Exploring Perception of Chronic Hepatitis C: An Idiographic Case Study

By Arshad, Hana; Malik, Subha | Pakistan Journal of Psychological Research, January 1, 2019 | Go to article overview

Exploring Perception of Chronic Hepatitis C: An Idiographic Case Study


Arshad, Hana, Malik, Subha, Pakistan Journal of Psychological Research


Approximately, 3% of the world's population is afflicted with Hepatitis C virus (HCV), with the highest prevalence rates prominent in Africa and Asia (Alter, 2007). In the United States and Europe, numerous liver transplants were carried out for persistent HCV patients (Rockstroh et al., 2012). However, Khattak, Salamat, Bhatti, and Qureshi (2002) have found that Pakistan was on the second highest incidence of HCV varying from 4.5% to 8%. Furthermore, another study has indicated that the occurrence of positive HCV was high in rural regions as compared to urban districts of Pakistan (Aziz, Khanani, Noorulain, & Rajper, 2010).

Chronic HCV disease does not depend on a single factor. It affects various aspects of life, for example, lack of ability to carry out everyday activities, problems to manage expenses, marital distress, family issues, difficulties in social relations, as well as the trauma of dealing with the diseased status and symptoms. The incidence of symptoms most reported in HCV patients are sleep disturbances in less than 50% patients, fatigue, irritability, cognitive disturbances with impairment of concentration and memory (Dieperink & Willenbring, 2000; Schaefer, Wittchen, Seufert, & Kraus, 2007), 30-45% with anxiety, 30-60% with mild depression, decreasing self-esteem, loss of interest, anhedonia, spontaneous crying, 20-30% with moderate to severe depressive episodes, 0-0.02% suicidal thoughts, and 3-10% suicidal attempts (Bonaccorso et al., 2002). Other symptoms observed in these participants of the study were red palms, muscle and joint aches, itchy skin (usually no rash), and right side pain. These symptoms can occur in the early stages of infection or develop gradually (Dieperink & Willenbring, 2000).

Furthermore, hypertension, diabetes, liver diseases, gastrointestinal disorders, connective tissue diseases, and non traumatic joint disorders were also more common in HCV population (Ali et al., 2015; Qureshi, 2002). A number of researchers (Gohier et al., 2003; Hilsabeck & Malek, 2004) have found that anxiety and depression levels not merely elevate when taking interferon therapy, but also prolong later. In addition, the progression of HCV may also differ depending on several factors such as age and gender (Svirtlih et al., 2007), ethnic background (Sterling et al., 2004), environmental factors (Lim & Kim, 2008), HCV-specific cellular immune response (Hraber, Kuiken, & Yusim, 2007), and viral co-infections (Gebo et al., 2002).

One of the most fundamental predictor of mental control and psychological adjustment is social support (Norbeck & Tilden, 1988). It may have an effect on health in varied ways that is, physiological, emotional, and behavioral. A significant social aspect in prolonging the quality of life and reducing psychological side effects of Hepatitis C treatment schedules is support from loved ones, especially, life partners. A study was conducted to explore the reasons to initiate the treatment of HCV based on patient's choices (McNally, TempleSmith, & Pitts, 2004). These researchers also noticed that such patients were commonly expressing depression and mood swings when they went through the stress of demanding support from family members and were required to remain calm and silent at the given time.

Furthermore, the relationship between being healthy and social support was mediated by people's preferences in using different coping techniques (Holland & Holahan, 2003). For example, perceived social support might encourage a person to rely on many types of coping and manipulate one's preference or make use of particular coping strategies that might improve or worsen the social support effects on health. Therefore, social support contributes to play a vital role to increase the coping ability of a person (Tam, 2008).

Similarly, coping of the patient with a persistent disease can be considered as a central and vital element in the recovery process. …

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