“Look, I'm fit, I'm positive and I'll be all right, thank you very much”: Coping with hepatitis C treatment and unrealistic optimism

Hepatitis C treatment is known to produce significant physical and psychiatric side-effects. Healthcare workers in hepatitis C treatment clinics focus on preparing people to cope with these side-effects. Unrealistic optimism, or judging oneself to be at low risk of negative events, has been implicated in contributing to practices that place health at risk and to delays in seeking help or facilitating coping with negative events. In the context of hepatitis C treatment, patients with overly optimistic expectations of their ability to cope with treatment-related side-effects are less prepared for their impact and therefore may be more likely to discontinue treatment. In this exploratory qualitative study, data from semi-structured interviews with 20 people undergoing hepatitis C treatment and six healthcare workers at three hepatitis C treatment clinics in Sydney, Australia were explored for the presence of unrealistic optimism and also the impact that this had on patients' processing of information pre-treatment and management of side-effects during treatment. The concept of unrealistic optimism was evident in both patients' and healthcare workers' interview transcripts. Patients' descriptions of their preparation for hepatitis C treatment included references to delays in seeking help for depressive symptoms attributable to unrealistic optimism. Healthcare workers also discussed their observations of the effects of unrealistic optimism on patients' coping strategies. Data from this study contribute to an understanding of unrealistic optimism and its impact on the experience of hepatitis C treatment side-effects, patients' coping styles and potential for delays in seeking help. Unrealistic optimism should be explored as part of pre-treatment assessments for hepatitis C treatment and considered throughout treatment to avoid delays in help seeking.