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Carroll S, Moon Z, Hudson J, Hulme K, Moss-Morris R. An Evidence-Based Theory of Psychological Adjustment to Long-Term Physical Health Conditions: Applications in Clinical Practice. Psychosom Med 2022; 84:547-559. [PMID: 35412516 DOI: 10.1097/psy.0000000000001076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Around 30% of people with long-term physical health conditions (LTCs) experience comorbid anxiety and depression. For many, comorbid distress is linked to difficulties adjusting to the challenges of the LTC. The aims of this article are to present a transdiagnostic theoretical model of adjustment to LTCs (TMA-LTC), demonstrate the application of this model in clinical practice, and highlight the distinguishing features of treating LTC-related distress compared with treating primary anxiety and/or depression. METHODS A systematic review (k = 21) was conducted to collate preexisting evidence-based models of adjustment across LTCs. Models of adjustment for a range of LTCs were extracted and synthesized into a new preliminary TMA-LTC. Two expert consensus meetings were held, where experts rated the relevance and importance of all concepts within the models. RESULTS The TMA-LTC proposes that acute critical events or ongoing illness stressors can disrupt emotional equilibrium, and that whether a person returns to equilibrium and achieves good psychological adjustment depends on a number of cognitive and behavioral factors, as well as their interpersonal, intrapersonal, environmental, and illness-specific contexts. A case study is presented to demonstrate the clinical application of this model in treating illness-related distress, highlighting how it overcomes roadblocks that may be encountered when working primarily within traditional mental health paradigms. CONCLUSIONS As an empirically and clinically informed model, TMA-LTC provides a useful guide for assessment, formulation, and treatment in the context of psychological adjustment to LTCs. Future studies are needed to test treatments that have been developed based on TMA-LTC.
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Affiliation(s)
- Susan Carroll
- From the Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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2
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Joseph Mattingly T, Li K, Ng A, Ton-Nu TL, Owens J. Exploring Patient-Reported Costs Related to Hepatitis C on the Medical Crowdfunding Page GoFundMe®. PHARMACOECONOMICS - OPEN 2021; 5:245-250. [PMID: 32997279 PMCID: PMC8160064 DOI: 10.1007/s41669-020-00232-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Successful medical crowdfunding campaigns may alleviate or even eliminate the financial burden of expensive, cumulative medical bills. GoFundMe® crowdfunding pages for hepatitis C virus (HCV) patients were reviewed and analyzed to better understand the characteristics that contribute to a successful fundraising campaign in a disease often associated with patients with a lower social standing or stigma. METHODS A pilot cross-sectional study of all publicly available GoFundMe® crowdfunding pages was conducted for posts related to HCV on GoFundMe® in June 2019. Similar to data extraction steps in a systematic literature review, page data were reviewed to identify whether the source of the patient's HCV infection was disclosed, if disclosed then how did the patient report contracting the disease, and all costs reported in the description as part of the rationale for requesting funds. Descriptive statistics of category and numeric variables were reported for the full sample, and exploratory analyses were conducted to determine any potential associations with categorical variables and the amount of donations received, categorized as small (< US$1000), moderate (US$1000-4999), and large (≥ US$5000). RESULTS A total of 685 unique GoFundMe® pages were included in the analysis. Only 30% (206/685) of the pages disclosed the source of HCV infection. Of those that disclosed a virus source, 86% (177/206) described a source that appeared more socially desirable to our research team (blood transfusion, organ transplant, occupational exposure, etc.). In terms of actual donations received by a page, 46% (312/685) were less than US$1000, 38% (262/685) were between US$1000 and US$4999, and 16% (111/685) were US$5000 or more. Disclosing the virus source was associated with a higher donation category (p = 0.0099). CONCLUSION These exploratory findings yield important insights, both for patients or caregivers seeking support on GoFundMe® crowdfunding websites and for researchers interested in exploring the types of costs self-reported by patients in their public requests for financial assistance.
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Affiliation(s)
- T Joseph Mattingly
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Room 224, Baltimore, MD, 21201, USA.
| | - Karen Li
- University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Arnold Ng
- University of Maryland School of Pharmacy, Baltimore, MD, USA
| | | | - Jennifer Owens
- University of Maryland Graduate School, Baltimore, MD, USA
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Goutzamanis S, Doyle JS, Horyniak D, Higgs P, Hellard M. Peer to peer communication about hepatitis C treatment amongst people who inject drugs: A longitudinal qualitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 87:102983. [PMID: 33126166 DOI: 10.1016/j.drugpo.2020.102983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/23/2020] [Accepted: 10/09/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Little is known about how information on direct-acting antiviral treatment for hepatitis C circulates through peer networks of people who inject drugs. In this study we aimed to explore what and how treatment-related information is shared between people undergoing treatment and their peers. METHODS Participants were recruited from two general practice clinics and the community-based hepatitis C Treatment and Prevention Study. Semi-structured interviews were conducted with each participant (N = 20) before, during and following treatment. Interviews explored hepatitis C treatment experiences, key sources of DAA information and the impact of receiving and sharing knowledge. Inductive thematic analysis was conducted. Time sequential matrices were generated to understand thematic change over time. RESULTS Fifty-four interviews were conducted with 20 participants across seven field-sites in Melbourne, Australia. Key themes were: 'peers as a source treatment information', 'do it together' and 'becoming a treatment advocate'. Peers were a crucial trusted source of information. Positive treatment anecdotes were important for building confidence in and motivation to initiate treatment. Many participants adopted a 'treatment advocate' role in their close peer networks, which was described as empowering. Some participants described benefits of undertaking treatment alongside members of their close network. CONCLUSION Findings illustrate the importance of close peers in shaping treatment perceptions and engagement. This will be important in designing health promotion messaging and interventions to increase treatment uptake.
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Affiliation(s)
- Stelliana Goutzamanis
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, SA, 3004; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne VIC 3004.
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, SA, 3004; Department of Infectious Diseases, The Alfred and Monash University, 85 Commercial Rd, Melbourne, Victoria, SA, 3004
| | - Danielle Horyniak
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, SA, 3004; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne VIC 3004; Behaviour and Health Risks Program, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, SA, 3004
| | - Peter Higgs
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, SA, 3004; Department of Public Health, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora VIC 3086
| | - Margaret Hellard
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, SA, 3004; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne VIC 3004; Department of Infectious Diseases, The Alfred and Monash University, 85 Commercial Rd, Melbourne, Victoria, SA, 3004
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4
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Mallolas J, Ahumada A, Ampuero J, Blanco JR, Hidalgo Á, Londoño MC, Molina E, Ruiz S. Quality of life in patients with hepatitis C. Importance of treatment. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 42 Suppl 1:20-25. [PMID: 32560769 DOI: 10.1016/s0210-5705(20)30184-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chronic hepatitis C virus infection is a systemic disease that impairs the quality of life of affected individuals. The impairment is not only due to physiological factors, such as the non-hepatic manifestations of the disease or certain symptoms such as fatigue, weakness and nausea, but is also due to the substantial psychological impact of the infection. Treatment with direct-acting antivirals (DAA) has been demonstrated to substantially improve patient's quality of life, starting in the initial phases. Supplement information: This article is part of a supplement entitled "The value of simplicity in hepatitis C treatment", which is sponsored by Gilead. © 2019 Elsevier España, S.L.U. All rights reserved.
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Affiliation(s)
- Josep Mallolas
- Servicio de Enfermedades Infecciosas, Hospital Clínic de Barcelona, Barcelona, España.
| | - Adriana Ahumada
- Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Javier Ampuero
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas; Instituto de Biomedicina de Sevilla, Sevilla, España; Universidad de Sevilla, Sevilla, España
| | - José Ramón Blanco
- Servicio de Enfermedades Infecciosas, Hospital San Pedro, Logroño, España
| | - Álvaro Hidalgo
- Economista de Salud, Universidad de Castilla-La Mancha, Ciudad Real, España
| | | | - Esther Molina
- Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago, A Coruña, España
| | - Salvador Ruiz
- Psiquiatría de Urgencias, Hospital Universitario Príncipe de Asturias, Madrid, España
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5
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Winston A, Wurcel AG, Gordon C, Goyal N. Viral hepatitis in patients on hemodialysis. Semin Dial 2020; 33:254-262. [PMID: 32394502 DOI: 10.1111/sdi.12882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Hepatitis B and hepatitis C (HCV) prevalence are higher in people on hemodialysis (HD) than the general population. Through implementation of prevention interventions including vaccines, serologic screening, and post-exposure management, transmissions linked to HD have decreased dramatically. In this manuscript, we review epidemiology of viral hepatitis, summarize current screening and vaccine recommendations, and appraise the available data about efforts to decrease incidence within HD facilities, including isolation of people with viral hepatitis within HD units. Also included is a discussion of the highly effective all-oral HCV treatment options and treatment for HCV in people awaiting kidney transplant.
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Affiliation(s)
- Anna Winston
- Tufts University School of Medicine, Boston, Massachusetts
| | - Alysse G Wurcel
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
| | - Craig Gordon
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Nitender Goyal
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
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6
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Trigg A, Chan E, Kitchen H, Willgoss T, Ho KF, Pierson R, Scott J. Psychometric Validation of the Hepatitis C Symptom and Impact Questionnaire (HCV-SIQv4) in a Diverse Sample of Adults with Chronic Hepatitis C Virus Infection Treated with an Interferon-free Simeprevir-containing Regimen. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2019; 6:1-19. [PMID: 32685576 PMCID: PMC7299472 DOI: 10.36469/9675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) infection and its treatments are associated with significant symptoms, side effects and impact on patients functioning. The Hepatitis C Symptom and Impact Questionnaire version 4 (HCV-SIQv4) was developed according to FDA Patient Reported Outcomes (PRO) Guidance, for evaluating chronic HCV infection and its treatment. OBJECTIVES This study evaluated the psychometric properties and clinically important change (CIC) thresholds of the measure. METHODS PRO data were pooled from three Phase IIb and III trials evaluating interferon-free simeprevir-containing regimens for treatment of chronic HCV infection. Scale range adequacy, reliability, validity, responsiveness and CIC thresholds were assessed incorporating knowledge of the appropriate measurement model. RESULTS Data from 437 patients were analyzed. Stage of liver disease was associated with symptom severity and functioning at baseline. Reliability was acceptable (test-retest ICC ≥0.7) for most scores except the Gastrointestinal and Integumentary domains. Convergent validity was observed between HCV-SIQv4 scores and concurrent measures of conceptual similarity. Greater symptom severity and worse impact scores were associated with liver cirrhosis, depression, severe fatigue and health limitations. Patients who achieved SVR12 had better outcomes than those failing to. HCV-SIQv4 symptom and domain scores were responsive to changes in health state (effect sizes ≥0.5). Exploratory thresholds for change in scores indicating a clinically important improvement and worsening were HCV-SIQv4 Overall Body System Score (BSS), 8 and 8; Constitutional BSS, 10 and 10; Gastrointestinal BSS, 5 and 5; Psychiatric BSS, 8 and 8; Neurocognitive BSS, 8 and 8; and Integumentary BSS, 5 and 5. CONCLUSIONS The HCV-SIQv4 offers reliable, responsive assessments within HCV clinical development. CIC thresholds are now available to aid score interpretation.
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Affiliation(s)
- Andrew Trigg
- Formerly of DRG Abacus, Manchester, United Kingdom
| | - Eric Chan
- Janssen Global Services, LLC, Raritan, NJ, USA
| | | | - Tom Willgoss
- Formerly of DRG Abacus, Manchester, United Kingdom
| | | | | | - Jane Scott
- Janssen Global Services, LLC, High Wycombe, United Kingdom
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The emotional universe of women affected by hepatitis C: A hermeneutic approach. ENFERMERIA CLINICA 2018; 29:216-224. [PMID: 30459051 DOI: 10.1016/j.enfcli.2018.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/05/2018] [Accepted: 08/13/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Understanding the emotional universe of women from Cordoba affected by hepatitis C. METHOD Hermeneutic qualitative study. Participants met the criteria of being adult women with a current diagnosis of hepatitis C and belonging to the Plataforma de Afectad@s por la Hepatitis C of Cordoba. The intentional sampling was nominated and followed a criterion of intensity. Data collection was conducted through in-depth interviews. The analysis took place in 3levels: Explanation, naïve understanding and in-depth understanding. In the second level, the metaphor universe of emotions was incorporated, which is a taxonomy that organizes emotions into clusters of galaxies to facilitate understanding of affective phenomena. RESULTS Four participants were included. Seven themes roam the galaxies in the emotional universe of women. «Damned disease» explores their disgust, sadness and shame. «Intimate affections» focuses on happiness and love as well as sadness. «Friendship-platform» focuses on understanding, welfare and affection. «Physicians» deal with distrust and disappointment regarding new treatment, and with «curing» sadness, fear, anxiety and hope. «State of ill-being» focuses on anxiety. And «universal access now» explores anger. CONCLUSIONS Despite the presence of love in the complex emotional universe of women with hepatitis C, anger, sadness and anxiety are highlighted. Hermeneutics of their emotions facilitates nursing care and nursing research humanization.
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Mattingly TJ, Perfetto EM, Johnson SL. Engaging hepatitis C infected patients in cost-effectiveness analyses: A literature review. Hepatology 2018; 67:774-781. [PMID: 28834597 DOI: 10.1002/hep.29482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/25/2017] [Accepted: 08/18/2017] [Indexed: 12/13/2022]
Abstract
Cost-effectiveness analyses (CEAs) of hepatitis C virus (HCV) treatment strategies have become common, but few appear to include patient engagement or the patient perspective. The objectives of the current study were to (1) identify published HCV CEA studies that include patient input and (2) derive insights on patient-informed variable and outcome selection to build a framework for future economic analyses of HCV. A literature search was conducted using SCOPUS, EMBASE, and PubMed from January 1, 2012 to May 28, 2017. Terms sought included a combination of "incremental cost-effectiveness ratio" OR "economic evaluation" OR "cost effectiveness analysis" OR "cost utility analysis" OR "budget impact analysis" OR "cost benefit analysis" AND "hepatitis C". A total of 1,040 articles were identified in the search and seven articles were selected for further evaluation after abstracts and the full text of eligible articles were screened. One economic evaluation used direct patient engagement to account for patient preferences in the final model. The study endpoints identified included a variety of clinical, social, psychological, and economic outcomes. Costs primarily focused on productivity loss, missed work, out-of-pocket treatment costs, and indirect costs to family or friends supporting the patient. Conclusion: To date, the inclusion of the patient voice through patient engagement as part of methods in cost-effectiveness research in existing published studies has been limited. Future CEA studies should consider how patient engagement may impact economic models and their implementation into practice. (Hepatology 2018;67:774-781).
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Haapa T, Suominen T, Paavilainen E, Kylmä J. Experiences of living with a sexually transmitted disease: an integrative review. Scand J Caring Sci 2017; 32:999-1011. [PMID: 29193238 DOI: 10.1111/scs.12549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/05/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE This integrative review describes experiences related to living with a sexually transmitted disease (STD). DESIGN The data search was conducted using the CINAHL, MEDLINE (Ovid), PsycINFO and PubMed databases between the years 2000 and 2016. A manual search was also used. The retrieved data consisted of 33 original articles which were analysed using deductive and inductive content analysis. RESULTS Based on the results, an infected person has a need for information about STDs and experiences emotions such as a loss of purity and control over his/her body. In addition, the ego of the infected person is wounded due to the infection. Concerns about the results of treatments, suffering side effects, and experiences of unprofessional behaviour by nursing staff are related to the treatment of an STD. Having an STD in everyday life means coping with a changing condition, but there are resources that can provide support. The quality of life can also be negatively affected by an STD, and a future with an STD can manifest different hopes and concerns. In relation to other people, an STD has a marked effect, especially concerning sexual relations. The person's sex life can fade away; however, it may remain as an enjoyable experience. The infected person may also adopt safer sexual behaviours or continue with a risk-taking behaviour. CONCLUSION The results of this review can be used in the development of nursing practices, as well as be used in the prevention of STDs.
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Affiliation(s)
- Toni Haapa
- Nursing Science, Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Hospital District of Helsinki and Uusimaa, Helsinki University Hospital, Helsinki, Finland
| | - Tarja Suominen
- Nursing Science, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Eija Paavilainen
- Nursing Science, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Jari Kylmä
- Nursing Science, Faculty of Social Sciences, University of Tampere, Tampere, Finland
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Abstract
Chronic hepatitis C virus (HCV) infection is a systematic disease that affects several aspects of patients' well-being, including physical, mental, social, and sexual quality of life. In recent years, there has been a growing body of literature focusing on HCV patients' sexual health, providing evidence of clinically significant and enduring disturbances that disrupt everyday living, but commonly evade clinicians' attention. Relevant studies are characterized by considerable methodological heterogeneity and their findings should be interpreted using a systematic and integrative approach. In this context, we performed a systematic literature review on the topic of HCV patients' sexual functioning aiming at identifying high-quality investigations reporting scientifically sound and clinically useful data. We performed a thorough search of PudMed, ScienceDirect, and GoogleScholar according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Twenty-five articles were included to the review, reporting data from over 5300 chronic HCV patients. Sexual dysfunction, predominantly in the domains of sexual desire, drive, and satisfaction, is commonly reported by HCV patients at rates ranging between 19 and 88%. The current review yielded three distinct patterns of sexual impairment, namely, precirrhotic sexual impairment, cirrhosis-induced sexual decline, and interferon-associated sexual difficulties. Our search yielded significant findings on the prevalence, the characteristics, and the determinants of HCV-associated sexual dysfunction. In addition, we detected several areas of scientific controversy and inadequate information, thus highlighting novel directions for future research.
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11
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Families Living with Blood-Borne Viruses: The Case for Extending the Concept of "Serodiscordance". Interdiscip Perspect Infect Dis 2017; 2017:4352783. [PMID: 29230242 PMCID: PMC5688372 DOI: 10.1155/2017/4352783] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/14/2017] [Indexed: 12/23/2022] Open
Abstract
The concept of “serodiscordance” (mixed infection status) is primarily associated with epidemiological concerns about HIV transmission risk in couples. We make the case for extending this concept to include families with mixed HIV and viral hepatitis status. Social research on couples with mixed HIV and hepatitis C status has laid an important foundation for illuminating how experiences of serodiscordance within intimate partnerships are much broader than concerns about risk. This body of work attests to serodiscordance holding promise as a valuable concept for understanding viral infections as socially situated and intensely relational phenomena. However, serodiscordance is still limited as a concept because of its near universal focus on couples. It is rarely applied to wider relationships, including family networks beyond the couple. Despite evidence in the literature that families are affected by blood-borne viruses in multiple social, emotional, financial, and generational ways, the concept of serodiscordance does not capture these broader dynamics. Making serodiscordance more inclusive is an important step in recognising the diverse ways families' everyday lives, relationships, and futures can be entangled with HIV, hepatitis C, and hepatitis B, and for understanding how today's era of effective treatment options might shape the “family life” of viral infections.
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12
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A Qualitative Study on Marital Challenges of Chronic Hepatitis B Patients. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.55577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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13
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Turner BJ, Craig K, Makanji VS, Flores BE, Hernandez L. Improving support and education of low-income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening. J Clin Nurs 2017; 26:4605-4612. [PMID: 28295785 DOI: 10.1111/jocn.13806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2017] [Indexed: 02/07/2023]
Abstract
AIMS AND OBJECTIVES To identify support needs of low-income baby boomers recently diagnosed with chronic hepatitis C virus infection. BACKGROUND The U.S. Preventive Services Task Force has endorsed one-time screening of all baby boomers (born 1945-1965) for hepatitis C because 75% of the estimated 2-3 million persons with chronic infection are in this age range. We hypothesised that persons diagnosed by routine screening would have significant psycho-emotional, cognitive and healthcare challenges that need to be met by collaborative care and services from nurses and other healthcare personnel. DESIGN Qualitative descriptive study of data from three focus groups with predominantly minority participants (N = 16). Data were analysed using qualitative content analysis, and transcribed data were categorised by three domains in a previously developed model and a new domain identified in this study. Frequencies of unique participants' comments about each theme were calculated. RESULTS Elucidated domains were as follows: (i) psycho-emotional effects due to social stigma, shame, fear and dealing with risky behaviours; (ii) social effects due to concerns about infecting others; and (iii) cognitive deficits because of poor understanding about hepatitis C virus infection and its care. A new domain related to health care emerged reflecting the following themes: poor access to care, barriers to costly treatment, and navigating complex care for comorbidities. Despite these challenges, participants strongly endorsed universal baby boomer hepatitis C virus screening. CONCLUSIONS This study describes psycho-emotional and social challenges of people dealing with a hepatitis C diagnosis which are compounded by poor knowledge and barriers to supportive care. RELEVANCE TO CLINICAL PRACTICE Nursing and other allied health personnel require structured support programmes to assist older persons diagnosed with hepatitis C with addressing these common challenges with the ultimate goal of achieving a cure.
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Affiliation(s)
- Barbara J Turner
- Department of Medicine, University of Texas Health San Antonio (UT Health San Antonio), San Antonio, TX, USA.,Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA
| | - Kathryn Craig
- School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Vidhi S Makanji
- School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Bertha E Flores
- Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA.,School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Ludivina Hernandez
- Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA
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14
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Dusheiko G. The impact of antiviral therapy for hepatitis C on the quality of life: a perspective. Liver Int 2017; 37 Suppl 1:7-12. [PMID: 28052638 DOI: 10.1111/liv.13292] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 12/12/2022]
Abstract
Instruments to assess the impact of hepatitis C virus infection on health and measurements of reported outcomes in patients (health-related quality of life [HRQOL]) are not frequently used to assign priority for treatment. Several systematic reviews have been performed that provide a comprehensive analysis to help understand patient reported outcomes (PROs) with direct acting antiviral treatment. Clinical trials with direct acting antivirals (DAAs) provide an important opportunity to assess PROs without interferon or ribavirin. Significant improvement in quality of life parameters have been noted with DAA therapy. The results show improvement in HRQOL indices when interferon-free and particularly interferon and ribavirin-free treatments are compared to interferon and ribavirin treatment. Improvements in HRQOL indices are an encouraging aspect of the cure of chronic hepatitis C. It is unclear whether these measurable HRQOL improvements can be translated into a net benefit improvement in work productivity and a social dimension that is significant enough to convince payers of the added value of early and more widespread treatment.
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Affiliation(s)
- Geoffrey Dusheiko
- UCL Institute of Liver and Digestive Health, University College London Medical School, Kings College Hospital, London, UK
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15
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Mohammed MA, Moles RJ, Chen TF. Meta-synthesis of qualitative research: the challenges and opportunities. Int J Clin Pharm 2016; 38:695-704. [PMID: 27052213 DOI: 10.1007/s11096-016-0289-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/14/2016] [Indexed: 01/08/2023]
Abstract
Synthesis of qualitative studies is an emerging area that has been gaining more interest as an important source of evidence for improving health care policy and practice. In the last decade there have been numerous attempts to develop methods of aggregating and synthesizing qualitative data. Although numerous empirical qualitative studies have been published about different aspects of health care research, to date, the aggregation and syntheses of these data has not been commonly reported, particularly in pharmacy practice related research. This paper describes different methods of conducting meta-synthesis and provides an overview of selected common methods. The paper also emphasizes the challenges and opportunities associated with conducting meta-synthesis and highlights the importance of meta-synthesis in informing practice, policy and research.
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Affiliation(s)
| | - Rebekah J Moles
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia
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