Hepatitis B-Related Concerns and Anxieties Among People With Chronic Hepatitis B in Australia

Abstract

BackgroundThe psychological wellbeing of people with chronic hepatitis B (CHB) may be negatively affected due to the chronic and transmissible nature of the disease, and possible serious complications (e.g. cirrhosis and liver cancer). There are limited data investigating concerns and anxieties among people living with CHB.ObjectivesThis study examined feelings about having hepatitis B among people with CHB, including hepatitis B-related concerns and anxieties.Patients and MethodsUsing convenience sampling, people with CHB attending four public liver clinics and one general practice in three Australian jurisdictions between April and September 2013 completed a self-administered questionnaire about their feelings about having hepatitis B.ResultsNinety-three people completed the survey. Mean age was 45 years, 57% were men, and 93% were born overseas (75% from Asia). Seventy-six percent of participants reported having hepatitis B-related concerns and anxieties. The most common concerns were of developing liver cancer (57%), and infecting other people (53%). Thirty-five percent of participants were unwilling to talk to anyone about their hepatitis B while 25% changed how they lived as a result of having hepatitis B. Lower educational level was associated with feeling scared of hepatitis B (adjusted Odds Ratio [OR]: 4.04; 95%CI: 1.09, 14.90; P = 0.04), and an unwillingness to talk to anyone about hepatitis B (adjusted OR: 4.41; 95%CI: 1.09, 17.83; P = 0.04). Very good English proficiency was associated with a higher likelihood of participants changing how they lived (adjusted OR: 12.66; 95%CI: 2.21, 72.42; P < 0.01), and seeing life differently as a result of having hepatitis B (adjusted OR: 21.10; 95%CI: 3.70, 120.19; P < 0.01). Health professionals were the key person for 34% of participants in helping them cope with having hepatitis B, while 18% reported that no one supported them.ConclusionsHepatitis B-related concerns and anxieties are prevalent among people with CHB. Clinical management of people with CHB must address their psychological support needs as an essential component of comprehensive care.

Families Living with Blood-Borne Viruses: The Case for Extending the Concept of “Serodiscordance”

“…A study of Chinese-Americans in San Francisco similarly found that hepatitis B was framed as a family matter, with affected participants keen to educate their family members and encourage them to seek testing to protect the health of the family [ 94 ]. There are suggestions that the intergenerational and endemic nature of hepatitis B in Asian communities has the capacity to “normalise” the virus in families and decouple it from stigma and shame in ways that differ quite markedly from hepatitis C and HIV [ 87 , 90 , 95 , 96 ]. Conversely, other US studies have found that migrant families can discourage testing due to the importance of maintaining “face” [ 97 ] or fear of disclosing status to family members [ 91 ].…”

Feasibility, acceptability and safety of a nurse led hepatitis B clinic based in the community

“…We have identified three major roles for the CNC in the clinic; these are triage, case management, GP and patient support. The clinic aligns well with at least two of the Priority Actions identified in The Second Australian National Hepatitis B Strategy 2014-2017 (Australian Government Department of Health, 2014) and the NSW Hepatitis B Strategy 2014-2020 as well as recommendations of the Australian Hepatitis B Patient and Clinical Practice Survey (Hajarizadeh, Wallace, Ngo, & Richmond, 2014) and The Economic Cost and Health Burden of Liver Disease in Australia Report (Deloitte Access Economics, 2013). The nursing practice draws considerably from the successful Australian in rural settings (Nazareth et al, 2013) and in shared care arrangements experience of nurse models of hepatitis C care in a variety of settings, e.g.…”

Categorization and Characterization of Activities Designed to Help Health-care Professionals Involved in Hepatitis Care Increase Their Awareness of the Disease: The Classification of Hepatitis Medical Care Coordinators

“…Previous studies examining the prejudice experienced by hepatitis patients in the workplace (31) have shown that approximately 30% people attempt to engage in as little contact as possible with coworkers who have hepatitis and hold certain prejudices against them. Furthermore, research has shown that individuals and patients with hepatitis fear social prejudice and feel a great deal of apprehension about informing their friends and coworkers that they have the condition (18,19,32).…”

“…Such human resources are known as "hepatitis medical care coordinators," and the first group of these professionals has recently been trained, with 34 prefectural and city governments in Japan providing training courses (10). Multiple reports have shown that individuals with hepatitis suffer from a poor understanding of the disease, fatigue, the side effects of treatment, and anxiety concerning the progression of the disease, while their quality of life (QOL) is directly affected by the disease itself (11)(12)(13)(14)(15)(16)(17); in addition, several reports have indicated the existence of prejudice and discrimination against people with infectious diseases (18,19). Previous studies on support for patients with hepatitis C (20) have shown that the individual needs of each patient must be addressed, and that better understanding of individual needs is linked to increased appropriateness of the provided care.…”