Abstract
Background: Hepatitis B virus (HBV) is considered as a significant public health issue in Pakistan, where lack of awareness, inadequate training of diagnostic facilities, and ethical issues are common. A vast variety of epidemiological data is available regarding the prevalence of HBV; however, the lived experiences of doctors regarding the treatment and management of HBV patients are scarce. Therefore, this study aims to explore the perceptions, challenges, and ethical dilemmas encountered by doctors while treating and managing HBV patients in clinical settings.
Methods: A qualitative phenomenological approach was used to explore the perceptions, challenges, and ethical dilemmas doctors face while managing and treatment of HBV patients. 11 interviews were conducted with the doctors working in private and public sector hospitals of Lahore, Pakistan, based on the principle of saturation. Participants were recruited using purposive and snowball sampling following a pre-defined inclusion and exclusion criterion. Data was analyzed using a dual approach of thematic analysis, i.e., through NVivo software and manual technique.
Results: The study found that, according to doctors, there is a considerable lack of knowledge and awareness regarding HBV among the general population. Further, doctors reported facing several clinical challenges in diagnosing HBV patients, including inadequate diagnostic and screening facilities and follow-up barriers, which often result in delayed or incidental diagnoses. They also highlighted significant occupational risk exposures stemming from the inadequate provision of personal protective equipment, as well as limited awareness regarding HBV vaccination and the management of needle-stick injuries. These challenges place doctors under substantial ethical and psychological stress. Additionally, institutional level gaps identified through interviews highlighted a disconnection between policy formulation and frontline clinical practice.
Conclusion: Conclusively, the study reveals critical gaps in public awareness, protective measure systems, ethical standard maintenance, and training delivery regarding HBV. There is a need to introduce massive system and community-level awareness and screening campaigns to deal with the prevalent misconception and misinformation related to HBV infection as well as to promote early diagnosis.