Reasons for Nonattendance across the Hepatitis C Disease Course

This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care throughout the disease course. Eighty-four patients and health and social care providers were interviewed. Thematic analysis of the data yielded 6 int...

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Published inISRN nursing Vol. 2013; pp. 579529 - 10
Main Authors Butt, Gail, McGuinness, Liza, Buller-Taylor, Terri, Mitchell, Sandi
Format Journal Article
LanguageEnglish
Published Egypt Hindawi Publishing Corporation 2013
Hindawi Limited
Subjects
Alcohol
Chronic illnesses
Community support
Confidentiality
Data processing
Diagnosis
Gastroenterology
Health care access
Health care policy
Hepatitis
Hepatitis C
Hepatitis C virus
Hepatology
Liver cancer
Liver diseases
Patients
Primary care
Public health
Qualitative research
Stigma
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Abstract This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care throughout the disease course. Eighty-four patients and health and social care providers were interviewed. Thematic analysis of the data yielded 6 interrelated nonattendance themes: self-protection, determining the benefits, competing priorities, knowledge gaps, access to services, and restrictive policies. Factors within the themes varied with the disease course, type of provider/service, and patient context. Nonattendance could span months to years and most frequently began at diagnosis where providers either advised that followup was not necessary or did not recommend any followup. The way services were organized (low barrier access) and delivered (nonjudgmental approach) and higher HCV knowledge levels of patients and providers encouraged attendance. This is the first study to explore the reasons for nonattendance for HCV care throughout the disease course and validate them from multiple perspectives. There are missed opportunities for providers to encourage attendance throughout the disease course beginning at diagnosis. Interventions required include development of integrated health and social service delivery models; mechanisms to improve knowledge dissemination of the disease, its management, and treatment; and implementation of standardized followup protocols for liver disease monitoring in primary care.
AbstractList This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care throughout the disease course. Eighty-four patients and health and social care providers were interviewed. Thematic analysis of the data yielded 6 interrelated nonattendance themes: self-protection, determining the benefits, competing priorities, knowledge gaps, access to services, and restrictive policies. Factors within the themes varied with the disease course, type of provider/service, and patient context. Nonattendance could span months to years and most frequently began at diagnosis where providers either advised that followup was not necessary or did not recommend any followup. The way services were organized (low barrier access) and delivered (nonjudgmental approach) and higher HCV knowledge levels of patients and providers encouraged attendance. This is the first study to explore the reasons for nonattendance for HCV care throughout the disease course and validate them from multiple perspectives. There are missed opportunities for providers to encourage attendance throughout the disease course beginning at diagnosis. Interventions required include development of integrated health and social service delivery models; mechanisms to improve knowledge dissemination of the disease, its management, and treatment; and implementation of standardized followup protocols for liver disease monitoring in primary care.
Author Buller-Taylor, Terri
Mitchell, Sandi
McGuinness, Liza
Butt, Gail
AuthorAffiliation 2 BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4
1 UBC/BCCDC, 655 West 12th Avenue, Vancouver, BC, Canada V5Z 4R4
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Snippet This descriptive qualitative study examined the patient, provider, and institutional factors contributing to nonattendance for hepatitis C (HCV) care...
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SubjectTerms Alcohol
Chronic illnesses
Community support
Confidentiality
Data processing
Diagnosis
Gastroenterology
Health care access
Health care policy
Hepatitis
Hepatitis C
Hepatitis C virus
Hepatology
Liver cancer
Liver diseases
Patients
Primary care
Public health
Qualitative research
Stigma
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Title Reasons for Nonattendance across the Hepatitis C Disease Course
URI https://dx.doi.org/10.1155/2013/579529
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