الفهرس 
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Abstract
Hepatitis C virus (HCV) is a blood-borne infectious disease and is considered the second biggest cause of death following heart diseases in Egypt, around 75% of all cases of liver cirrhosis and liver cancer caused by Hepatitis Cinfections.
The primary goal of chronic HCV detection and treatment is preventing complications and death from HCV infection. And adherence to therapy may be particularly challenging for patients undergoing antiviral therapy for Hepatitis C. Understanding the factors that increase a patient’s risk of non-adherence to HCV treatment is a crucial first step in success of treatment.
Aim of the Study:
The aim of this study was to identify factors affecting adherence toward therapeutic regimen for patients with viral hepatitis C.
Research Questions:
What are the factors affecting adherence toward therapeutic regimen for patients with viral hepatitis C?
Methodology:
Research design:
A descriptive exploratory research design was used in this study.
Setting:
This study was conducted in interferon outpatient clinic at Beni Suef general Hospital.
Study Subject:
A purposive subject was used. The total numbers of 100 patients were taken.
Tools for data collection:
The data were collected through using the following tools:
• Socio-demographic characteristics of patients: developed by the researcher, it wasbased on recent literature to assess socio-demographiccharacteristics and patients medicalhistory
• Patient’s Adherence assessment sheet:questionnaire sheet was used to assess the patient adherence to therapeutic regimen consists of 2partsfirst partMorisky Medication Adherence Scale to assess adherenceto medication, second part developed by the researcher to assessadherence to follow up, diet and exercise.
• Factors affecting patient’s adherence questionnaire sheet: developed by the researcher based on recent literature to assess factors affecting patient’s adherence toward therapeutic regimen.
Results:
The main results of the study revealed that:
• The age of studied subject ranged from 20-50years old, the mean age was (37.6 ± 7.9).Around half of them were female (51%)
2. The Majority of themwere married, live inrural area (87%, 84.0%) respectively.
3. The highest ratios were illiterate (62%).
4. In relation to occupation more than half of studied patients do not work (59%).
5. Regarding Monthly income, not-enough for therapy costs for majority of the subjects (98%).
6. There was (30%) total adherence level to therapeutic regimen for studied subject versus (70%) non adherence level.
7. Adherence level distributed as, (12%) adherence to medication regimen, (6%) adherence to follow up regimen, (17%) adherence to diet regimen, (0 %) adherence to exercise regimen.
8. There was statistically significance relation between patient socio-demographic characteristics and level of adherence with regard to;
Level of education, were low educational level had negative effect on adherence level.
Monthly income and home care provider where insufficient monthly income and absence of home care provider had negative effect on adherence.
While no statistical relation between level of adherence andage, sex, residence, marital status, occupation and health history of patients
9. There was negative statistically significant relation between adherence level and patients centered factor including; Patient’s psychological, Patient’s motivation, patient’s knowledge. While there was positive statistically significant relation between adherence level and Patient’s believes
10. There was negative statistically significant relation between adherence level and socio-economic factors.
11. There was highly negative statistically significant relation between adherence level and therapy-related factor as well as Health care system factor, which considered highest, affected factors.
Conclusion:
The results of the present study have concluded that:
Low level of adherence among the studied subjects: approximately only one third of patients adhered to therapeutic regimen.
There are several factors that seem to influence adherence of hepatitis C patients toward therapeutic regimen. These factors vary in their effect: one of them has a positive effect upon adherence like patient belief, while the rest have negative effects upon adherence, like socio-demographic data with regard to of the low monthly income, the low educational level and the absence of home care provider. Patient’s factor with regard to the psychological disturbance, low motivation, and poor knowledge level. Therapy related factor. Furthermore, insufficient social and economic support and Heath care system factors.
Recommendations:
Based on the results of the present study the following recommendations are suggested:
• A comprehensive plan is needed to prevent and control hepatitis C in Egypt.
• Periodic health teaching programs for hepatitis C patients and their family including nature of disease, therapeutic regimen, how they manage with side effect of therapy and how family provides social support.
• Providers should implement strategies tailored to each patient’s needs to help increase adherence or maintain high levels of antiviral adherence during HCV treatment.
• Interventional programming should be focused on family support for those patients
• More studies are needed to develop and refine interventions to improve adherence for hepatitis C regimen especially with new treatment therapy.