Alcohol and other drug treatment experiences of hepatitis C-positive and negative clients: implications for hepatitis C treatment.

To assess whether HCV-positive clients perceive that alcohol and other drug (AOD) staff discriminate against them, this study compared the treatment experiences of 120 HCV-positive clients with those of 120 HCV-negative clients attending the same AOD treatment facility. Despite the overall findings of favourable attitudes of HCV-positive clients toward their health care workers, these attitudes were less positive than those of their HCV-negative counterparts. Clients with HCV also rated their interpersonal treatment by their health care workers less favourably. These findings suggest that HCV-positive clients' attitudes towards their health care workers and their experiences of differential treatment by these health care workers might be a barrier to HCV treatment uptake in AOD treatment facilities.

The influence of specialists on prescribing by GPs. A qualitative study.

OBJECTIVE: To investigate specialists' influence on prescribing by general practitioners. METHOD: A focus group study of 35 GPs. SETTING: Hunter Urban Division of General Practice, New South Wales. RESULTS: Although GPs thought specialists had only a small influence on their prescribing overall, it was substantial in some clinical areas, in complex conditions and conditions seen infrequently. Specialists were seen as authoritative and unbiased. Local specialists were particularly influential. Specialist influence came from seeing how specialists managed patients, clinical meetings, and specific verbal advice. It influenced the prescribing of new drugs, selection of drugs within a class and sometimes changed established prescribing practices. DISCUSSION: Interventions to change GPs' prescribing practices should address the importance of specialist influence, and not focus on GPs alone.

Hepatitis C treatment in pharmacotherapy services: increasing treatment uptake needs a critical view.

ISSUES: In an effort to increase the number of people undergoing hepatitis C treatment, a range of initiatives are planned or underway to provide treatment in non-specialist services, such as opioid pharmacotherapy treatment (OPT) clinics. APPROACH: This commentary considers the implications of this new approach to treatment delivery, taking account of individual-level issues generally discussed in the literature, such as knowledge of treatment and concerns about side effects. In addition, because less visible organisational and structural factors would equally influence the successful implementation of hepatitis C treatment in OPT services, these are also explored. KEY FINDINGS: Provision of hepatitis C treatment in OPT services raises a broad range of pressing questions, from individual knowledge and concern about treatment, to workforce issues, such as discrimination, and tensions between the need for supportive care during hepatitis C treatment and the surveillant, regulatory nature of OPT clinic operations. IMPLICATIONS: A thorough critical examination of the structure and delivery of all services involved is necessary. Social research can play a unique role in this assessment because of its ability to generate detailed insights into lived experience and make use of social theories that allow previously invisible operations of power to become visible. CONCLUSION: The success of hepatitis C treatment in new sectors, such as OPT clinics, is not a given. Close attention needs to be paid to the context and culture in which OPT is delivered. In turn, this needs to be considered alongside the context and culture necessary for successful hepatitis C treatment delivery.

Evaluation of a revised instrument to assess the needs of men diagnosed with prostate cancer.

BACKGROUND: This study was conducted to assess the face, content and construct validity and the internal validity of the revised version of an instrument to measure the perceived needs of men diagnosed with prostate cancer [Prostate Cancer Needs Questionnaire version 2 (PCNQv2)]. The PCNQ was constructed in two parts with Part 1 measuring needs at diagnosis and initial treatment and Part 2 measuring current needs. METHODS: A random sample of 650 men diagnosed with prostate cancer attending a Urologist of the Hunter Urology Group in Newcastle, New South Wales, Australia, were invited to participate in the study and sent by post the self-administered PCNQ. Information was provided on 145 men who were considered ineligible to participate. Completed questionnaires were received from 300 men. RESULTS: The principal components method of factor analysis with varimax orthogonal rotation identified eight factors with eigenvalues greater than 1, which together accounted for 68% of the variance in Part 1 of the PCNQ. Likewise, six factors were identified in Part 2 which accounted for 68% of the variance. Internal reliability coefficients (Cronbach's alpha) were adequate for identified factors with values ranging from 0.71 to 0.90 for Part 1, and from 0.80 to 0.92 for Part 2. CONCLUSIONS: These results support the validity and reliability of the PCNQv2 to assess the perceived needs experienced by men diagnosed with prostate cancer.

Evaluation of an instrument to assess the needs of men diagnosed with prostate carcinoma: an assessment of the validity and reliability of a self-administered questionnaire developed to measure the needs experienced by men diagnosed with prostate carcinoma.

BACKGROUND: This study was conducted to evaluate a self-administered questionnaire developed to measure the needs experienced by men diagnosed with prostate carcinoma (the Prostate Cancer Needs Questionnaire [PCNQv1.1]). The PCNQv1.1 was constructed in two parts. Part 1 measures the needs at diagnosis and initial treatment and Part 2 measures current needs. METHODS: A random sample of 650 men diagnosed with prostate carcinoma who were being treated by a urologist of the Hunter Urology Group in Newcastle, New South Wales, Australia, were invited to participate in the study. They were sent by post the self-administered PCNQv1.1. Completed questionnaires were received from 385 men. Information provided on 100 additional men was considered ineligible. RESULTS: The principal components method of factor analysis with varimax orthogonal rotation identified eight factors with eigenvalues greater than 1, which accounted for 61.7% of the variance in Part 1 of the PCNQv1.1. Likewise, six factors were identified in Part 2, which accounted for 63.5% of the variance. Internal reliability coefficients (Cronbach alpha) were adequate for identified factors with values ranging from 0.70 to 0.88 for Part 1 and from 0.71 to 0.87 for Part 2. Test-retest reliability was acceptable with intraclass correlation coefficients ranging from 0.61 to 0.78 for Part 1 and from 0.60 to 0.82 for Part 2. CONCLUSIONS: These results suggest that the PCNQv1.1 is a valid and reliable instrument to assess the needs experienced by men diagnosed with prostate carcinoma.