Liver Health Literacy and Health Status Among Adults With Hepatitis C: Implications for the Nursing Profession as Part of the 2030 Global Elimination Goal

J Nurs Scholarsh. 2020 Mar;52(2):128-135. doi: 10.1111/jnu.12533. Epub 2019 Nov 21.

Abstract

Purpose: To explore the prevalence of hepatitis C virus (HCV) infection as well as the levels of liver health literacy and association with the health status of people with HCV through the nurse-led community health development goal of global elimination.

Methods: A community-based, cross-sectional study was conducted between July 2018 and June 2019 in coastal Western Yunlin County, Taiwan. This study was conducted at five townships, and serum HCV antibody (anti-HCV) screening was used for the identification of potentially infected people by a collaborating local hospital.

Results: Of the 1,963 adults from rural areas enrolled in this study, 321 (16.4%) were anti-HCV positive, 237 (73.8%) reported that they were unaware of their HCV positivity, and none of them were provided information on direct-acting antiviral agent therapy. The levels of anti-HCV positivity were higher among female patients (p < .05), elderly people (p < .001), those with a low education level (p < .001), and those from the Sihu Township within Yunlin County (p < .001). Participants with anti-HCV positivity tended to have lower intakes of vegetables (p < .01) and fruit (p < .05), a greater number of comorbidities (p < .05), as well as a greater incidence of abnormal liver (p < .001) and renal function (p < .001) compared to those with anti-HCV negativity. Multivariable linear regression analysis showed that the presence of HCV infection and a greater number of metabolic syndrome components were associated with poor liver and renal function.

Conclusions: These findings showed a high prevalence of HCV infection among adults living in rural areas, who had low literacy levels on hepatitis, unhealthy lifestyles, and abnormal liver and renal function.

Clinical relevance: Clinicians and primary healthcare providers should initiate efforts to increase the levels of liver health literacy by increasing the accessibility to infection confirmation tests and reducing the number of barriers to the reception of antiviral treatment.

Keywords: Direct-acting antiviral therapy; hepatitis C virus rural; liver health literacy; prevalence; unhealthy lifestyle.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Community Health Services / organization & administration
  • Cross-Sectional Studies
  • Diet
  • Disease Eradication
  • Female
  • Global Health
  • Health Education / organization & administration
  • Health Knowledge, Attitudes, Practice
  • Health Literacy*
  • Health Status
  • Hepacivirus
  • Hepatitis C Antibodies / blood
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / epidemiology
  • Hepatitis C, Chronic / nursing*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nursing / methods*
  • Patient Education as Topic / methods*
  • Prevalence
  • Rural Population
  • Taiwan / epidemiology
  • Young Adult

Substances

  • Antiviral Agents
  • Hepatitis C Antibodies