Recognition and Management of HBV Infection in a Social Context

Abstract

Chronic viral hepatitis B and C infection is three to five times more frequent than HIV in the USA, and chronically infected people are at risk for long-term sequelae including cirrhosis, liver decomposition, and hepatocellular carcinoma (Institute of Medicine, 2010). Socio-cultural factors are central to the way an individual constructs hepatitis B virus (HBV) infection, perceives it as serious health problem, and moves on to appropriate health behavior (Lee et al., J Canc Educ 25:337-342, 2010; Kim, J Health Care Poor Underserved 5:170-182, 2004; Lee et al., Asian Nurs Res 1:1-11, 2007; Wu et al, Asian Pac J Cancer Prev 8(1):127-234, 2007; Yang et al., J Korean Academy Nurs 40:662-675, 2010). The purpose of this study was to seek "real world" data about factors that influence the recognition and management of HBV infection in Korean Americans' socio-cultural contexts. The descriptive qualitative study used an interview informed by ethnography to collect data and was guided by the Network-Episode Model. (Pescosolido, Adv Med Sociol 2:161-184, 1991; Pescosolido, AJS 97:1096-1138, 1992; Pescosolido, Res Sociol Health Care 13A:171-197, 1996). The sample comprised 12 HBV patients and nine key informants. Six factors that influenced the management of HBV infection emerged from the interviews: recognition of disease within a social context, unrecognized disease in a hidden health system, the socio-cultural meaning of disease, lay construction of the cause of disease, misunderstandings and cultural learning styles, and personal and environmental barriers to health care. Each theme was associated with Korean American (KA) social contexts, participants' experiences, and the beliefs they held about the disease. The findings explored that the family network is "genetic code" for social networking among KAs and the network of patients was not geographically bound. Health management behaviors are mediated by an array of types and levels of social and personal networks, and this raises questions about current health education, management of HBV, and prevention of liver cancer.

HBV-related health behaviors in a socio-cultural context: Perspectives from Khmers and Koreans

“…Two community-based participatory studies were conducted: 1) a study with KAs was conducted in 2010 with findings already published elsewhere (Lee, Hann, Yang, & Fawcett, 2011) and 2) the method used in the study with KAs was replicated with CAs in 2012. Both studies utilized a descriptive qualitative approach informed by ethnography and guided by the revised NEM.…”

Debunking the myth: low knowledge levels of HBV infection among Asian American college students

“…[323334] Despite the heterogeneity of AA culture, most AA cultures have in common several cultural values: Interdependence, collectivism, family centeredness. [353637] Given the collectivist nature of AA culture, having HBV is a reflection on the family rather than the individual and families with HBV infection might perceive or encounter public stigma.…”

“…Misunderstanding of transmission through casual contact means individuals suspected of being infected have avoided sharing a meal. [3334] In the same vein, the infected individuals with inadequate knowledge can lead to self-isolation, which may be associated with delays in seeking health care. Especially, not being allowed to share meals in AA communities is a very serious social pressure since sharing food is seen as public acknowledgement of being related that is an important bond-strengthening social interaction in Asian culture.…”

Khmer American Mothers' Knowledge about HPV and HBV Infection and Their Perceptions of Parenting: My English Speaking Daughter Knows More

“…The way people respond to HBV is both a sociocultural process and the result of individual experiences [25,26]. Based upon these considerations, the theoretical framework guiding this research study is the revised Network-Episode Model (NEM) [36].…”