Syftet med denna systematiska litteratursstudie var att undersöka hur personer med hepatit C upplever mötet med sjukvården. / The aim of this systematic literature review was to explore how persons with Hepatitis C experience the encounters with health care settings.

Forsberg, A & Kjällquist-Petrisi, A. Studenters attityder gentemot personer med Hepatit C. Empirisk undersökning om sjuksköterske- och socionomstuderandes attityder. Examensarbete i omvårdnad 10 poäng. Malmö högskola: Utbildningsområde, Hälsa och Samhälle, 2007. Diskriminering och stigmatisering är mångfacetterad och sker inom många olika områden. Fördomar är ofta ett resultat av fobier och attityder gentemot personer med Hepatit C. De kan även vara kopplade till kunskapsnivån hos vårdgivarna. Tidigare forskning har visat att personer med Hepatit C har bemötts på ett diskriminerande sätt. Denna studies syfte var att undersöka sjuksköterske- och socionomstuderandes attityder gentemot personer med Hepatit C. Frågeställningen löd:Vilka attityder har sjuksköterskestuderande respektive socionomstuderande i början av sin utbildning? Av 167 utlämnade enkäter besvarades 162 , resultatet av dessa visade i stort sett att attityderna gentemot personer med Hepatit C var positiva. Kunskapen om smittvägar var högre, om man kände någon med Hepatit C, men att erfarenhet inte var avgörande för en positiv eller negativ attityd. Trots den generellt positiva attityden, fanns det en rädsla att, efter kontakt med Hepatit C smittad person, utsätta familj och vänner för smitta. Denna empirirska enkätstudie har genomförts på ett kvantitativt deskriptivt sätt. / Forsberg, A & Kjällquist-Petrisi, A. Students´ attitudes towards persons with Hepatitis C. Empirical investigation concerning the attitudes of students within nursing and social works. Degree project, 10 credit points. Malmö University, Faculty of Health and Society, Department of Nursing and Caring science, 2007. Discrimination and stigmatization have many faces and occur in many different places. Attitudes towards persons with Hepatitis C is a common result of bias, but could also be connected with the level of professional education and experience. Previous research shows that persons with Hepatitis C have been treated in a discriminating manner. The aim of this study was to investigate the attitudes of students towards persons with Hepatitis C. The population consisted of students of nursing and social work. The question asked was: What attitudes do these students, in the beginning of their education, have towards persons with Hepatitis C? Of 167 questionnaires 162 were filled in and according to the results the general attitude towards Hepatitis C infected persons was positive. The knowledge about transmission of the virus was higher in responders who personally knew someone with Hepatitis C but this was not a decisive factor in the general attitude towards Hepatitis C infected persons. Despite the generally positive attitudes towards infected persons there was a fear that working or socialising with an infected person could lead to possible transmission to family and friends. This empirical study was based on the quantitative result of a questionnaire.

Hepatit C är en sjukdom som är utbredd över hela världen med cirka 300 miljoner bärare (Iwarson, 1998). Hepatit C associeras ofta med intravenöst drogmissbruk och kan därför leda till diskriminering och fördomar i samhället och hos sjukvårdspersonal. Syftet med denna studie är att belysa patienters erfarenheter av att leva med hepatit C. Med frågeställningar rörande patienters upplevelser av att leva med hepatit C, hur diagnosen påverkat det dagliga livet samt patienters uppfattning av fördomar. Studien är en litteraturstudie där tio stycken artiklar kvalitativa och kvantitativa artiklar granskats. Utifrån artiklarna utformades fyra stycken teman som sammanställts i resultatet. Dessa är bemötande från hälsovårdspersonal, symtomens påverkan på det dagliga livet, patientens oro och rädsla samt patientens erfarenhet av stigmatisering. / Hepatitis C is a disease that is widespread throughout the world with an estimated of 300 million carriers (Iwarson, 1998). Hepatitis C is often associated with intravenous drug abuse and can lead to discrimination and prejudice in society and among health care professionals. The purpose of this study is to highlight the patient´s experience of living with hepatitis C. With questions concerning patient´s experiences of living with hepatitis C, how the diagnosis affected the daily life and patients' perception of prejudice. This study is a literature review. Ten qualitative and quantitative articles where reviewed. From this ten articles were four themes designed and compiled in the outcome. These four themes are experience of treatment from health care professionals, how hepatitis C-related symptoms have affected the daily life, the patient's anxiety and fear and at last patients experience of stigmatization.

Bakgrund: Den vanligaste smittvägen för hepatit C är genom intravenöst drogmissbruk. Smittöverföring kan även ske via blodtransfusioner eller stickskador i vården. Det finns många fördomar förknippade med sjukdomen och risken är stor att dessa färgar mötet med patienter. Det är viktigt att som vårdpersonal vara medveten om hur den egna synen på sjukdomen kan påverka bemötandet. Syfte: Syftet var att belysa vilka erfarenheter patienter med hepatit C har av bemötandet i vården. Metod: Studien utformades som en allmän litteraturöversikt av tolv kvalitativa artiklar. Manifest innehållsanalys användes. Resultat: Patienter med HCV hade blandade erfarenheter av mottagandet: välkomnande, avvisande eller otryggt. Vidare ledde detta till erfarenheter av stöd eller diskriminering. Patienter kunde ha erfarenheter av professionellt stöd eller brist på professionellt stöd. Diskriminering kunde orsakas av antingen vårdpersonal eller organisation. Slutsats: På grund av stigmatisering kring sjukdomen är patienter med hepatit C en utsatt grupp i samhället. Vårdpersonalens kunskap är en viktig del i bemötandet. Det krävs utbildning för att kunna erbjuda en mer holistisk vård vid hepatit C än i dagsläget. Genom ökad kunskap kring både sjukdom och bemötande kan bemötandet påverkas positivt, det vill säga: mottagandet blir bättre, stödet ökar och diskrimineringen minskar. / Background: The most common route of transmission of hepatitis C is through intravenous drug abuse. Transmission can also occur through blood transfusion. There are many prejudices associated with hepatitis C. Chances are that this colors interactions with patients. It is important that healthcare professionals are aware of how their own perception of the disease may affect the encounter.  The Objective was to highlight the experiences patients with hepatitis C have of the encounter in the healthcare. Method: The study was designed as a general literature review of twelve qualitative articles. Manifest content analysis was used. Results: Patients with hepatitis C had mixed experiences of receipt: welcoming, rejecting or unsafe. This led to experiences of support or discrimination. Patients experienced professional support or lack of professional support. Discrimination could be caused either by healthcare professionals or the organization. Conclusion: Because of stigma surrounding the disease patients with hepatitis C are a vulnerable group in society. The knowledge of healthcare professionals is an important part of the encounter. It requires training to provide holistic care for hepatitis C. Increased knowledge about both the disease and patient-professional relation can positively affect the encounter: the reception gets better, support increases and discrimination is reduced.

Introduction: Hepatitis B is a highly contagious infection. Basic knowledge about hepatitis B is necessary; with more knowledge people take preventive actions against hepatitis B, such as using stick proof cannulas. In Thailand an expected number of 8-20% of the population are currently carriers of the HBV infection.   Aim: The aim of the study was to investigate the knowledge about hepatitis B and the attitudes towards the vaccination among Thai university students.   Method: A cross-sectional study with a quantitative method was used. 280 students participated in the study, and the response rate was 93.9 %. The data was analysed using SPSS Statistics 20.   Result: Both genders had poor knowledge about hepatitis B, however 91.1 % of the students had heard about hepatitis B. About half of the students (55.4 %) knew correctly that hepatitis B is sexually transmitted and 40.0 % of the students knew that hepatitis B could cause liver cancer. There was no significant difference in knowledge between the genders. The attitudes towards the vaccine were satisfactory between both genders, 89.3 % of the students knew that healthy people need the vaccination and 81.1 % believed that they would receive the vaccination. However, only 43.6 % knew that the vaccination could be free or low cost through certain programs. There was a significant difference (p-value = 0.042) between the genders; the male students had a more positive attitude towards the vaccine than the female students.   Conclusion: The results from the Thai students showed that more information about the Hepatitis infection is needed to raise awareness among this certain group of people. Information about how it is transmitted is essential to improve the public health. It is also important to improve the individual's self-care, to encourage them to receive the vaccination. From a nursing point of view improving the knowledge about HBV and a positive attitude towards the vaccine in the prolonging contribute to improve the public health by getting a lower rate of cases with HBV.

Hepatitis C infection is a global disease that causes an estimated 399,000 deaths per year. Treatment has improved dramatically in recent years through the development of direct acting antivirals that target specific regions of the Hepatitis C virus (HCV). Unfortunately the virus can have a preexisting resistance or become resistant to these drugs by mutations in the genes that code for the target proteins. These mutations are called resistance-associated substitutions (RASs). Since RASs can cause treatment failure for patients, resistance detection is performed in clinical practice to select the ideal regimen. Currently RASs are detected by using Sanger sequencing and a partly manual workflow that can discriminate the presence of a RAS if it is present in 15-20% of viruses in a patients blood. A new method with the capacity to detect lower ratios of RASs in HCV sequences was developed, which utilizes Pacific Biosciences’ (PacBio’s) sequencing and a bioinformatics analysis software called CLAMP. To validate this new approach, 123 HCV patient samples were sequenced with both methods and then analyzed. The RASs detected with the new method were congruent to what was found with the Sanger-based workflow. The new approach was also shown to correctly genotype the virus samples, identify any co-existing mutations on the same sequences, and detect if there were any mixed genotype infections in the samples. The new procedure was found to be a valid replacement for the Sanger based workflow, with the possibility to perform additional analyses and perform automated and time efficient RAS detection.

Made available in DSpace on 2014-07-29T15:04:35Z (GMT). No. of bitstreams: 1 Grecia Carolina Pessoni.pdf: 1074052 bytes, checksum: 1a6c39b31bb8fa1188db36c9d804d866 (MD5) Previous issue date: 2010-04-05 / In order to investigate the seroepidemiological profile of hepatitis B virus (HBV) infection among female inmates from the Metropolitan Region of Goiânia, 148 women were interviewed on sociodemographic and risk factors for HBV. After, blood samples were collected for the detection of HBsAg, anti-HBs and anti-HBc by enzyme linked immunosorbent assay (ELISA). The majority of women had less than 36 years of age (77.1%), less than nine years of education (69.8%) and family income less than two Brazilian minimum wage (65.2%). Almost half (46.6%) of female inmates reported stable relationships. An overall HBV prevalence of 18.9% was found. One (0.7%) woman was HBsAg-positive. The anti-HBc was detected in 27 (18.2%) women, being 25/27 associated to anti-HBs, and 2/27 alone. In only 36 (24.3%) female inmates the anti-HBs isolated was detected, suggesting previous hepatitis B vaccination. The analysis of risk factors showed that age over 35 years, less than ten years of education, sexual partner in the prison , and previous STD were independently associated to HBV markers. The results of this study highlight the need for action to prevent the hepatitis B in the prison environment, including health education and immunization against hepatitis B. / Com o objetivo de investigar o perfil soroepidemiológico da infecção pelo vírus da hepatite B (HBV) em reeducandas da Regional Metropolitana de Goiás, 148 mulheres foram entrevistadas sobre dados sócio-demográficos e fatores de risco para a infecção pelo HBV. A seguir, foram coletadas amostras sanguíneas para a detecção dos marcadores HBsAg, anti-HBs e anti-HBc pelo ensaio imunoenzimático (ELISA). A maioria possuía menos de 36 anos de idade (77,1%), tempo de estudo inferior a nove anos (69,8%) e renda familiar de até um salário mínimo (65,2%). Praticamente a metade (46,6%) referiu relacionamento estável. Do total de reeducandas, verificou-se uma prevalência global de 18,9% para os marcadores da infecção pelo HBV. Uma (0,7%) reeducanda apresentou positividade para o HBsAg. O marcador anti-HBc foi detectado em 27(18,2%) mulheres, sendo que em 2/27 isoladamente e, em 25/27 associado ao anti-HBs. Em somente 36 (24,3%) reeducandas detectou-se positividade isolada para o anticorpo anti-HBs, sugerindo vacinação prévia contra o vírus da hepatite B. A análise dos fatores de risco mostrou que idade acima de 35 anos; escolaridade inferior a 10 anos, parceiro na agência prisional e antecedentes de DST foram independentemente associados aos marcadores de exposição ao HBV. Os resultados deste estudo evidenciam a necessidade de ações de prevenção da hepatite B no ambiente carcerário, incluindo educação em saúde e vacinação contra hepatite B.

Bakgrund: Hepatit C (HCV) är en virussjukdom som smittar via blodet. Personer sominjicerar droger (PSID) riskerar att drabbas av HCV till följd av injektionsrelateraderiskbeteenden. Idag finns det effektiv behandling mot HCV men det kräver viss följsamhet avden som behandlas. Syfte: Syftet var att undersöka sjuksköterskors upplevelser av följsamhet till behandling avhepatit C hos personer som injicerar droger. Metod: En kvalitativ intervjustudie genomfördes. Totalt intervjuades åtta sjuksköterskor frånfyra mottagningar. Datan analyserades sedan enligt Lundberg och Graneheims modell förkvalitativ innehållsanalys. Resultat: Resultatet sammanfattades under fyra huvudkategorier: Livssituation, Samverkan,Behandlingsrelaterade aspekter och Stigma. Totalt identifierades tretton subkategorier. Slutsats: Sjuksköterskor upplevde stora variationer i följsamhet till behandling hos PSID. Detupplevdes som positivt för följsamheten om PSID fick förutsättningar såsom en stabil tillvarooch regelbunden kontakt med en mottagning. I resultatet framkom att det var viktigt attvården var tillgänglig och att PSID fick ordentlig information om behandlingen. Det upplevdesäven som positivt om det fanns fungerande samverkan med både PSID och mellan deverksamheter som de kom i kontakt med. Stigmatiseringen av HCV och PSID upplevdessom ett centralt hinder för följsamhet. / Background: Hepatitis C (HCV) is a viral disease which is transmitted through blood. Peoplewho inject drugs (PWID) are at risk of developing HCV as a result of injection-related riskbehaviors. There is effective treatment for HCV, but it requires some degree of adherence. Aim: The aim was to investigate nurses’ experiences of adherence to treatment for hepatitisC in people who inject drugs. Method: A qualitative interview study was conducted. Eight nurses from four clinics wereinterviewed. The data was analyzed according to Lundberg and Graneheim's model forqualitative content analysis. Results: The results were summarized under four main categories: Life situation,Collaboration, Treatment-related factors and Stigma. Thirteen subcategories were identified. Conclusion: Nurses experienced large variations in adherence to treatment among PWID. Itwas perceived as positive for adherence if PWID had stable living conditions and regularcontact with a clinic. Availability and information about the treatment were important factors.It was also perceived as positive if there was functioning collaboration with PWID andbetween the institutions they came in contact with. The stigmatization of HCV and PWID wasperceived as a key obstacle to adherence.

Introduktion: Hepatit C är en global folkhälsoutmaning, med 58 miljoner som lever med kronisk infektion. Sverige har cirka 45 000 diagnostiserade fall, med hög odiagnostiserade förekomst. Hepatit C är ofta asymtomatisk, kan leda till allvarliga leverkomplikationer och död. Hepatit C är en blodsmitta och den vanligaste smittvägen är delade injektionsnålar/utrustning därav är intravenösa missbrukare en grupp som ofta drabbas. Behandlingen mot hepatit C har utvecklats med effektiva antivirala läkemedel sedan 2014, och nya riktlinjer innebär behandling för alla, även de med pågående missbruk. Eliminering av hepatit C är ett globalt hälsomål och kopplas till FN:s Agenda 2030 för hållbar utveckling. Syfte: Syftet med denna litteraturstudie var 1) beskriva olika interventioner som syftar till att eliminera hepatit C bland personer som missbrukar intravenösa droger genom att öka deltagande och 2) utvärdera interventionernas effekter avseende behandlingsdeltagande och behandlingsresultat. Metod: En strukturerad litteraturstudie genomfördes med tematisk analys och deduktiv ansats som analysmetod. Resultatet baseras på tio artiklar som kvalitetsgranskades. Resultat: Två teman identifierades; “Interventioner med fokus att öka delaktighet och deltagande av personer som injicerar droger i hepatit C-interventioner” och “Effekter på behandlingsdeltagande och behandlingsutfall”. Till dessa teman fanns även sex subteman. Resultaten visar att interventioner som inkluderar uppsökande verksamhet och integrerad vård har varit framgångsrika med att engagera personer som injicerar droger i hepatit C-vård. Slutsats: Eliminering av hepatit C är ett globalt mål som kan uppnås genom effektiva interventioner. Framgångsrik implementering av interventioner kräver ökad tillgänglighet, minskade hinder och förtroendeskapande interaktion. Det krävs fortsatt utveckling och breddning av interventioner. / Introduction: Hepatitis C is a global public health challenge, with 58 million people living with a chronic infection. Sweden has approximately 45 000 diagnosed cases, with a high prevalence of undiagnosed cases. Hepatitis C is often asymptomatic, can lead to severe liver complications and death. Hepatitis C is a bloodborne infection, and the most common route of transmissions is through shared injection needles/equipment hence intravenous drugs users are at a higher risk. Treatment for hepatitis C has evolved with effective antiviral drugs since 2014, and new guidelines advocate treatment for everyone, including those with ongoing substance abuse. Eliminating hepatitis C is a global health goal linked to the UN’s Agenda 2030 for sustainable development. Aim: The aim of this literature review was 1) to describe various interventions used to attempt the eradicate of hepatitis C among people who inject drugs, and 2) to evaluate the effects of the interventions in terms of treatment participation and treatment outcomes. Method: A structured literature review was conducted using thematic analysis with a deductive approach as the analysis method. The results are based on ten quality-reviewed articles. Results: Two themes were identified: "Interventions with a focus on increasing involvement and participation of people who inject drugs in hepatitis C interventions" and "Effects on treatmeant participation and treatment outcomes." Six subthemes also emerged within these themes. The results indicate that interventions involving outreach and integrated care have been successful in engaging people who inject drugs in hepatitis C care. Conclusion: Elimination of hepatitis C is a global goal achievable through effective interventions. Successful implementation requires increased accessibility, reduced barriers, and trust-building interaction. Continued development and expansion of interventions are necessary.

Title: Nurse’s experience of spreading awareness about self-care regarding Hepatitis B in Bali, Indonesia: A qualitative study. Background: Three to seven percent of the population has Hepatitis B (HBV) in Indonesia and six percent in Bali. Patients who apply self-care are more likely to achieve health. Self-care is about hygiene and eating habits where the healthcare provider should support the patient. Dorothea Orem’s theory about self-care is about the relationship between patients’ self-care abilities and needs for nursing support.  Aim: Describe nurses’ perception and experiences of informing patients about self-care regarding HBV in Bali, Indonesia. Method: Qualitative design, with semi-structured interviews with an inductive approach. Ten nurses have been interviewed at three hospitals and clinics in Bali.  Result: Three main findings, 1. Perception and experience of what information needed for a patient about self-care, 2. The nurses’ perception and experience of informing patients about transmission, 3. The nurses’ perception and experience of who is responsible for informing about vaccination for HBV. The result is presented in themes and subthemes. Conclusion: The nurses' experiences of informing patients about self-care regarding HBV, include hygiene, sexual contact, transmission, and vaccination. Their experiences differ in certain themes. However, nurses share their thoughts about self-care, even if their work experience differs. / Titel: Sjuksköterskans erfarenhet av att sprida medvetenhet om egenvård angående Hepatit B i Bali, Indonesien: En kvalitativ studie. Bakgrund: I Indonesien har tre till sju procent av befolkningen Hepatit B (HBV), samt sex procent på Bali. Patienter som tillämpar egenvård är mer benägna att uppnå hälsa. Egenvård handlar om att patienten tar hand om sina matvanor, hygien och medicinering, där vårdgivaren ska stötta och motivera patienten. Dorothea Orem’s teori om egenvård handlar om relationen mellan patienternas egenvårdsförmåga och behov av omvårdnadsstöd.   Syfte: Beskriva sjuksköterskors uppfattning och erfarenhet av att informera patienter om egenvård angående HBV i Bali, Indonesien.  Metod: Kvalitativ design, med semi strukturerade intervjuer och en induktiv ansats. Tio sjuksköterskor har intervjuats på tre sjukhus och kliniker på Bali.Resultat: Tre huvudfynd, 1. Uppfattning och erfarenhet om vilken information som behövs om egenvård, 2. Sjuksköterskornas uppfattning och erfarenhet av att informera patienter om smittspridning, 3. Sjuksköterskornas uppfattning och erfarenhet av vem som ansvarar för att informera om vaccination mot HBV. Resultat presenteras i teman och underteman. Slutsats: Sjuksköterskornas erfarenheter att informera patienter om egenvård kring HBV innefattar hygien, sexuell kontakt, smittvägar och vaccination. Deras erfarenheter skiljer sig åt i vissa teman. Sjuksköterskorna delar de flesta åsikter om egenvård även om deras arbetslivserfarenhet skiljer sig åt.