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Improving support and education of low-income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening.

AIMS AND OBJECTIVES: To identify support needs of low-income baby boomers recently diagnosed with chronic hepatitis C virus infection.

BACKGROUND: The U.S. Preventive Services Task Force has endorsed one-time screening of all baby boomers (born 1945-1965) for hepatitis C because 75% of the estimated 2-3 million persons with chronic infection are in this age range. We hypothesised that persons diagnosed by routine screening would have significant psycho-emotional, cognitive and healthcare challenges that need to be met by collaborative care and services from nurses and other healthcare personnel.

DESIGN: Qualitative descriptive study of data from three focus groups with predominantly minority participants (N = 16). Data were analysed using qualitative content analysis, and transcribed data were categorised by three domains in a previously developed model and a new domain identified in this study. Frequencies of unique participants' comments about each theme were calculated.

RESULTS: Elucidated domains were as follows: (i) psycho-emotional effects due to social stigma, shame, fear and dealing with risky behaviours; (ii) social effects due to concerns about infecting others; and (iii) cognitive deficits because of poor understanding about hepatitis C virus infection and its care. A new domain related to health care emerged reflecting the following themes: poor access to care, barriers to costly treatment, and navigating complex care for comorbidities. Despite these challenges, participants strongly endorsed universal baby boomer hepatitis C virus screening.

CONCLUSIONS: This study describes psycho-emotional and social challenges of people dealing with a hepatitis C diagnosis which are compounded by poor knowledge and barriers to supportive care.

RELEVANCE TO CLINICAL PRACTICE: Nursing and other allied health personnel require structured support programmes to assist older persons diagnosed with hepatitis C with addressing these common challenges with the ultimate goal of achieving a cure.

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