Barriers to accessing care in patients with chronic hepatitis C: the impact of depression.
Barriers to accessing care in patients with chronic hepatitis C: the impact of depression.
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DOI：
10.1111/j.1365-2036.2010.04460.x
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发表时间：
2010-11
影响因子：
7.6
通讯作者：
Fried MW
中科院分区：
文献类型：
--
作者：
Evon DM;Simpson KM;Esserman D;Verma A;Smith S;Fried MW
丙型肝炎病毒（HCV）患者可能会感知到获得HCV专科护理的障碍，这些障碍可能与抑郁症状有关。评估护理障碍、人口统计学和抑郁症状之间的关系。两个专科HCV诊所126例HCV患者的横断面分析。护理障碍，抑郁症状和社会人口统计学使用标准化的工具进行测量。进行回顾性病历审查以收集临床结局数据。26%的人报告有抑郁症状。常见的障碍包括缺乏个人财政资源;社区缺乏对丙型肝炎病毒的了解;缺乏有能力进行丙型肝炎病毒护理的专业人员;对丙型肝炎病毒的污名化;以及距离提供护理的诊所很远。在我们控制了社会人口统计学因素后，抑郁在所有障碍中占额外的7-18%（所有p值<0.01）。在38%（45/120）的患者中，较低的抑郁、婚姻和就业状况与随后接受HCV治疗相关;感知障碍则无关。抑郁症与感知的护理障碍独立相关。较高的抑郁评分，但不知觉的障碍，与非治疗。诊断HCV的医疗保健提供者需要认识到获得HCV护理的许多感知障碍，以及抑郁症可能对这些感知和接受治疗的影响。
Patients with hepatitis C viral (HCV) may perceive barriers to accessing speciality care for HCV, and these barriers may be related to depressive symptoms. To evaluate the relationship between barriers to care, demographics, and depressive symptoms. A cross-sectional analysis of 126 patients referred for HCV at two speciality HCV clinics. Barriers to care, depressive symptoms and sociodemographics were measured using standardized instruments. A retrospective chart review was conducted to collect clinical outcome data. Depressive symptoms were reported in 26%. Common barriers included lack of personal financial resources; lack of HCV knowledge in the community; lack of professionals competent in HCV care; stigmatization of HCV; and long distances to clinics offering care. After we controlled for sociodemographics, depression accounted for an additional 7–18% of variability in all barriers (all p values <0.01). Lower depression, marital and employment status were associated with subsequent receipt of HCV treatment in 38% (45/120) of patients; perceived barriers were not. Depression is independently associated with perceived barriers to care. Higher depressive scores, but not perceived barriers, were associated with nontreatment. Healthcare providers who diagnose HCV need to be cognizant of numerous perceived barriers to accessing HCV care, and the impact that depression may have on these perceptions and receipt of treatment.
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1016/j.sapharm.2005.09.002
发表时间：
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期刊：
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1998-06-01
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作者：
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