299例人类免疫缺陷病毒感染者生命质量的调查

Quality of life and hostile mentality trend among 299 patients living with HIV/AIDS

目的用定性访谈和36条目简明量表(short form-36,SF-36)定量调查的方法研究人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者的生命质量,评价 HIV 感染者的敌意心理趋势。方法在四川、湖北和贵州抽取299例 HIV 感染者,用 SF-36调查其生命质量,并进行信度效度分析。对感染者和防治人员进行访谈,以了解感染者目前最关注的内容。SF-36曾用于与本次调查对象具有相似经济文化背景的四川普通农村居民(1603例),将两次调查的结果进行比较。通过与相关专家及防治人员进行小组讨论,设计7个条目以评价感染者的敌意心理趋势。结果 SF-36共有8个维度,各维度内部一致性信度系数范围0.75～0.90,重测信度系数范围0.54～0.80(40例)。条目与其维度的相关系数范围为0.46～0.97。HIV 感染者各个维度平均得分在28.50～77.87之间,四川普通农村居民各个维度平均得分在70.27～91.87之间,各维度得分经 Mann-Whitney test 检验,u 值在-17.43～-23.87之间,P 值均<0.01。评价敌意心理趋势的7个条目平均得分范围为46.21～82.89。结论 HIV 感染带来生命质量的严重恶化。SF-36可用于 HIV 感染者生命质量的研究。

Objective To assess the quality of life （QOL） and hostile mentality trend （HMT） of 299 patients living with HIV/AIDS （Human immunodeficiency virus / Acquired immune deficiency syndrome） in three provinces in China, and to understand the major concerns of the these patients. Methods The SF-36 （ short form -36） was used for assessing the QOL among 299 HIV-infected patients in Sichuan, Hubei and Guizhou provinces. Reliability and vahdity of SF-36 were evaluated. Consulting with experts and professionals, seven additional items were developed to evaluate the HMT. Mean scores of the 8 scales were compared between the patients and general rural residents in Sichuan province. Results For SF-36, internal consistent coefficients （ Cronbach＇ s or） of the 8 scales were between 0. 75 to 0. 90, test-retest reliability coefficient ranged from 0. 54 to 0. 80. The item-subscale correlation coefficients ranged from 0. 46 to 0. 97. Mean scores of the 8 scales of the patients ranged from 28.50 to 77. 87, and 70. 27 to 91.87 for the general rural residents. The variations of the scales were tested by means of Mann-Whitney test with u va/ue ranged from - 17.43 to - 23.87. The QOL of the patients living with HIV/AIDS were significantly inferior to those of general population （ all P 〈 0. 01 ）. The mean scores of the seven items to evaluate HMT ranged from 46. 21 to 82. 89. The major concerns of the patients living with HIV/AIDS included financial insecurity and family responsibilities, followed by death threat and no cure of HIV/AIDS. Conclusion The SF-36 is a reliable instrument for assessing QOL of patients living with HIV/AIDS. The QOL of the patients living with HIV/AIDS in China is poor.