Related Articles Environmental factors affecting self-management of chronic hepatitis B from the patients’ perspective. J Clin Nurs. 2019 Jun 25;: Authors: Lin WS, Lee TT, Yang YH, Mills ME Abstract AIMS AND OBJECTIVES: To explore factors affecting self-management experiences of patients with chronic hepatitis B within their social and cultural environments. BACKGROUND: Many cases of hepatitis B are not detected until they are in end-stage liver disease. Despite an increasing trend of indicating a lack of health awareness as the reason, studies have rarely referred to the personal, social and cultural environmental constraints from patients’ perspectives. DESIGN: A descriptive qualitative study. METHODS: Forty-seven adults diagnosed with chronic hepatitis B were interviewed in a private area of a hospital clinic in Taiwan in 2018. Four open-ended questions relating to care self-management included: disease detection; disease control; preventive care; and, perceptions of screening and follow-ups. Data were examined using content analysis. This study also adhered to the consolidated COREQ guidelines. RESULTS: Five main themes emerged: personal experiences, awareness of occupational health, the availability of conventional treatment, cultural beliefs about healthcare, and family roles. Findings of note were that some participants became aware that they had never known the difference between follow-up for hepatitis B and regular adult/laborer health checks due to a lack of information within their living environment. Many participants added alternative treatments to their self-management strategies and others frequently ignored follow-up appointments because of different cultural health beliefs. CONCLUSIONS: Patients’ disease self-management perceptions are driven by dynamic influences suggesting that development of policies integrating personal, family, social, and cultural environmental factors could enhance individual screening and subsequent health behaviors of patients with chronic hepatitis B. RELEVANCE TO PRACTICE: Adding person-centered case management of hepatitis B could enhance patients’ adherence to follow-up. Attention should be given to increasing provider awareness of the influence of their own attitude and communication on patients’ participation in self-management. This article is protected by copyright. All rights reserved. PMID: 31240796 [PubMed – as supplied by publisher]

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Environmental factors affecting self-management of chronic hepatitis B from the patients’ perspective.