Evaluation of Health Care Needs and Patient Satisfaction among Hepatitis C Patients Treated at a Hospital-Based, Viral Hepatitis Clinic
Balfour, Louise, Cooper, Curtis, Tasca, Giorgio A., Kane, Marie, et al., Canadian Journal of Public Health
Objective: To define self-reported hepatitis C knowledge, health care needs, and patient satisfaction in a representative cohort of hepatitis C virus (HCV)-infected adults treated at a university hospital-based viral hepatitis clinic in Canada.
Methods: A questionnaire package evaluating HCV knowledge, health care needs, and patient satisfaction was administered to 111 consecutive consenting HCV patients during their first and 10-month follow-up HCV clinic visits.
Results: At their first HCV clinic visit, 52% of patients rated their current HCV knowledge as "fair" or "poor". Patients identified HCV education, quality medical care, medication coverage, and psychological counselling as important HCV health care needs. Health care satisfaction outcome data at 10-month follow-up indicated that patients felt significantly better informed, more satisfied, and more actively involved in their HCV health care.
Conclusion: A bio-psychosocial framework in which medical, psychological, educational, and social issues are addressed is desirable for optimal HCV health care.
In Canada, an estimated 240,000 individuals are HCV-infected.1'2 Only a minority has been identified and even fewer have accessed appropriate care for this chronic infection. There is little published information describing hepatitis C knowledge among HCV-infected Canadians. Research from other countries suggests that knowledge about HCV may be particularly inadequate among individuals at high risk for HCV infection, including injection drug users,3'4 gay men,5 and American ethnic minorities.6
The needs of patients living with chronic illnesses, such as HCV, usually involve both physical and psychological components. For example, patients often need help managing recurrent symptoms of physical and emotional fatigue affecting work and family life.7 Medical patients for whom such needs are addressed by health care providers report better health care satisfaction.8 This is important because satisfied patients attend their medical appointments more regularly and adhere better to their treatments.9,10 Patient satisfaction is multi-determined and includes diverse aspects of care such as accessibility of services, quality of medical care, clarity of communication, and the interpersonal style of the health provider." Studies repeatedly demonstrate that patients who feel more actively involved in their health care decision-making process are more committed to their care, adhere better to positive health behaviours, and are more satisfied with their health care.12'14 To our knowledge, no studies have examined HCV-related health care needs and health care satisfaction among HCV-infected patients. Thus, the present study was designed to evaluate HCV knowledge, determine health care needs, and quantify health care satisfaction in HCV patients before and after receiving care in a hospital-based viral hepatitis clinic.
The Ottawa Hospital Division of Infectious Diseases Viral Hepatitis Clinic was established in june 2000 with a mandate to provide care to adults living with viral hepatitis, to increase patients' knowledge about HCV risk factors and treatment options, and to empower patients to actively participate in their HCV treatment plan. To this end, at HCV patients' first clinic visit, patients receive basic HCV education through discussion with medical staff. Patients are also provided with HCV-specific educational literature. An evaluation of patients' bio-psychosocial needs is conducted by a clinic nurse and physician, and patients are subsequently referred to psychology, social work, and other allied health care services, as required.
This study was a joint effort between the Department of Psychology and Division of Infectious Diseases conducted at The Ottawa Hospital Viral Hepatitis Clinic. All English- or French-speaking adult HCV-seropositive patients attending their initial Viral Hepatitis Clinic visit were approached to participate in this study. …