Chronic Hepatitis C and Antiviral Treatment Regimens: Where Can Psychology Contribute?
Chronic Hepatitis C and Antiviral Treatment Regimens: Where Can Psychology Contribute?
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DOI：
10.1037/a0029030
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发表时间：
2013-04-01
影响因子：
5.9
通讯作者：
Keefe, Francis J.
中科院分区：
文献类型：
--
作者：
Evon, Donna M.;Golin, Carol E.;Keefe, Francis J.
目的：我们的目的是评估关于慢性丙型肝炎病毒（HCV）感染和抗病毒治疗的心理、社会和行为方面的现有文献；提供目前阻碍丙型肝炎相关健康结果的领域的行为科学状况；并对临床心理学可以做出重大贡献的领域提出建议。方法：回顾现有关于丙型肝炎病毒和抗病毒治疗的相关文献，包括心理健康、物质/酒精使用、生活质量、应对、耻辱、种族差异、副作用、治疗依从性、综合护理和心理干预等生物心理因素。结果：由于尚未很好阐明的原因，感染HCV的个体会出现心理和躯体问题，并报告与健康相关的生活质量较差。先前存在的疾病，包括精神健康状况不佳和酒精/药物使用，可干扰获得和成功完成丙型肝炎病毒治疗。感知到的耻辱非常普遍，并与心理困扰有关。在HCV患病率、接受治疗和治疗成功方面存在种族差异。在HCV治疗期间，患者会出现症状加重、治疗副作用和生活质量下降，使其难以完成治疗。尽管在HCV治疗方面取得了药理学进展，但临床和公共卫生结果的改善尚未实现。这种缺乏影响的原因是多方面的，包括许多患者的转诊和获得护理的机会不够理想，治疗相关的副作用，治疗不依从性，以及缺乏基于经验的方法。结论：HCV生物医学的进步和抗病毒治疗创造了一个肥沃的领域，心理学家在HCV的管理和治疗中具有独特的地位，做出了重要贡献。
Objective: Our goal was to evaluate the existing literature on psychological, social, and behavioral aspects of chronic hepatitis C viral (HCV) infection and antiviral treatment; provide the state of the behavioral science in areas that presently hinder HCV-related health outcomes; and make recommendations for areas in which clinical psychology can make significant contributions. Method: The extant literature on HCV and antiviral therapy was reviewed as related to biopsychosocial factors such as mental health, substance/alcohol use, quality of life, coping, stigma, racial disparities, side effects, treatment adherence, integrated care, and psychological interventions. Results: For reasons that have not been well elucidated, individuals infected with HCV experience psychological and somatic problems and report poor health-related quality of life. Preexisting conditions, including poor mental health and alcohol/substance use, can interfere with access to and successful completion of HCV treatment. Perceived stigma is highly prevalent and associated with psychological distress. Racial disparities exist for HCV prevalence, treatment uptake, and treatment success. During HCV treatment, patients experience exacerbation of symptoms, treatment side effects, and poorer quality of life, making it difficult to complete treatment. Despite pharmacological advances in HCV treatment, improvements in clinical and public health outcomes have not been realized. The reasons for this lack of impact are multifactorial, but include suboptimal referral and access to care for many patients, treatment-related side effects, treatment nonadherence, and lack of empirically based approaches. Conclusions: Biomedical advances in HCV and antiviral treatment have created a fertile field in which psychologists are uniquely positioned to make important contributions to HCV management and treatment.