Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
Int J Ment Health Nurs. 2024 Dec;33(6):1840-1873. doi: 10.1111/inm.13396. Epub 2024 Aug 5.
Diagnostic overshadowing refers to a phenomenon whereby people with mental health conditions encounter inadequate or delayed medical attention and misdiagnosis. This occurs when physical symptoms are mistakenly attributed to their mental health condition. This paper presents a scoping review focusing on direct causes and background factors of diagnostic overshadowing in the context of hepatitis C infection in people who inject drugs and have concurrent mental health conditions. Despite significant strides in hepatitis C treatment with direct-acting antiviral drugs, the complex interplay of mental health conditions and physical symptoms necessitates a nuanced approach for accurate diagnosis and effective screening. This review was conducted using Joanna Briggs Institute's methodology for scoping reviews. The databases searched included Medline, Embase, PsycInfo, Global Health, CINAHL and Scopus. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategies identified 1995 records. Overall, 166 studies were excluded. Forty-two (42) studies met the inclusion criteria. Three (n = 3) studies represented direct causes, and 39 (n = 39) with background factors related to diagnostic overshadowing. Studies highlighted six key themes encompassing diagnostic overshadowing, with communication barriers, stigma and knowledge deficiencies being the most prominent. Recognising and addressing diagnostic overshadowing in chronic hepatitis C will lead to increased screening, diagnosis and timely administration of life-saving antiviral therapy, resulting in profound enhancements in well-being and health outcomes. Moreover, this proactive approach will play a pivotal role in advancing the global effort towards eliminating hepatitis C by 2030.
诊断遮蔽是指一种现象，即患有心理健康问题的人会遇到不充分或延迟的医疗关注和误诊。当身体症状被错误地归因于他们的心理健康状况时，就会发生这种情况。本文介绍了一项范围综述，重点关注在注射毒品且同时患有心理健康问题的人感染丙型肝炎的情况下，导致诊断遮蔽的直接原因和背景因素。尽管直接作用抗病毒药物在丙型肝炎治疗方面取得了重大进展，但心理健康状况和身体症状的复杂相互作用需要一种细致入微的方法来进行准确诊断和有效筛查。这项综述使用乔安娜·布里格斯研究所的范围综述方法进行。搜索的数据库包括 Medline、Embase、PsycInfo、Global Health、CINAHL 和 Scopus。本综述遵循了用于系统评价和荟萃分析扩展的首选报告项目 (PRISMA-ScR)。搜索策略确定了 1995 条记录。总体而言，有 166 项研究被排除在外。有 42 项（42 项）研究符合纳入标准。其中 3 项（n=3）研究代表直接原因，39 项（n=39）研究与与诊断遮蔽相关的背景因素相关。研究突出了六个关键主题，包括诊断遮蔽，其中沟通障碍、污名化和知识不足是最突出的。在慢性丙型肝炎中认识和解决诊断遮蔽问题将导致增加筛查、诊断和及时实施救命的抗病毒治疗，从而显著改善福祉和健康结果。此外，这种积极主动的方法将在 2030 年消除丙型肝炎的全球努力中发挥关键作用。
