Issues contributing to non-attendance for chronic illness care for hepatitis C

Purpose: To identify and describe the personal and systems factors related to not seeking, delaying or deferring chronic illness care for hepatitis C. Theory: A multi-level ecological theory guided the analysis, organization and interpretation of findings. Methods: This qualitative study, nested within a larger exploration and intervention study, used an interpretive descriptive method. Data were collected through a demographic questionnaire and open-ended individual and focus group interviews which were transcribed, coded and subjected to thematic analysis. Results and conclusions: Data were obtained from 4 focus groups, attended by 29 health and social service providers, and 55 interviews with affected individuals (55% male) from five Canadian provinces. Issues contributing to non-attendance were identified at multiple levels: personal, interpersonal, provider-system and structural. Key themes contributing to non-attendance were previous negative experience, provider and/or client disease knowledge and communication, stigma, restrictive policies, treatment eligibility criteria, personal priorities, poverty and unstable lifestyles.