were actualised during treatment as participants began to feel uncertainty and stress easing. Completing treatment improved some participants perceptions of self. Some participants consciously changed their injecting behaviours during treatment.
Undertaking and completing treatment was an emotionally and behaviourally transformative period. Participant perceived benefits should be used to inform how treatment benefit is conceptualised and how treatment is promoted in primary care settings.
对于接受直接作用抗病毒（DAA）治疗丙型肝炎的患者，人们对其情感体验和获益知之甚少。更深入地了解个体的治疗结果，可以为可接受的治疗提供依据，并促进治疗。我们旨在探讨开始接受 DAA 治疗的吸毒者在治疗过程中的个体感知治疗获益和变化。
从社区为基础的临床试验或社区卫生诊所招募参与者。在治疗前、治疗期间和治疗后，对每位参与者进行半结构式访谈。访谈重点是治疗认知、身心健康和可改变的健康行为。对访谈进行录音、逐字转录，并进行主题分析。制作参与者和队列矩阵，以评估主题在何时出现，以及主题是否随时间变化或保持稳定。
本文报告了 2017 年至 2019 年间接受采访的 19 名参与者的分析结果。大多数参与者为男性，纤维化程度无或轻微。基线时，除 1 名参与者外，所有参与者在过去一个月内均有注射毒品。与情绪健康和行为改变相关的 3 个主题描述了一种常见的治疗经历，即“对更好的健康状况充满希望”、“减轻负担”和“翻过这一篇”。参与者希望治疗能改善他们的情绪健康。随着治疗的进行，参与者开始感到不确定性和压力减轻，希望得以实现。完成治疗改善了一些参与者对自己的看法。一些参与者在治疗期间有意识地改变了他们的注射行为。
接受和完成治疗是一个情感和行为上具有变革性的时期。参与者感知到的获益应该用于告知如何概念化治疗获益以及如何在基层医疗环境中推广治疗。
