335078
Complexity of patient-caregiver relationships in veterans undergoing hepatitis C treatment
INTRODUCTION
Caregiving research has generally not explored the sometimes quite complex dynamics of the patient-caregiver dyad that shape caregiving. This study examined patient-caregiver relationships among patients undergoing hepatitis C (HCV) treatment that entailed unpleasant and debilitating side effects.
METHODS
Individual semi-structured interviews with 14 veterans with HCV and their 14 informal caregivers were audio-recorded and transcribed. Analysis examined coded data relating to characteristics of the dyad relationship, dyad communication related to the illness, and disease treatment and side effects.
RESULTS
Informal caregivers included friends, siblings, spouses, intimate partners, and children. Dyad relationships varied in amounts of communication, emotional connection, fragility, and tension. Several relationships were affected by histories of substance abuse, and veterans often struggled to maintain autonomy despite reduced physical capabilities and concerned caregivers. Some relationships were strengthened by the shared goal of eliminating HCV, yet others frayed under the physical and psychological strains caused by HCV treatment. Overall, veterans were strongly committed, and adherent, to HCV medication treatment. Informal caregivers facilitated this by addressing physical side-effects, being attuned to depressive side effects, and providing instrumental and emotional support.
DISCUSSION
In a population with fewer social supports, there are dyads in which bonds are sufficiently strong and flexible to facilitate completion of very difficult medication treatment. More research is needed in how to support such dyads in this difficult time period, and to understand how to support patients who lack informal caregivers.
Learning Areas:
Chronic disease management and preventionProvision of health care to the public
Social and behavioral sciences
Learning Objectives:
Identify aspects of relationships between patients and their caregivers that contribute to completion or termination of hepatitis C medication treatment.
Formulate means of enhancing patient-caregiver relationships to achieve hepatitis C treatment completion, and of supporting patients who lack informal caregivers.
Keyword(s): Hepatitis C, Caregivers
Qualified on the content I am responsible for because: I conduct implementation research with the VA's Quality Enhancement Research Initiative in the area of hepatitis C and HIV. I have conducted several studies of patients with hepatitis C and/or HIV.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.