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

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.