Hepatitis C in a new therapeutic era: Recontextualising the lived experience

Whiteley, David; Whittaker, Anne; Elliott, Lawrie; Cunningham-Burley, Sarah

Abstract

Aims and Objectives
To explore the experience of adults living with hepatitis C in a new era of interferon-free treatment.
Background
Hepatitis C is a leading cause of morbidity and mortality worldwide, posing a significant challenge to global public health. Historically, the treatment of hepatitis C was poorly efficacious and highly demanding, however, more effective and tolerable therapies have become available in high-income nations in recent years. This is the first study to explore how these significant developments in the treatment of hepatitis C may have influenced the experience of those living with the virus, and their understanding of the disease.
Design
A qualitative study underpinned by social phenomenological theory.
Methods
Data were generated through semi-structured interviews with a purposive sample of 20 hepatitis C positive adults living in a large city in Scotland.
Results
Thematic analysis identified three over-riding themes. ‘Positioning hepatitis C’ illustrated how the disease was understood within wider sociocultural, medical and politico-economic contexts. ‘Beyond a physical burden’ emphasised the emotional aspect of infection, and ‘a new uncertainty’ revealed participants’ cautious response to the advances in hepatitis C therapy.
Conclusions
Inter-thematic discourse portrayed the new era of hepatitis C treatment as holding little sway over constructions of the illness, as narratives resonated with previous studies. Such unmoving ‘lay’ understandings of hepatitis C may pose potential barriers to the new therapeutic era from reaching its full potential.
Relevance to clinical practice
How people living with the virus perceive and understand hepatitis C can have an adverse impact on their engagement with care and treatment. Whilst global medical discourse eulogises the arrival of a new era of therapy, there remain significant challenges for nurses engaging those with hepatitis C in therapeutic pathways.

Citation

Whiteley, D., Whittaker, A., Elliott, L., & Cunningham-Burley, S. (2017). Hepatitis C in a new therapeutic era: Recontextualising the lived experience. Journal of Clinical Nursing, https://doi.org/10.1111/jocn.14083

• Journal Article Type: Article
• Acceptance Date: Sep 19, 2017
• Online Publication Date: Sep 27, 2017
• Publication Date: Oct 23, 2017
• Deposit Date: Sep 29, 2017
• Publicly Available Date: Sep 28, 2018
• Journal: Journal of Clinical Nursing
• Print ISSN: 0962-1067
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/jocn.14083
• Keywords: Direct-acting antivirals; hepatitis C; interferon-free treatment, lived experience, social phenomenology, thematic analysis, treatment rationing
• Public URL: http://researchrepository.napier.ac.uk/Output/991847