The hepatitis B virus is second only to tobacco as a known human carcinogen. However, chronic hepatitis B usually does not produce symptoms and people feel healthy even in the early stages of live cancer. Therefore, chronically infected people should perceive it as a serious health problem and move on to appropriate health behaviour. The purpose of this paper is to develop and validate an online program for promoting self-management among Korean patients with chronic hepatitis B. The online program was developed using a prototyping approach and system developing life cycle method, evaluated by users for their satisfaction with the website and experts for the quality of the site. To evaluate the application of the online program, knowledge and self-management compliance of the subjects were measured and compared before and after the application of the online program. There were statistically significant increases in knowledge and self-management compliance in the user group. An online program with high accessibility and applicability including information, motivation, and behavior skill factors can promote self-management of the patient with chronic hepatitis B. Findings from this study allow Korean patients with chronic hepatitis B to engage in proactive and effective health management in the community or clinical practice. 1. Introduction The hepatitis B virus is known as not only the second highest carcinogen after smoking, but also the cause of 75% of primary hepatocellular carcinoma [1]. A carrier of hepatitis B is 30–100 times more likely to have a risk of dying from liver disease than the average person [2]. Approximately 350 million people have hepatitis B worldwide, and, every year, about 620,000 die of liver diseases associated with hepatitis B [3, 4]. Hepatitis B is a disease that is more common in Asians than Westerners. Asian Americans have an infection rate of 5–15%, which is, approximately, more than 20 times higher than the hepatitis B infection rate of the entire population of the US [5]. Korea was ranked 5th in cancer incidence rate in 2010 for liver cancer, and is ranked second in cancer mortality [6]. The prevalence of hepatitis B in Korea was 4.0% of the population over the age of 30 [7]. Likewise, even today, hepatitis B remains a common disease among the average person, but there is a lack of management on disease monitoring and treatment compliance of hepatitis B virus carriers or patients [8]. Currently, a significant number of hepatitis B patients in Korea are caused by vertical infection from the mother during the perinatal
References
[1]
American Cancer Society, “California cancer facts & figures 2005,” 2005, http://www.ccrcal.org/pdf/Reports/ACS_2011.pdf.
[2]
D. J. Suh, “Current treatment in chronic hepatitis B,” Korean Journal of Hepatology, vol. 14, no. 5s, pp. S39–S43, 2008.
[3]
C. M. Weinbaum, I. Williams, E. E. Mast et al., “Recommendations for identification and public health management of persons with chronic hepatitis B virus infection.,” MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report, vol. 57, no. 8, pp. 1–20, 2008.
[4]
M. F. Sorrell, E. A. Belongia, J. Costa et al., “National Institutes of Health Consensus Development Conference Statement: Management of hepatitis B,” Annals of Internal Medicine, vol. 150, no. 2, pp. 104–110, 2009.
[5]
C. Cohen, A. A. Evans, W. T. London, J. Block, M. Conti, and T. Block, “Underestimation of chronic hepatitis B virus infection in the United States of America,” Journal of Viral Hepatitis, vol. 15, no. 1, pp. 12–13, 2008.
[6]
National Cancer Information Center, “Cancer mortality rate,” 2011, http://www.cancer.go.kr/cms/statics/mortality/index.html.
[7]
Korea National Health and Nutrition Examination Survey, “2009 Korea National Health and Nutrition Examination Survey,” 2010, http://knhanes.cdc.go.kr/knhanes/index.do.
[8]
J. H. Yang, “Development and evaluation of a program to promote self-management in patients with chronic hepatitis B,” Journal of Korean Academy of Nursing, vol. 42, no. 2, pp. 258–268, 2012.
[9]
B. Hepatitis Foundation, “What is hepatitis B?” 2009, http://www.hepb.org/hepb/.
[10]
J. H. Choe, N. Chan, H. H. Do, E. Woodall, E. Lim, and V. M. Taylor, “Hepatitis B and liver cancer beliefs among Korean immigrants in Western Washington: report of a qualitative study,” Cancer, vol. 104, no. 12, pp. 2955–2958, 2005.
[11]
A. R. Levy, K. V. Kowdley, U. Iloeje et al., “The impact of chronic hepatitis B on quality of life: a multinational study of utilities from infected and uninfected persons,” Value in Health, vol. 11, no. 3, pp. 527–538, 2008.
[12]
A. H. M. Alizadeh, M. Ranjbar, and M. Yadollahzadeh, “Patient concerns regarding chronic hepatitis B and C infection,” Eastern Mediterranean Health Journal, vol. 14, no. 5, pp. 1142–1147, 2008.
[13]
J. H. Yang, M. O. Cho, and H. O. Lee, “Qualitative research investigating patterns of health care behavior among Korean patients with chronic hepatitis B,” Journal of Korean Academy of Nursing, vol. 39, no. 6, pp. 805–817, 2009.
[14]
A. L. Gifford and E. J. Groessl, “Chronic disease self-management and adherence to HIV medications,” Journal of Acquired Immune Deficiency Syndromes, vol. 31, no. 3, pp. S163–S166, 2002.
[15]
F. Hill-Briggs, “Problem solving in diabetes self-management: a model of chronic illness self-management behavior,” Annals of Behavioral Medicine, vol. 25, no. 3, pp. 182–193, 2003.
[16]
J. H. Yang, H. O. Lee, and M. O. Cho, “The meaning of illness among Korean Americans with chronic hepatitis B,” Journal of Korean Academy of Nursing, vol. 40, no. 5, pp. 662–675, 2010.
[17]
R. Perrillo, “Management of chronic hepatitis B virus infection: current perspectives for the nurse practitioner,” Journal of the American Academy of Nurse Practitioners, vol. 18, no. 5, pp. 203–215, 2006.
[18]
W. L. Wang, C. J. Wang, and H. F. Tseng, “Comparing knowledge, health beliefs, and self-efficacy toward hepatitis B prevention among university students with different hepatitis B virus infectious statuses.,” The Journal of Nursing Research, vol. 17, no. 1, pp. 10–19, 2009.
[19]
H. Lee and S. Y. Baik Seong-Yi, “Health disparities or data disparities: sampling issues in hepatitis B Virus infection among Asian American Pacific Islander studies,” Applied Nursing Research, vol. 24, no. 2, pp. e9–e15, 2011.
[20]
K. S. Kim, M. Yi, E. O. Choi, S. W. Paik, S. Kwak, and S. Kwon, “Quality of life and related factors in patients with chronic hepatitis B,” Journal of Korean Academy of Fundamentals of Nursing, vol. 14, no. 3, pp. 331–339, 2007.
[21]
A. Nyamathi, Y. Liu, M. Marfisee et al., “Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults,” Nursing Research, vol. 58, no. 1, pp. 13–22, 2009.
[22]
The Korea Herald, “Korea's high-speed wireless Internet penetration tops 100 percent,” 2012, http://www.koreaherald.com/view.php?ud=20120722000046.
[23]
G. M. Samaras and R. L. Horst, “A systems engineering perspective on the human-centered design of health information systems,” Journal of Biomedical Informatics, vol. 38, no. 1, pp. 61–74, 2005.
[24]
H. A. Park, Development of Internet-Based Health Information Service Program for the Disabled, Health Promotion Fund, Ministry of Health and Welfare, Seoul, Republic of Korea, 2003.
[25]
H. A. Park, H. J. Kim, M. S. Song, T. M. Song, and Y. C. Chung, “Development of a web-based health information service system for health promotion in the elderly,” Journal of Korean Society of Medical Informatics, vol. 8, no. 3, pp. 37–45, 2002.
[26]
Y. C. Chung and H. A. Park, “Development of a system for health information on the internet,” Journal of Korean Society of Medical Informatics, vol. 6, no. 1, pp. 53–66, 2000.
[27]
M. J. Park, Knowledge, health belief and preventive health behavior on hepatitis in hepatitis B carriers [M.S. thesis], Yonsei University, Seoul, Republic of Korea, 2002.
[28]
A. Bandura, Social Foundations of Thought and Action: A Social Cognitive Theory, Prentice-Hall, Englewood Cliffs, NJ, USA, 1st edition, 1986.
[29]
H. R. Holman and K. Lorig, “Perceived self-efficacy in self-management of chronic disease,” in Self-Efficacy: Thought Control of Action, R. Schwarzer, Ed., pp. 305–324, Hemisphere Publishing, Washington, DC, USA, 1st edition, 1992.
[30]
N. C. Tan and S. L. Cheah, “What barriers do primary care physicians face in the management of patients with chronic hepatitis B infection in primary care?” Singapore Medical Journal, vol. 46, no. 7, pp. 333–339, 2005.
[31]
N. C. Tan, S. L. Cheah, and E. K. Teo, “A qualitative study of health-seeking behavior of Hepatitis B carriers,” Singapore Medical Journal, vol. 46, no. 1, pp. 6–10, 2005.
[32]
C. E. Hsu, G. Zhang, F. A. Yan, N. Shang, and T. Le, “What made a successful hepatitis b program for reducing liver cancer disparities: an examination of baseline characteristics and educational intervention, infection status, and missing responses of at-risk asian Americans,” Journal of Community Health, vol. 35, no. 3, pp. 325–335, 2010.
[33]
J. Wallace, S. McNally, J. Richmond, B. Hajarizadeh, and M. Pitts, “Managing chronic hepatitis B: a qualitative study exploring the perspectives of people living with chronic hepatitis B in Australia,” BMC Research Notes, vol. 4, article 45, pp. 1–7, 2011.
