The Burnet Institute, Melbourne, Vic, Australia; and Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic, Australia.
Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) Health, Sydney, NSW, Australia.
Aust J Prim Health. 2024 Sep;30. doi: 10.1071/PY23198.
Background Australia's commitment to eliminate hepatitis C by 2030 is underpinned by the mobilisation of the primary care sector. Primary care nurses are well placed to contribute to achieving elimination given their unique access to people with/at risk of hepatitis C and their person-centred approach to care delivery. This study examines the enablers to primary care nurse involvement in elimination efforts. Methods Primary care nurses involved in the care of people with/at risk of hepatitis C were recruited through two national nursing organisations. Participants provided verbal consent to participate in an electronically recorded, semi-structured interview. Interview data were transcribed verbatim, coded and analysed using a thematic analysis. Results Sixteen interviews were conducted with nurses working in general practice, community health, alcohol and other drug services, and custodial settings, with the findings framed using a social-ecological model. The study identified individual attributes, such as empathy and advocacy for clients deemed 'too hard for everyone else'. Interpersonal enablers included participants' ability to effectively communicate with clients and colleagues, and using trusted professional relationships to improve client access to care. Public policy that addressed community factors, including stigma and confidentiality, were seen as supportive. Conclusions This study identified the critical and varied role primary care nurses play in hepatitis C elimination. Effective scale up of hepatitis C care involves recognising the pivotal role of primary care nurses, which will help to create an enabling environment that supports nurses to work to their full scope of practice and enhance their contribution to the elimination response.
澳大利亚承诺到 2030 年消除丙型肝炎，其基础是调动初级保健部门。鉴于初级保健护士能够接触到患有/有感染丙型肝炎风险的人群，并采用以患者为中心的护理方法，他们非常适合为实现消除目标做出贡献。本研究考察了促使初级保健护士参与消除努力的因素。
通过两个全国性的护理组织招募参与护理丙型肝炎患者/高危人群的初级保健护士。参与者通过口头同意参与电子记录的半结构化访谈。访谈数据逐字转录、编码，并使用主题分析进行分析。
对在全科医疗、社区卫生、酒精和其他药物服务以及监禁场所工作的护士进行了 16 次访谈，研究结果采用社会生态学模型进行了阐述。该研究确定了个人属性，如对被认为“对其他人来说太难”的客户的同理心和倡导。人际促进因素包括参与者与客户和同事有效沟通的能力，以及利用可信赖的专业关系来改善客户获得护理的机会。解决社区因素（包括耻辱感和保密性）的公共政策被认为是支持性的。
本研究确定了初级保健护士在丙型肝炎消除方面的关键和多样化作用。有效扩大丙型肝炎护理规模需要认识到初级保健护士的关键作用，这将有助于创造一个有利的环境，支持护士充分发挥其工作范围，并增强他们对消除反应的贡献。
