RESUMEN
BACKGROUND: This study aimed to better understand the barriers to perinatal hepatitis B prevention and to identify the reasons for poor hepatitis B knowledge and delivery of education to hepatitis B surface-antigen- positive pregnant women among healthcare providers in Santa Clara County, California. MATERIALS AND METHODS: Qualitative interviews were conducted with 16 obstetricians and 17 perinatal nurses in Santa Clara County, California, which has one of the largest populations in the United States at high risk for perinatal hepatitis B transmission. RESULTS: Most providers displayed a lack of self-efficacy attributed to insufficient hepatitis B training and education. They felt discouraged from counseling and educating their patients because of a lack of resources and discouraging patient attitudes such as stigma and apathy. Providers called for institutional changes from the government, hospitals, and nonprofit organizations to improve care for patients with chronic hepatitis B. CONCLUSIONS: Early and continuing provider training, increased public awareness, and development of comprehensive resources and new programs may contribute to reducing the barriers for health care professionals to provide counseling and education to pregnant patients with chronic hepatitis B infection.
Asunto(s)
Actitud del Personal de Salud , Consejo , Conocimientos, Actitudes y Práctica en Salud , Hepatitis B/psicología , Enfermeras y Enfermeros/psicología , Médicos/psicología , Guías de Práctica Clínica como Asunto , Adulto , California , Femenino , Estudios de Seguimiento , Hepatitis B/prevención & control , Hepatitis B/transmisión , Vacunas contra Hepatitis B/uso terapéutico , Virus de la Hepatitis B/patogenicidad , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Pronóstico , Estados UnidosRESUMEN
OBJECTIVE: To evaluate current levels of hepatitis-B-related knowledge and clinical practice among perinatal nurses. DESIGN: Cross-sectional study. SETTING: Santa Clara County, California, home to one of the largest U.S. populations at risk of perinatal hepatitis B transmission. PARTICIPANTS: Perinatal nurses (N = 518) from eight birthing hospitals. METHODS: In 2008-2010, nurses completed a baseline survey evaluating existing hepatitis-B-related knowledge and preventive clinical practices, participated in an educational seminar, received instructional materials about hepatitis B, and completed a follow-up knowledge survey. RESULTS: Eighty percent of perinatal nurses had provided health care to a pregnant woman with chronic hepatitis B, but only 51% routinely provided patients with educational information about hepatitis B. While 75% routinely informed patients about effective methods to prevent mother-to-child transmission, only a small minority (17-34%) educated infected women about standard recommendations for protecting themselves and household members. One fourth or fewer nurses correctly answered most questions about hepatitis B prevalence, risks, and symptoms. After the educational seminar, knowledge increased statistically significantly. CONCLUSION: Existing knowledge about hepatitis B is limited, and nationally recommended preventive clinical practices are commonly overlooked by perinatal nurses. This lack of knowledge and preventive care represents a noteworthy gap and an opportunity for targeted training and education to improve perinatal hepatitis B prevention and medical management of infected mothers.