Original Research
Illness Intrusiveness of a Hepatitis C Diagnosis: A Pilot Study and the Implications for Practice

https://doi.org/10.1016/j.nurpra.2010.03.018Get rights and content

Abstract

The experience of receiving a diagnosis of hepatitis C virus (HCV) has significant psychological effects. Examining illness intrusiveness offers an opportunity to describe the impact of a diagnosis of HCV infection on important aspects of a person's life. The purpose of this pilot study was to describe the illness intrusiveness of a diagnosis of HCV in 30 adults who presented to a hepatology clinic for evaluation of their disease. The illness intrusiveness scores were lower than scores observed in other chronic conditions. Implications for practice and recommendations for future research are included.

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Background

Illness intrusiveness has been described in a variety of chronically ill populations, resulting in significant empirical evidence established by researchers over the past 2 decades. Researchers have found a inverse relationship between illness intrusiveness and measures of health-related QOL,7 overall QOL,8 and subjective well-being.9

Except for the quality of life literature, there remains a paucity of information about the impact of a new diagnosis of HCV. Additional information is needed,

Setting and sample

Patients were recruited through the outpatient Digestive Disease Center at an urban tertiary care and referral center located in the Midwest. Criteria for inclusion in the study include age 18 or older, having a diagnosis of HCV as evidenced by a blood test (the HCV PCR RNA). Exclusion criteria included de-compensated liver disease requiring liver transplant evaluation, end-stage renal disease requiring hemodialysis, and current or past treatment of HCV infection with alpha interferon or a

Results

Thirty subjects were enrolled in the study. All testing was completed within one visit to the hepatology clinic. Half of the participants were men and half were women; ages ranged from 20 to 75 years (M 5 53). Twenty-one (70%) participants were white; 30% (n 5 9) were Black/non-Hispanic. Fourteen study subjects (46.7%) had private insurance coverage, 7 (23.3%) had Medicaid, and 9 (30%) were covered by Medicare. Fifteen subjects (50%) were married, 10 (33%) were single, and 5 (16.7%) were

Discussion

The majority of subjects had received a diagnosis of hepatitis C within the past 24 months. In general, they were middle-aged, married, white, had a high school education, and were employed full-time. Most had acquired their HCV through past illicit drug use. None had de-compensated liver disease or a life-threatening serious co-morbid condition, nor had they received any previous treatment for their HCV disease.

The mean total IIRS score for this study was 35.46. This score was lower than

Implications for Practice and Future Research

Individuals who are newly diagnosed with hepatitis C are told that they have a chronic illness that could potentially result in liver dysfunction or decompensated liver disease. Some patients have the additional burden of knowing that they contracted the virus through illicit drug use. The treatment for the disease has significant side effects and is successful for less than half of the patients who choose to have it. The literature on adjustment to chronic illness is rich with evidence

References (12)

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Cited by (0)

In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.

1

Madeleine B. Murphy, DNP, CNP, is a nurse practitioner in the division of gastroenterology and hepatology at University Hospitals Case Medical Center in Cleveland, OH.

2

Joyce J. Fitzpatrick, PhD, RN, FAAN, is the Elizabeth Brooks Ford Professor of Nursing in the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland.

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