The modern world constantly introduces changes in various aspects of life. In her article, Prinzin (2022) describes modifications in children’s health due to an outbreak of acute hepatitis (AH) of unknown origin. Some major points that the author explains concern the primary causes of hepatitis, possible contributors, and the current state of the investigation regarding the outburst of the infection (Prinzin, 2022). The report provides several noteworthy insights about AH in youths. First, the outbreak began in 2021 at the Children’s Hospital of Alabama, where some minor patients started presenting with AH (Prinzin, 2022). Second, the children did not have histories of significant diseases but, at the hospital, were having such symptoms as vomiting, abdominal pain, diarrhea, and jaundice (Prinzin, 2022). Third, doctors do not yet know the etiology of hepatitis, but the patient’s blood tests are reported to have adenovirus infection (AI), which can generate various health problems (Prinzin, 2022). Fourth, while medics have some hypotheses, stating the reasons behind AH in moderately healthy children (Prinzin, 2022) is difficult. The unidentified source of AH outbursts in the younger generation raises worries for many people.
Furthermore, the article provides information about multiple cases in different countries and the progress of the investigation. First, after the USA, AH of unknown cause was detected in children across Scotland and the United Kingdom (Prinzin, 2022). Second, despite having similar symptoms of AH, none of the patients have other types of hepatitis viruses (Prinzin, 2022). Third, the age of those diagnosed ranges from 1 month to sixteen years old (Prinzin, 2022). Fourth, the youths are noted to be previously healthy with no common exposure between cases (Prinzin, 2022). Fifth, determining the cause of the outbreak is intricate because the researchers have to consider multiple factors regarding such aspects as context and changes in diagnostic testing approaches (Prinzin, 2022). Sixth, there are five working hypotheses, and it appears that AH is likely to be provoked by more than a single infectious agent (Prinzin, 2022). Overall, the article was interesting to me as I am concerned about diseases of unidentified origin. The presented information is relevant to my career as a nurse because it is crucial for medical professionals to be knowledgeable about illnesses that are spread worldwide.
The healthcare system faces the essential task of supporting public health. Epidemiology contributes to this goal by defining the patterns of diseases and striving to develop the most effective measures for their prevention and control. Nurses play an influential role in developing and applying epidemiology knowledge, primarily through community outreach (Macha & McDonough, 2012). The current paper considers a hepatitis incident of unknown etiology in a child in North Dakota. Such a problem can become a severe threat to public health, and it is of particular concern that the younger generation is affected since the disease can impact their entire life.
Background
Over the March-September period, the half year of 2022, several diseases have been of concern in the United States. Despite a slight decline in incidence, COVID-19 continues to spread, and an additional threat has emerged due to the monkeypox outbreak. However, a review of the news presented on the North Dakota Department of Health (NDDoH, 2022) website showed that a hepatitis incident caused the most significant concern in the state over the studied period. The disease affected the child, and its cause is unknown. The young patient from Grand Forks County was hospitalized for a short period, after which the child recovered at home (NDDoH, 2022). North Dakota is not the only state where children have suffered from this condition.
The cases of hepatitis caused severe concern and therefore required investigation. Locally, NDDoH (2022) urged medical officers to check records for various suspicious cases of hepatitis, also requiring studies. Moreover, the Department joined the Centers for Disease Control and Prevention (CDC), which uses epidemiological investigation tactics to discover the causes of hepatitis in children (NDDoH, 2022). While there was only one patient in North Dakota, 109 cases were recorded, of which 90% needed hospitalization, 14% had a liver transplant, and five children died nationwide in May 2022 (Kimball, 2022). According to the World Health Organization (WHO, 2022), hepatitis affects patients of both genders, but most cases are children under six years old. Epidemiological research is the basis for searching for the causes of the disease and ways to combat it.
Public Health Implications
The investigation, which NDDoH joined, did not reveal the exact cause of hepatitis. The latest updates were in August 2022, reporting an increase in cases in various states (Centers for Disease Control and Prevention [CDC], 2022b). Some children exposed to the disease also had signs of adenovirus infection, resulting in assumptions about the association between diseases (NDDoH, 2022). However, this linkage has not been officially confirmed as a prerequisite for the emergence of hepatitis (Kimball, 2022). At the same time, the study also discarded such possible causes as bacteria, the virus causing COVID-19, Wilson disease, and autoimmune hepatitis (CDC, 2022a). As a consequence, the key findings of the investigation are the exclusion of possible causes, but work continues, concentrating on control and prevention.
The spread of hepatitis to children carries a significant threat, having a negative impact on their health. In particular, the disease has symptoms such as vomiting, diarrhea, jaundice, fever, hepatomegaly, and other manifestations that occur in a majority of patients (Zhaori, 2022). Since the causes of the condition have not yet been established, treatment is primarily supportive. At the same time, hepatitis can lead to severe liver damage and failure, and as a result, the child may need transplantation (Zhaori, 2022). As statistics confirm, in severe cases, the disease leads to the death of patients.
The negative impact on health and demand in treatment and control also leads to financial implications. The treatment for considered hepatitis is supportive and directed towards the symptoms, which may vary in cases (Zhaori, 2022). As a result, the cost of treatment is also different for patients. Liver transplantation surgery, necessary for those whose liver is badly damaged, has a high price. According to Ewumi (2022), payment must cover procurement, preparation for surgery, physician services, post-operative care, and other aspects, which in total is more than $875,000. Additional expenses are spent on conducting an epidemiological study, which includes providing employees, paying for materials, and other necessary elements. Thus, hepatitis of an unknown cause should already have significant financial consequences, and the potential cost may increase with its spread.
Planned Response. Health Promotion & Illness Prevention
Given the complexity of the disease and its health and financial implications, it is essential to take measures to prevent it. In particular, recommendations from NDDoH (2022) suggest that parents closely monitor potential symptoms of hepatitis and, in case of suspicion, consult a doctor for the necessary help. While the association with adenovirus infections is not officially confirmed, the Department still recommends monitoring its symptoms as well (NDDoH, 2022). They include manifestations of sore throat, fever, pink eye, diarrhea, and pneumonia (NDDoH, 2022). Crucial aspects of health promotion are measures to prevent the appearance of diseases, including considered hepatitis. NDDoH (2022) suggests being careful when symptoms of any illness appear and staying at home, as well as washing hands, and following vaccination guidelines. The WHO (2022) expands recommendations by suggesting avoiding crowded places, using safe water and food, and keeping homes clean. These measures will reduce the number of children that can get hepatitis.
Another aspect of health promotion and prevention of hepatitis is the work of medical personnel with the public. The Intervention Wheel offers a framework for working with the population, considering various aspects (Minnesota Department of Health [MDH], 2019). Several interventions identified in this approach can be used in the studied case of hepatitis. Since there is no established cause of the disease, nurses must apply practical actions from red wedge interventions. They include surveillance, investigations, screening, case-finding, and outreach (MDH, 2019). Efforts to educate the population are also needed, which imply consultations, counseling, and teaching. Such measures will contribute to communities’ awareness and ability to prevent the disease and take action in the case of symptoms manifestation.
Part of the activity of public health nurses is the impact on politics. In the case of hepatitis of unknown cause, medical staff needs to protect the interests of patients and facilitate the investigation of its causes through stakeholder involvement. Moreover, their influence on the policy may include providing recommendations for disease control, drawing stakeholders’ attention to the problem, and urging society to follow guidelines (MDH, 2019). Although hepatitis is a serious concern, these measures are still sufficient to prevent it, and it is essential to direct efforts to investigate the cause.
Conclusion
Thus, a study of public health incidents in North Dakota found that in addition to COVID-19 problems, the case of hepatitis with an unknown cause in the child also caused serious concern in half a year. The disease has affected many more children in other states, and the NDDoH has joined the CDC epidemiological investigation to find the causes. Hepatitis negatively affects health, manifesting in unpleasant symptoms and leading to liver failure and, as a result, the need for transplantation. Such operations and investigations have significant financial implications but are necessary for treatment. Critical interventions include continuing research, educating the public, and protecting their interests.
Regardless of multiple attempts to address the issue and resolve the problem, Hepatitis B remains a relevant health issue. For this reason, the offered paper focuses on the in-depth analysis of the health condition, including its epidemiology, evaluation, and possible strategies for intervention aimed at reducing incidence rates and promoting better outcomes. The research determines the importance of nursing planning and interventions to attain the existing goals and how they can influence communities and populations’ health. In general, the investigation promotes a better understanding of Hepatitis B, its influence on populations, and how the problem can be addressed by using available resources.
Rationale
The choice of the topic is justified by several factors. First of all, statistics prove that Hepatitis B remains a severe challenge for the healthcare sector. About two billion people have the virus globally, while 1.5 million become newly infected every year (Tu et al., 2020). Moreover, 300 million have chronic forms of the given disease, which increases the scope of the problem (Tu et al., 2020). Another critical problem is that only 10% of all people with the disease are diagnosed, which results in 820,000 deaths every year associated with hepatitis B (Tu et al., 2020). Under these conditions, it becomes critical to address the problem.
Second, the relevance of the issue under discussion is justified by its significant influence on communities’ health. The virus can be spread in several ways, including sharing personal care items, making the risks more significant. The increased number of new cases every year means that communities’ health reduces. At the same time, hepatitis B spread is associated with low awareness and health literacy, meaning that interventions aimed at promotion and prevention might be an effective tool to address the problem (Soriano et al., 2020). For this reason, the significance of the topic and the necessity to address it impacted the choice.
Background
Prior to discussing the chosen health condition, it is critical to acquire its improved understanding. Hepatitis B is a severe infection resulting in serious inflammation, leading to liver damage if left untreated (Chen, Hsieh and Wu, 2021). The virus spreads the disease, which can be transmitted in several ways, making the threat more significant. Thus, the complications linked to the condition include liver cancer, cirrhosis, severe tissue damage, and even death (Chen, Hsieh and Wu, 2021). For this reason, hepatitis B is viewed as one of the complex infectious diseases requiring immediate treatment and specific measures to stop its further spread.
The disease has two forms, acute and chronic hepatitis B. The first one occurs during the first stages of being infected. During the first six months, a patient can clear their bodies and recover using specific treatment and methods recommended by a specialist (Sadlier et al., 2017). However, in numerous cases, hepatitis B becomes chronic, leading to severe inflammation and liver cancer. Appropriate care can slow down the development of the infection and increase the chances of surviving (Sadlier et al., 2017). In this regard, the disease is a critical concern influencing the population’s health and their chances for well-being.
Epidemiology
Hepatitis is one of the most common infections in the world. Statistics show about 350 million chronic cases of the virus. It is transmitted from mother to child during delivery, through contacts with blood or other body fluids during sexual contact with infected partners or unsafe injections (WHO, 2021). The major risk groups include people working in healthcare, individuals with numerous sex partners, children born from infected mothers, drug-addicted persons sharing needles, or groups living in areas with poor sanitation (Public Health England, 2017). In such a way, hepatitis B has several ways of transmission, making it more dangerous for different cohorts.
At the same time, several risk factors might simplify being infected with hepatitis B. These include diabetes or HIV infection, resulting in weakened immunity and reducing a person’s chance for successful recovery. Moreover, health workers providing care to infected patients are also at high risk (MacLachlan and Cowie, 2015). Finally, the lack of awareness and health literacy promotes the higher risks of being infected because of the lack of knowledge of how the disease is transmitted and how to protect themselves from it. These factors influence the high incidence rates, about 1,5 million new cases every year (WHO, 2021). For this reason, it is critical to address the problem.
Assessment
Regarding the relevance of the outlined problem, it is vital to possess the necessary information to address it. It means that assessment acquires the top priority as one of the tools helping to perform the task. In the nursing practice, it means collecting and evaluating data pertaining to a particular condition to acquire a holistic understanding of existing clients’ needs and risk factors (Maniago et al., 2020). Regarding hepatitis B, a health worker should focus on working with patients to realise the challenges they face and possible facilitators of the further disease’s spread. It would lead to better virus control and improved outcomes.
Hepatitis B can be discovered by collecting information about specific changes in the functioning of the body and paying attention to the main symptoms. Thus, fever, fatigue, and loss of appetite are one of the first signs signalising problems with the liver and the necessity to address the doctor (de Mendoza et al., 2019). Furthermore, vomiting, abdominal pain, and dark urine will also help to conclude the existence of the virus (de Mendoza et al., 2019). Collecting this sort of information, a nurse, or a patient, can discover hepatitis B at early stages and prevent its development and transformation into a chronic condition. It means that assessment plays a critical role.
Finally, the diagnosis can be proven by several lab tests that should be done on a patient. First of all, the blood test will provide a clear answer whether the hepatitis B virus is present in the body and there is a need to start treatment (de Mendoza et al., 2019). Second, therapists can make a liver ultrasound to investigate the current state of the liver and conclude about the severity of liver damage (de Mendoza et al., 2019). The given tests, as well as assessment procedures, will help to diagnose the condition and prescribe an on-time and effective treatment leading to significant improvement of clients’ states and their recovery.
Goals
The importance and scope of the selected health condition demand introducing clear goals to improve the situation. They provide the direction for planning specific interventions and serve as the criteria needed to evaluate the current progress (Murdaugh Parsons and Pender, 2018). Speaking about hepatitis B, it is vital to focus on such promotion activities as the improved knowledge of the major symptoms, the increased awareness of the prevention mechanisms and prophylactic measures, better knowledge of vaccination’s effectiveness and access to it (Pattyn et al., 2021; Roade et al., 2021). Under these conditions, it is possible to formulate the following health promotion goals:
By the end of the intervention, to improve knowledge of hepatitis B symptoms among specific populations and risk groups.
By the end of the intervention, to enhance health literacy regarding the disease’s transmission and ways to avoid it.
To attain an improved understanding of vaccination effectiveness by community members and increase its accessibility by the end of the intervention.
The given goals are vital for the health promotion activities as their achievement will establish a healthier environment and improve communities’ well-being.
Interventions
The information above shows that hepatitis B remains a critical concern influencing numerous population groups globally. For this reason, numerous international health agencies, such as WHO, or national bodies, such as British Department for Health, are interested in establishing a practical paradigm to address the condition and reduce the number of new cases annually (WHO, 2021). Under these conditions, health promotion, as the process of enabling people to control and improve their health, acquires the top priority (Freeland et al., 2021). It helps to focus on individuals’ behaviours and provide them with methods and tools to monitor their health and ensure better outcomes. For hepatitis B, health promotion is viewed as one of the major methods to ensure the reduced number of chronic cases per year and the more effective treatment of acute forms (Freeland et al., 2021). Nurses, as the specialists directly interacting with clients, become the central care providers responsible for final success.
Thus, the goals introduced previously can be attained by using several specific nursing interventions and health promotion strategies. First of all, the lack of knowledge about hepatitis B among populations should be addressed. Nurses should be central actors engaged in the process and responsible for outcomes. One of the first essential interventions implies direct collaboration with patients belonging to risk groups or problematic communities (Freeland et al., 2021). Health workers should educate populations about the major symptoms associated with the health condition and the importance of regularly self-assessment. It will help to determine the disease at its early stage and ask for assistance (Nankya-Mutyoba et al., 2019). Moreover, statistics show that the disregard of the early symptoms, along with the inability to recognise them, is one of the most common causes for transforming acute hepatitis B into a chronic one (Potvin and Jourdan, 2021). For this reason, the offered intervention will help to address the problem directly and improve the current situation.
The second measure is linked to the first one and implies sharing knowledge about hepatitis B prophylactics and prevention. According to WHO (2021), the higher risk of becoming infected is peculiar to people living in areas with poor sanitation. The disregard of the principal rules, such as access to clean water, regular hand washing, and safe food, results in the emergence of a threat of further virus spread (Potvin and Jourdan, 2021). Moreover, poor knowledge of how hepatitis is transmitted also becomes a factor promoting the increased incidence and the worsening of the problem (Nankya-Mutyoba et al., 2019). For this reason, nurses should focus on explaining to patients the major prophylactic measures that might help to avoid being infected and remain healthy. At the same time, it will help to align the enhanced collaboration between a care provider and a client, which is vital for outcomes and health promotion.
The second goal, increased health literacy and awareness, can also be attained using specific nursing interventions. Thus, the employment of available community resources is one of the effective ways to achieve the purpose and promote success. A nurse is responsible for outcomes and the gradual improvement of communities’ states, meaning he/she should be ready to collaborate with local authorities and outline the necessity to support clients. It implies using schools, health facilities, and other public organisations as the platform for sharing knowledge and providing individuals with materials improving their health literacy and helping to acquire new information about hepatitis B, its epidemiology, and how the virus is transmitted (Nankya-Mutyoba et al., 2019). Employment of community resources is a potent intervention available to nurses as a part of health promotion incentives and helping to create the basis for future improvement and increased well-being.
The third goal implies promoting enhanced knowledge about vaccination and its importance in struggling against hepatitis B. Thus, WHO (2021) outlines several barriers to increasing the number of vaccinated people, including poor knowledge about this measure and limited access to required health care. For this reason, the nursing intervention to achieve the goal should focus on these two issues. One of the possible ways is to cooperate with local health facilities and care providers (Bridges et al., 2019). In numerous cases, vaccines are available to individuals, but they are not willing to be vaccinated because of the lack of understanding of the scope of the issue (Tian et al., 2019). In such a way, a nurse should engage in direct interaction with local health facilities to ensure its workers support the idea of vaccinating people and are ready to provide various resources to support the incentive (Jelsoe et al., 2018). Furthermore, regular screening and blood tests should be offered to clients from risk groups to reduce Incidence rates and assist in struggling against further hepatitis B spread.
The choice of the given measures is explained by several factors. First, effective health promotion implies using community resources to increase the effectiveness of selected interventions and ensure they are available to clients. For this reason, local authorities and agencies should be engaged in health promotion activities as a collaborative effort will help to enhance outcomes and reduce incidence rates. At the same time, educational activities aimed at cultivating awareness and health literacy among risk groups and community members demonstrate the levels of effectiveness (Potvin and Jourdan, 2021). Under these conditions, it is possible to focus on these interventions and align the close cooperation between nurses and clients to guarantee positive outcomes.
Altogether, nursing interventions aimed at health promotion and improving communities’ states acquire the top priority regarding the struggle against hepatitis B. The scope of the problem and its relevance require immediate and effective action to ensure the public health is improved and individuals can benefit from the improved quality of life. For this reason, community involvement and closer cooperation between nurses and clients will help to address the problem and attain success in reducing the incidence rates. It becomes vital to achieve the outlined goals by using offered interventions.
Evaluation
It is expected that the outlined measures and interventions will help to attain the major goals and improve the state of the health issue. However, it is vital to track the progress and introduce necessary changes if needed. For this reason, evaluation becomes a significant aspect of nursing care planning. It implies a continuous activity of monitoring and documenting the patients’ or clients’ status and overall progress towards achieving the goals of the introduced interventions (Murdaugh, Parsons and Pender, 2018). It means a nurse should be responsible for observing the effects promoted by the strategies implemented regarding health promotion activities and introducing necessary changes. Otherwise, there is a high risk of unexpected outcomes and deterioration of the situation.
The evaluation process should also be applied to the proposed intervention to determine whether it is effective or not. Thus, it means that a nurse should use the previous experience and information about a client or community, as well as the condition, to determine whether the plan works and the goals are achieved. Regarding hepatitis B and health promotion activities, several major factors should be addressed. First of all, the number of new cases can be monitored (Nankya-Mutyoba et al., 2019). The reduction in incidence will indicate the program’s effectiveness and its contribution to promoting better well-being. Second, the overall level of health literacy can be monitored by communicating with clients. It will help to reveal remaining gaps and address them by offering new interventions. Finally, official health statistics related to the area should be reviewed to acquire credible data. It will help to determine the effectiveness of the planned intervention and its influence on the community’s health.
However, health promotion activities should be continuous, meaning there is a need for maintenance and improvement. That is why it is essential to create the basis for improving and achieving long-term goals. First, educational activities should be available during the prolonged term and should not be stopped. Better health literacy and awareness are the core components of health promotion as they enable clients to make informed decisions about their conditions (Patrick and Kingsley, 2019). It will guarantee that the intervention will remain active, and individuals will acquire relevant information about the disease (Freeland et al., 2021). Moreover, it is vital to ensure that local authorities are involved, as it is a key to better cooperation at different levels and the ability to resolve topical issues (Stanhope and Lancaster, 2021). By making these steps, the program can be maintained, and desired outcomes can be achieved.
At the same time, continuous enhancement is vital for attaining planned goals. For this reason, it can be recommended to add new information to provided guidelines. WHO (2021) and other international agencies update their recommendations regarding new methods of struggling against hepatitis B. Adding these concepts to already existing plans, it is possible to ensure better outcomes. Another recommendation implies the creation of supportive environments and strengthening community action (Melnyk and Fineout-Overholt, 2018). It means that individuals should be ready to engage in a collaborative effort to resolve relevant problems linked to hepatitis B and help each other to stop its spread (Melnyk and Fineout-Overholt, 2018). It will help to address the major determinants of health and ensure they are on the desired level.
Improvement of used measures remains a critical step vital for attaining outlined goals. The planned activities can be enhanced if additional resources are available. For instance, the lifestyle changes programs for drug-addicted individuals might be added to the existing approach as it will help to reduce incidence rates (Raingruber, 2016). Moreover, the importance of safe sex regarding the high rates of hepatitis B spread through unprotected sexual acts should be emphasised (Edelman and Connelly, 2017). It will also help to address the problem and minimise the risks of being infected with the virus.
Altogether, evaluation and improvement should be two basic components of the offered health promotion program. The constant analysis and monitoring of the current situation will provide specialists with data to implement necessary changes to make the intervention more effective. Moreover, assessing results, nurses might outline enhancement areas necessary for attaining long term goals and reducing the burden of hepatitis B for communities and the healthcare sector. For this reason, the health promotion activities should be supported with practical monitoring practices to ensure no failures occur and established goals are achieved.
Conclusion
Altogether, hepatitis B remains a significant concern affecting the health of the nations. The official statistics show that about 1.5 million people become newly infected every year. For this reason, there is a critical need for health promotion activities aimed at reducing the incidence and guaranteeing people are provided with the knowledge necessary for resisting the threat. The outlined goals for planned interventions imply enhancing health literacy, improving access to health care, and strengthening community response by increasing awareness and mutual support. They can be achieved by educating individuals about hepatitis B epidemiology, prophylactics, and measures that can be used to attain desired outcomes. The paper shows the critical importance of health concerns for the heal of the nation and the necessity to address the most nagging issues to ensure people have more chances for better well-being and can enjoy a high quality of life, which is one of the fundamental goals of the healthcare system.
Reference List
Bridges, C. B. et al. (2019). Challenges with hepatitis B vaccination of high-risk adults – a pilot program. Vaccine, 37(35), pp. 5111–5120. doi:10.1016/j.vaccine.2019.05.089
Chen, C.-H., Hsieh, H.-H. and Wu, T.-Y. (2021) ‘Real-world prevalence of hepatitis B virus reactivation in cancer patients in Taiwan’, Journal of Oncology Pharmacy Practice, 27(1), pp. 63–70. doi:10.1177/1078155220913095.
de Mendoza, C. et al. (2019) ‘Screening for retroviruses and hepatitis viruses using dried blood spots reveals a high prevalence of occult hepatitis B in Ghana’, Therapeutic Advances in Infectious Disease, 6. doi:10.1177/2049936119851464.
Edelman, C. and Connelly, E. (2017). Health promotion throughout the life span. 9th edn., New York, NY: Mosby.
Freeland, C. et al. (2021) ‘Common concerns, barriers to care, and the lived experience of individuals with hepatitis B: a qualitative study’, BMC Public Health, 21, p. 1004. doi:10.1186/s12889-021-11093-0
Jelsoe, E. et al. (2018) ‘A future task for health-promotion research: Integration of health promotion and sustainable development’, Scandinavian Journal of Public Health, 46(20), pp. 99–106. doi:10.1177/1403494817744126.
MacLachlan, J. and Cowie, B. (2015) ‘Hepatitis B virus epidemiology’, Cold Spring Harbor Perspectives in Medicine, 5(5), a021410. doi:10.1101/cshperspect.a021410
Melnyk, B. and Fineout-Overholt, E. (2018) Evidence-based practice in nursing & healthcare: a guide to best practice. 4th edn. Philadelphia, PA: LWW.
Murdaugh, C., Parsons, M. and Pender, N. (2018) Health promotion in nursing practice. 8th edn., New York, NY: Pearson.
Maniago, J.D. et al. (2020) ‘Barriers in performing physical assessment among nursing students: An integrative review’, International Journal of Nursing Sciences, 8(1), pp. 120–129. doi:10.1016/j.ijnss.2020.12.013
Nankya-Mutyoba, J. et al. (2019) ‘Hepatitis B virus perceptions and health seeking behaviors among pregnant women in Uganda: implications for prevention and policy’, BMC Health Services Research, 19, pp. 760. doi:10.1186/s12913-019-4516-0
Patrick, R. and Kingsley, J. (2019) ‘Health promotion and sustainability programmes in Australia: barriers and enablers to evaluation’, Global Health Promotion, 26(2), pp. 82–92. doi:10.1177/1757975917715038.
Pattyn, J. et al. (2021) ‘Hepatitis B vaccines’, The Journal of Infectious Diseases, 224(4), pp. 343-351. doi:10.1093/infdis/jiaa668
Potvin, L. and Jourdan, D. (2021) ‘Health promotion research has come of age! Structuring the field based on the practices of health promotion researchers’, Global Health Promotion, 28(4), pp. 26–35. doi:10.1177/17579759211044077.
Raingruber, B. (2016) Contemporary health promotion in nursing practice. 2nd edn., New York, NY: Jones & Bartlett Learning.
Roade, L. et al. (2021) ‘Long-term efficacy and safety of nucleos(t)ides analogues in patients with chronic hepatitis B’, Therapeutic Advances in Infectious Disease, 8. doi:10.1177/2049936120985954.
Sadlier, C. et al. (2017) ‘Development of chronic hepatitis B infection in a hepatitis B vaccine responder’, International Journal of STD & AIDS, 28(5), pp. 526–528. doi:10.1177/0956462416674835.
Soriano, V. et al. (2020) ‘Advances in hepatitis B therapeutics’, Therapeutic Advances in Infectious Disease, 7. doi:10.1177/2049936120965027.
Stanhope, M. and Lancaster, J. (2021) Foundations for population health in community/public health nursing. 6th edn., New York, NY: Elsevier.
Tian, X. et al. (2019) ‘Evaluation of a multi-layered health promotion approach in rural China’, Global Health Promotion, 26(4), pp. 14–24. doi:10.1177/1757975917743532.
Tu, T. et al. (2020) ‘The lived experience of chronic Hepatitis B: a broader view of its impacts and why we need a cure’, Viruses, 12(5), p. 515. doi:10.3390/v12050515
The prevention and treatment of hepatitis C are major public health concerns because many ignore the symptoms and avoid therapeutic recommendations. According to Lee et al. (2020), ignoring Hepatitis C symptoms and avoiding therapeutic recommendations resulted in an acute state despite the disease being curable. Some studies have identified people with chronic immune problems as the most vulnerable to hepatitis C contamination (Koniares et al., 2020). For example, pregnant women, children, the elderly, and people who have had liver transplants are among the most vulnerable groups (Koniares et al., 2020). Regular Hepatitis C screening can reduce the number of individuals with a chronic liver infection due to ignorance. In addition, routine screening may influence the overall efficacy of hepatitis C treatment. Universal screening can protect vulnerable groups from hepatitis C, promote timely infection diagnosis, and facilitate effective treatment plans.
PICOT Question: Compared to no screening, does obligatory screening for hepatitis C increase the timely diagnosis of the infection within 12 months in patients with immunity problems?
Background of the Studies
The section analyzes the problem statement, significance to nursing, purpose, objective, and research question of two quantitative studies. Koniares et al. (2020) study sought to determine whether universal Hepatitis C screening in pregnant women is more effective than risk-based screening. So, the study asks whether risk-based screening is as effective as universal screening. It is relevant to nursing research because it focuses on screening pregnant women who belong to the vulnerable patient group at high risk of hepatitis C contamination.
The second study evaluates the effectiveness of screening for hepatitis C among populations with immunity problems. Lee et al. (2020) intended to determine if community-based screening for hepatitis C among drug addicts can reduce the spread of infection. Therefore, the study asked whether a Hepatitis C screening test is necessary among drug addicts. Because drug addicts are among those with immune deficiencies, the study’s goal is consistent with nursing research.
How the Two Studies Support the Nursing Practice Problem
The two articles are relevant to my PICOT question because they investigate Hepatitis C virus infection among vulnerable groups. For instance, Koniares et al. (2020) focused on screening pregnant women who belong to vulnerable patients with high risks of contamination with hepatitis C. The study intervention identifies critical areas where healthcare providers are inconsistent in identifying risk factors for hepatitis C virus infection. Similarly, Lee et al. (2020) evaluated the effectiveness of screening for hepatitis C among populations with immunity problems. Since screening in high-risk settings identified a substantial hepatitis C burden and the significance of reflex testing, it reinforces my research PICOT question. The study intervention that recommends hepatitis C screening to be conducted in at-risk younger groups in drug treatment centers also answers my research question.
Methods of the Studies
The two studies used different methodologies to assess hepatitis C virus screening practices in high-endemic populations. Koniares et al. (2020) used the survey method, whereas Lee et al. (2020) used the experimental method. A 10-question electronic survey was sent to residents and attending physicians who provide obstetrical care (Koniares et al., 2020). The experimental research was conducted between 2016 and 2018 in shelters, drug treatment centers, and Federally Qualified Health Centers that engaged in the screening. It took a coordinator to help people confirm their viremia and connect with substance abuse treatment or primary care providers who prescribe hepatitis C medication (Lee et al., 2020). The experiment results from all stations were analyzed to determine the efficacy of screening in high-risk settings.
Surveys have a high level of general capability in representing a large population. Data collected via the survey method provide a more accurate description of the relative characteristics of the study population (Nayak & Narayan, 2019). Nevertheless, it is possible to use inappropriate questions in surveys because of the need to accommodate everyone. An experimental research method is more accurate because it allows for a high degree of control. For example, researchers can isolate specific variables with this method, making it possible to make a precise conclusion or determine if a potential outcome is viable. However, experiment results are highly subjective due to the possibility of human error. Any error, whether systematic or random, would render the results invalid.
Results of the Studies
The study finding shows a strong correlation between screening and Hepatitis C detection in vulnerable groups. For instance, the Koniares et al. (2020) survey showed that risk-based screening for the Hepatitis C virus might be less effective than universal screening because healthcare providers are inconsistent in identifying risk factors. Universal screening might reduce the number of Hepatitis C virus infections that go undetected during pregnancy. The finding is crucial in nursing practice because it provides valuable information on the need for universal screening for pregnant women.
The second study evaluated the effectiveness of community-based test programs for people at drug treatment centers. Results indicated that drug addicts are high-risk and should be tested for Hepatitis C on visiting healthcare facilities (Lee et al., 2020). The results raised awareness in nursing practice about the importance of focusing on high-risk groups (drug users), typically ignored by public health. Nurses should keep these vulnerable patients in mind as they strive to create a society free of Hepatitis C.
Ethical Considerations
Getting approval for your study is one example of ethical consideration in any research involving data collection with people. Review boards or other responsible authorities must determine if the research goals and design are ethical or follow your institution’s code of conduct. Koniares et al. (2020) followed this guideline by submitting their proposal to the Tufts Medical Center Institutional Review Board for approval. Similarly, Lee et al. (2020) presented their study for approval by the University of Alabama at Birmingham (UAB) review board. These studies followed the correct procedure in seeking permission from the appropriate authorities.
Voluntary participation is another ethical consideration that is crucial in research involving subjects. Research subjects are free to choose to participate without any pressure or coercion (Kaewkungwal & Adams, 2019). Lee et al. (2020) required frontline workers to inform patients that free and confidential HCV antibody testing would be administered unless they declined. Similarly, Koniares et al. (2020) emailed the surveys to residents and attending physicians based on mutual consent. Therefore, participants in both studies were aware of their rights to withdraw or continue participation.
Conclusion
Ignoring the symptoms of Hepatitis C and ignoring therapeutic recommendations will always result in an acute state of the virus infection. Those at risk for Hepatitis C infections include pregnant women, children, the elderly, and those who have received a liver transplant. Lee et al. (2020) and Koniares et al. (2020) evaluated the efficacy of universal Hepatitis C screening among drug addicts and pregnant women, respectively. The findings suggest that regular Hepatitis C screening increases the detection of virus infections that go undetected during pregnancy or among drug addicts. The studies identify critical areas in which providers are inconsistent in identifying risk factors and crucial information for nursing practice. In addition, both studies adhere to ethical considerations, such as obtaining approval from the appropriate authorities and the subjects’ informed consent.
References
Kaewkungwal, J., & Adams, P. (2019). Ethical consideration of the research proposal and the informed-consent process: An online survey of researchers and ethics committee members in Thailand. Accountability in Research, 26(3), 176-197. Web.
Koniares, K., Fadlallah, H., Kolettis, D., & Vindenes, T. (2020). Hepatitis C virus screening in pregnancy. American Journal of Obstetrics & Gynecology MFM, 2(3), 100-123. Web.
Lee, A., Karumberia, S., Gilmore, A., Williams, E., Bruner, N., Overton, E., Saag, M, & Franco, R. (2020). Hepatitis C among high-risk Alabamians: Disease burden and screening effectiveness. The Journal of Infectious Diseases, 222(5), 365-375. Web.
Nayak, M., & Narayan, K. (2019). Strengths and weaknesses of online surveys. IOSR Journal of Humanities and Social Sciences, 24(5), 31-38. Web.