Table 3.
Poor knowledge, beliefs and perceptions of the population and the disease by the community, clinicians and commissioners
| Themes | Definitions | Sample quotes |
|---|---|---|
| Knowledge of the disease among community members and patients | What the Chinese know about the disease and services (including myths and misunderstandings) | “[We] really know nothing about this (disease).” (Community focus group) |
| “In China we heard that it’s curable. How come it becomes incurable in the UK?” (Community focus group) | ||
| ‘Are there services? Are they reliable?’ (Community focus group) | ||
| What are the cultural norms, beliefs and expectations | “In China there are all sorts of stuff that doctors would prescribe to us to strengthen the immunity or detoxify the liver.” (Individual interviewee, person with hepatitis B) | |
| “What’s the point of taking all the blood tests, and (getting) no treatment?” (Individual interviewee, person with hepatitis B) | ||
| What stigma exists about disease and persons with the disease, as well as associated services | “Chinese people believe HBV is easily transmitted through social contacts, so HBV carriers are often treated as a public nuisance, who are expected to inform people about his condition and keep their distance” (Community focus group) | |
| ‘What if other people see me going into a sexual health clinic (for a hepatitis B test)? What will they think about me?’ (Individual interviewee) | ||
| Knowledge and attitudes of clinicians and commissioners | What clinicians and commissioners know of the disease and its management | “I reckon if you were to put down some hepatitis B results in front of any of us … I suspect we would probably have to go and have a little read on the internet or in the books.” (Clinician interviewee, General practitioner) |
| “Because most of us trained more than ten years ago, there’s a perception that well there’s no point in treating hepatitis. So there’s something about educating the decision makers.” (Commissioner interviewee, regional public health consultant) | ||
| What clinicians know about the Chinese and how they deal with it | “… we need to be careful about stereotyping people … there is a huge amount of in-group diversity.” (Clinician interviewee, hospital physician) | |
| “I’m hoping that there will be more ethnic training certainly in the primary care setting because as a primary care GP I think there’s desperately a lack of (training).” (Clinician interviewee, general practitioner) | ||
| Perception of risk of infection in Chinese persons | “… perception that (the Chinese) are much easier because they don’t have any problems …” (Clinician) | |
| “I am not sure that any GP is going to have a sufficient population of Chinese to know that this is a major risk factor … If we make a bizarre comparison, if you see a Black patient you think of sickle cell. If you see a Chinese patient you don’t think about hepatitis B.” (Commissioner interviewee, regional public health consultant) | ||