International journal of nursing sciences · 2026
A multi-domain qualitative study on factors influencing access to preventive hepatitis B care among rural population.
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Li Caixia, Zhong Mi, Yuan Gengyang, Liu Shujuan, Wen Shuangshuang, Tian Xiaofei, Ngo Sheung Chan Dorothy, Fu Xia
Аннотация
OBJECTIVES: This study aimed to explore barriers precluding hepatitis B virus (HBV) preventive care among the rural population.
METHODS: Guided by the National Institute on Minority Health and Health Disparities framework, this qualitative study applied an interpretative phenomenological approach. Participants (n = 34) were recruited from three healthcare settings in southern China from May 2024 to January 2025. Data from semi-structured interviews were analyzed using interpretative phenomenological analysis.
RESULTS: Barriers spanned four domains with 11 subthemes. 1) Behavioral: the last-resort paradigm in healthcare utilization, reliance on folk remedies, and intergenerational silence in familial HBV prevention; 2) Physical environment: remote residence from healthcare facilities and compound vulnerabilities in living and working environments; 3) Sociocultural: social marginalization stemming from HBV discrimination, fatalistic resignation towards health, and the myth of the hardy survivor; and 4) Healthcare system: misperceptions, underestimated needs, and access barriers related to labor, mobility, and misaligned healthcare insurance policy.
CONCLUSIONS: These barriers perpetuate late HBV diagnosis, low vaccine uptake, and poor treatment adherence among the rural population. This highlights the need for mobile health services to overcome geographic barriers; culturally appropriate interventions to dismantle misinformation, HBV discrimination, and myths; and policies to reduce financial burden and improve insurance coverage, thereby making HBV preventive care accessible for this marginalized group.
METHODS: Guided by the National Institute on Minority Health and Health Disparities framework, this qualitative study applied an interpretative phenomenological approach. Participants (n = 34) were recruited from three healthcare settings in southern China from May 2024 to January 2025. Data from semi-structured interviews were analyzed using interpretative phenomenological analysis.
RESULTS: Barriers spanned four domains with 11 subthemes. 1) Behavioral: the last-resort paradigm in healthcare utilization, reliance on folk remedies, and intergenerational silence in familial HBV prevention; 2) Physical environment: remote residence from healthcare facilities and compound vulnerabilities in living and working environments; 3) Sociocultural: social marginalization stemming from HBV discrimination, fatalistic resignation towards health, and the myth of the hardy survivor; and 4) Healthcare system: misperceptions, underestimated needs, and access barriers related to labor, mobility, and misaligned healthcare insurance policy.
CONCLUSIONS: These barriers perpetuate late HBV diagnosis, low vaccine uptake, and poor treatment adherence among the rural population. This highlights the need for mobile health services to overcome geographic barriers; culturally appropriate interventions to dismantle misinformation, HBV discrimination, and myths; and policies to reduce financial burden and improve insurance coverage, thereby making HBV preventive care accessible for this marginalized group.