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Exploring the experiences of an at-risk population with chronic hepatitis C infection (HCV) and their perceptions of accessing treatment through an integrated model of care

2021, O’Connor, Eileen, 0000-0002-9292-490X

Aim: The aim of the study was to explore the experiences of persons from marginalised/at-risk backgrounds living with HCV and the role of the nurse in supporting this at-risk population to access treatment for chronic Hepatitis C Virus (HCV). Design: An explorative qualitative study conducted with adult men and women who received the nurse intervention in order to support them through Hepatitis C Virus (HCV) treatment in community settings in Dublin. Data was collected from July 2019 to October 2019. Method: A Focused Ethnographic study design was used to complete this qualitative study. Participants were purposely sampled (n=9). The main setting for the interviews was an addiction treatment centre which provides opiate substitution therapy to patients. Semi-structured interviews were carried out to explore the experiences of at-risk populations living with HCV. Ethical approval was granted by the Institutional Review Board at the Mater Misericordiae University Hospital, Dublin. Findings: The data captured from nine interviews was analysed using a thematic networks technique as described by Attride-Stirling (2001) leading to four overarching themes: (a) living with addiction, (b) impact of living with HCV, (c) role of the nurse and (d) experiences of life without HCV. Each theme had an affinity with the patient’s experiences of living with HCV and obtaining a cure for this chronic illness. The importance of a strong relationship with the nurse emerged as did the perception of HCV as a disease with associated stigma and many barriers to treatment. Conclusions and implications for practice: Recommendations for improved care reported by participants included improved education, better support from peer support workers and healthcare staff and increased access to treatment in the community. Participants highly valued the personalised, patient centred approach provided by the nurse. Changes in care pathways to include better social structural supports, and changes to care are crucial to effect change.

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Study Protocol: Prospective, observational, cohort study of COVID-19 in General Practice (North Dublin COVID-19 Cohort [‘ANTICIPATE’] Study)

2020-09-17, Cullen, Walter, Avramovic, Gordana, Broughan, John, Burke, Mary Carmel, Cotter, Aoife, Crowley, Des, Downey, Joanne, Duggan, Paul, Fawsitt, Ronan, Guerandel, Allys, Hennessy, Eilis, Kelleher, Cecily, Mills, Gerald, McCombe, Geoff, McHugh, Tina, O’Connor, Eileen, Perrotta, Carla, Lambert, John

Background: It is accepted that COVID-19 will have considerable long-term consequences, especially on people’s mental and physical health and wellbeing. Although the impacts on local communities have been immense, there remains little data on long term outcomes among patients with COVID-19 who were managed in general practice and primary care. This study seeks to address this knowledge gap by examining how the COVID-19 pandemic has impacted the medium and long-term health and wellbeing of patients attending general practice, especially their mental health and wellbeing. Methods: The study will be conducted at 12 general practices in the catchment area of the Mater Misericordiae University Hospital, i.e. the North Dublin area, an area which has experienced an especially high COVID-19 incidence. Practices will be recruited from the professional networks of the research team. A member of the general practice team will be asked to identify patients of the practice who attended the practice after 16/3/20 with a confirmed or presumptive diagnosis of COVID-19 infection. Potential participants will be provided with information on the study by the clinical team. Data will be collected on those patients who consent to participate by means of an interviewer-administered questionnaire and review of clinical records. Data will be collected on health (especially mental health) and wellbeing, quality of life, health behaviours, health service utilisation, and wider impacts of COVID-19 at recruitment and at two follow up time points (6, 12 months). Deliverables: The project involves collaboration with Ireland’s Health Service Executive, Ireland East Hospital Group, and the Mater Misericordiae University Hospital, Dublin. The study is funded by the Health Research Board. Findings will inform health policies that attenuate the adverse impacts of COVID-19 on population mental health and health generally.