title: Determining the political influence of nurses who work in the field of hepatitis C: a Delphi survey.
abstract: OBJECTIVE
  The principle aim of this study was to determine the political influence and the professional profile of nurses who work in the field of hepatitis C.
  
  
  BACKGROUND
  Hepatitis C has emerged as a major public health problem. Its growing impact on health services has led to the development and expansion of a range of specialist nursing roles in hepatitis C. The professional group has never been profiled in the current political and social context, although many nurses traverse patient, organizational and strategic levels of practice and service development.
  
  
  METHODS
  A multi-centre survey design using the Delphi technique was undertaken to gain consensus. A total of 160 nurses who work in the field of hepatitis C, were invited to participate. The target population was located from 90 sites across the United Kingdom. Data collection comprised two questionnaire rounds. Final sample included 40 participants in round 1 and 34 in round 2.
  
  
  RESULTS
  The results showed strong consensus on the necessity of structural and policy changes at national and regional levels and nurses' inclusion within that process. Of note was the need for policy group representation and engagement in the commissioning agenda. Overall, the findings demonstrate that most nurses have advanced contextual understanding of the issues. There is evidence of political activities and nursing influence at local and regional levels. This is less evident at national level, where there is only a core of active members.
  
  
  CONCLUSIONS
  These findings reveal nurses to be operating and thinking strategically without referencing their activities as political. Nurses should be more focused in translating strategic thinking into political activities. This should be coordinated and supported through the Hepatitis Nurse Specialist Forum to ensure nurses become increasingly visible in driving services forward at policy level.
  
  
  CONCLUSIONS
  Successive governments have failed to address the serious structural problems in resource allocation, lack of public awareness and policy direction. This is where patient, organizational and strategy levels interface in hepatitis C because policy affects patients and organizations, patient level care affects policy direction and nurses can influence all three.
authors.affiliation: Health Promotion Service, Homefirst Community Trust, Ballymena, Northern Ireland.
authors.forename: Clare
authors.initials: C
authors.lastname: McKeown
authors.forename: Faith
authors.initials: F
authors.lastname: Gibson
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D032921:Consensus; D003697:Delphi Technique; D005260:Female; D018166:Health Care Reform / Q000458:organization & administration; D006291:Health Policy; D006526:Hepatitis C / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D020380:Needs Assessment; D024802:Nurse's Role / Q000523:psychology; D009726:Nurses / Q000523:psychology*; D015404:Nursing Methodology Research; D010344:Patient Advocacy; D011057:Politics; D013222:State Medicine / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D006113:United Kingdom