QUALITY OF LIFE AMONG SOUTHWEST AMERICAN INDIAN/ALASKA NATIVES LIVING WITH HEPATITIS C

Objectives:  Research aims: (a) characterize depression, alcohol consumption, stigma, and quality of life (QOL), and; (b) examine relationships among these factors, selected demographics, and QOL; and (c) identify factors that explain the greatest amount of variance in QOL among a sample of Southwest American Indian / Alaska Natives (AI/ANs) living with the hepatitis c virus (HCV).

Background:  HCV is considered to be a global public health threat because seventy-five percent of infected persons have no symptoms and are unaware of their infection.  AI/ANs commonly contend with issues that prevent them from receiving or seeking medical care, including cultural barriers, geographic isolation, educational level, and low income.

Design:  A descriptive, cross-sectional, correlational design with purposive sampling of 101 (54.5 % male) AI/AN adults with HCV living in the Southwestern U.S.

Method: Questionnaires were administered via oral interview.  Measures included the Center for Epidemiological Studies Depression Scale (CES-D), the Alcohol Use Disorders Identification Test (AUDIT) to examine patterns of alcohol consumption, the HCV Stigma Scale (modified) to assess the emotional and social aspects of having HCV, and the MOS SF-12v2 survey is a 12-item instrument assessing the Physical and Mental Component Scores (PCS, MCS) aspects of quality of life.

Results:  Of 101 responders, 38.6% reported no depressive symptomatology; 18.8% mild to moderate depression, and 42.6%, scored in the major depression range.  Half of all women in this sample (n = 22) had a score indicating the possibility of having major depression, significantly higher than men’s scores.  AUDIT scores indicated no association or implication of harmful or hazardous drinking for this sample.  Correlational analysis indicated a statistically significant positive relationship between Depression and Alcohol Use (r = .400, p = .000); Depression and Stigma (r = .485, p = .000).  Regression analysis indicated a significant overall model of factors with: Depression significantly contributing to QOL - Physical Health, R² = .252, R² _adj = .195, F (7, 92) = 4.429, p = .000; and Depression and Alcohol Use significantly contributing to QOL – Mental Health, R² = .569, R² _adj = .536, F (7, 92) = 17.352, p = .000.

Implications:  The factors that influence QOL in AI/AN persons living with HCV has potential in further development of interventions or culturally based models of HCV care that may improve life quality.  These findings have important implications for HCV education, treatment, AI/AN health care policy and practice improvements.  Specifically, understanding the role of depression impacting quality of life among AI/AN persons living with HCV suggests important targets for screening and intervention.