艾滋病防治管理体制与患者关怀模式的探讨

On the management mechanism for AIDS prevention and control and patient care model

目的通过对甲乙两省艾滋病患者生活质量及幸福度现状的比较，分析防治管理体制对确定艾滋病患者关怀模式的影响。方法采用世界卫生组织针对艾滋病患者设计的生活质量问卷和纽芬兰纪念大学主观幸福度问卷对甲省93名、乙省57名艾滋病患者进行生活质量和主观幸福度现状描述；通过访谈了解两省艾滋病管理制度安排及艾滋病患者关怀模式。结果两省艾滋病患者生活质量总分、主观幸福度得分差异有统计学意义（P〈0．05）；生活质量各维度得分除社会关系外两省得分差异有统计学意义（P〈0．05）。访谈结果显示，甲省艾滋病防治管理体制主要采用以医政、疾控部门联合，市、县、乡、村层级的管理方式，对艾滋病患者实施以村医为核心的治疗关怀模式。乙省则采用分区管理方式，以定点区疾病预防控制中心为核心、传染病医院为辅助的艾滋病患者治疗关怀模式。结论艾滋病防治管理体制的建立要依据地区资源特征，不同地区应根据当地艾滋病患者的需要提供不同的关怀模式。

Objective A comparison of the quality of life and present status of happiness between AIDS patients in Provinces A and B helps to analyze the impact of the prevention and control mechanism on choice of the AIDS patient care mode. Methods The quality of the life questionnaire designed by WHO for AIDS patients and the Subjective Well-being questionnaire from the Memorial University of Newfoundland were called into play to describe the quality of life and present subjective wellbeing of 93 and 57 AIDS patients respectively from Province A and Province B; these patients were interviewed to understand the systematic arrangements of AIDS control in the two provinces and their AIDS patient care models. Results Differences found in the scores of the total quality of life and subjective wellbeing between the two provinces are significant statistically （P〈0. 05）; differences found in the scores of respective dimensions of quality of life, except for social relations, are significant statistically （P〈 0.05）. Results of interview found that the prevention and control mechanism of Province A feature a combination of medical administration and disease control departments, management by level of city, county, township and village. The care mode is characteristic of that centering on village doctors. The patient care mechanism in Province B features sectionalized management, and its model is characteristic of that centering on local CDC aided by infectious disease hospitals. Conclusion Establishment of the AIDS prevention and control mechanism should take into account features of local resources, and different regions should provide care models to fit the needs of local AIDS patients.