الفهرس 
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Abstract
Hepatitis C virus is a chronic major health problem both in developed and developing countries. WHO (2017) estimated that there 325 million people worldwide are living with hepatitis C virus infection. Egypt is the highest country wide prevalence of hepatitis C virus in the world, and the main cause of HCV in Egypt is non –application of infection control and poor health control in health care settings as hospitals, clinic and so on.
Hepatitis C virus is more than just the existence of physical signs and symptoms, it also causes psychosocial, spiritual, functioning ability and productivity health status disruption. The substantial clinical and economic impact of HCV focus attention on the critical need to prevent and control HCV infection. Thus enhancing self care abilities for chronic conditions is to reduce the global burden of disease, achieve optimal self care and improve quality of life.
Self care practices for patients with HCV is composed of: avoiding alcohol consumption, eating a healthy diet, drinking plenty of water, exercising, managing stress, getting enough rest and compliance with prescribed medications. The nurse play an important role not only toward care of HCV symptoms, or side effects of treatment, but also toward teaching of those patients of how to live and cope with HCV disease in modification self care practices to promote general health , prevent disease progression and deal with factors associated with self care practices among patients with hepatitis C virus.
Aim of the study:
This study aimed to identify factors associated with self-care practices among patients with hepatitis C virus.
Materials and Method:
Research design:
A descriptive research design was utilized for this study.
Research setting:
The study was conducted at outpatient clinics of liver Institute in Kafr Elsheikh (Ministry of health).
Subjects:
This study was conducted on 340 adult patients diagnosed with HCV infection.
Tools:
Three tools were utilized for the purpose of data collection
Tool I: Socio-demographic and clinical data sheet.
Tool II: Hepatitis C virus patient’s knowledge structured interview questionnaire (HPKSIQ)
Tool III: Hepatitis C Virus self-care practices structured interview questionnaire (HSPSIQ).
The main results of the study:
- More than one - third of the studied patients(43.8%) were in the age group of 41-50 years, more than half (52.9%) were males, more than one –third (40.9%) were illiterate, (44.1)% were housewives and most of them were married(80.3%).
- The highest percentages of the studied patients had insufficient income to fulfill daily requirements(63.5%) and more than half of them came from rural area (62.6%).
- More than half of studied patients had family member infected with HCV (59.1%).In relation to clinical onset of disease, the highest percentage of patients (79.7%) discovered their disease accidentally
- The highest percentage of studied patients had no chronic diseases (72.4%).
- The majority of the studied patients had previous hospitalization and went to outpatients clinic (86.5%).Also it was found that the majority of them visited the dentist (81.6%).
- More than half of the studied patients had poor knowledge related to definition of HCV, risk factors, mode of transmission, laboratory investigations and treatment methods to HCV infection disease (52.6%) with a mean percent (12.5 ± 5.4).
- More than half of the studied patients had moderate total practices(51.5%) with a mean percent score (57.6 ± 13.2).
- There was statistically significant relation between patients total knowledge level and patients age, educational level, work and income (p=0.001) .
- There was statistically significant relation between patients total self care practices and patients age, educational level, work, marital status, income ( p=0.001), residence ( p=0.041) and sex ( p=0.003).
- There was statistical significant relation between patients total self care practices and patients clinical onset of disease, duration of disease (years), suffering from any associated disease ( p=0.001) and taking medications for this associated disease( p=0.006).
- There was statistically significant relation between total self care practices and total knowledge level. Most of the studied patients had poor knowledge related to moderate self care.
- There were very strong positive statistically significant correlation between total patients self care practices and total patients knowledge level.
from the findings of the present study, it can be concluded that:
- More than half of studied patients with HCV had poor total knowledge and moderate total self care practices.
- The majority of the studied patients had poor self care related to exercise and daily physical activity and more than one-third of them had moderate self care practices related social interactions and rest & sleep.
- Multiple factors influencing patients self care practices including age, sex, education level, marital status, type of work, income, residence and clinical onset and duration of disease (years), history of associated diseases and taking medications for these associated diseases.
The main recommendations of this study:
Recommendations for HCV patients:
1- Development of health education programs for HCV patients and their families to teach them how to apply self care practices and how to deal with factors affecting patients self care practices to avoid subsequent complications of HCV.
2- Inform HCV patients and their families about how to avoid HCV transmission of infection to others.
Recommendations for nurses:
1- Increase nurses awareness about HCV self care practices and factors affecting HCV patients self care practices through educational programs.
2- Develop manual guideline to nurses working with HCV patients about recent HCV self care practices.
Recommendations for the Ministry of Health:
1- Raise the community awareness regarding HCV specific risk factors and behaviors, mode of transmission and preventive measures about HCV through mass media.
2- Disseminate special message for community barbers, hairdressers to inform them about the importance of following preventive measures in reducing the disease burden.
3- Screening to identify persons with HCV infection: It is recommended that HCV serology testing be offered to individuals who are part of a population with high HCV prevalence or who have a history of HCV risk exposure/ behavior
4- Evaluation for advanced fibrosis using liver biopsy, imaging, and/or noninvasive markers is recommended for all persons with HCV infection, to facilitate an appropriate decision regarding HCV treatment strategy and to determine the need for initiating additional measures for the management of cirrhosis (eg, hepatocellular carcinoma screening)
5- Organize regular counseling sessions for meeting the patients’ needs and solving their problems by providing them with clear, full and accurate information in both verbal and written form in health care settings as hospitals, clinic and so on ,in rural areas.
Recommendations for further research:
1- Assess the role of family as caregiver for HCV patients.
2- Replication of this study is recommended using larger probability sample.