title: Education and counseling of pregnant patients with chronic hepatitis B: perspectives from obstetricians and perinatal nurses in Santa Clara County, California.
abstract: BACKGROUND
  This study aimed to better understand the barriers to perinatal hepatitis B prevention and to identify the reasons for poor hepatitis B knowledge and delivery of education to hepatitis B surface-antigen- positive pregnant women among healthcare providers in Santa Clara County, California.
  
  
  METHODS
  Qualitative interviews were conducted with 16 obstetricians and 17 perinatal nurses in Santa Clara County, California, which has one of the largest populations in the United States at high risk for perinatal hepatitis B transmission.
  
  
  RESULTS
  Most providers displayed a lack of self-efficacy attributed to insufficient hepatitis B training and education. They felt discouraged from counseling and educating their patients because of a lack of resources and discouraging patient attitudes such as stigma and apathy. Providers called for institutional changes from the government, hospitals, and nonprofit organizations to improve care for patients with chronic hepatitis B.
  
  
  CONCLUSIONS
  Early and continuing provider training, increased public awareness, and development of comprehensive resources and new programs may contribute to reducing the barriers for health care professionals to provide counseling and education to pregnant patients with chronic hepatitis B infection.
authors.affiliation: Asian Liver Center at Stanford University, Palo Alto, CA, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Yang
authors.forename: Chrissy M
authors.initials: CM
authors.lastname: Cheung
authors.forename: Samuel K S
authors.initials: SK
authors.lastname: So
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Chao
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002140:California; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011379:Prognosis; D014481:United States
chemical_list: D017325:Hepatitis B Vaccines