Date of Graduation


Document Type



nonalcoholic fatty liver disease, hepatitis C, illness perception, Brief Illness Perception Questionnaire, lifestyle modification

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level



Allison Scott

Committee Member

Callie Bradley


Chronic liver disease is becoming the most common cause of mortality, morbidity, and utilization of healthcare services globally. Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC) are frequent causes of chronic liver disease. Recently, there have been significant findings on the relationship between NAFLD and CHC; patients with CHC have a higher incidence of NAFLD. The introduction of direct-acting antivirals has cured more CHC patients than ever before. Unfortunately, the current interventions for NAFLD requiring behavioral change remain ineffective. Patient’s ability to follow advice depends largely on their health beliefs; therefore, understanding their illness perception is an integral part of planning effective interventions. In a cross-sectional study enrolling 81 CHC patients with NAFLD, the Brief Illness Perception Questionnaire explored their illness perception and willingness to adhere to treatment. The data showed that only 23.5% of patients fully understood their NAFLD diagnosis. Most participants did not experience symptoms (61.7%) and did not think their illness affected their lives (56.8 %). Although 39.5% of patients perceived NAFLD as a long-term condition, only 14.8% believed they have extreme personal control, and only 48.1% believed there is some form of treatment for their illness. Regarding emotional representation, only 12.3% were emotionally affected, and only 27.2% were extremely concerned. Causal factors were believed to be related to dietary habits, obesity, and lack of physical activity. Despite the low illness perceptions, 91.4% were willing to adhere to treatment.

Available for download on Tuesday, April 25, 2023