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接受抗病毒治疗HIV/AIDS病人的依从性影响因素及干预对策 被引量:22

Study on impact factors associated with HIV patients' compliance with HAART and relevant interventions
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摘要 目的通过分析影响接受高效抗反转录病毒治疗(HAART)的艾滋病病人服药依从性的诸多因素,探讨提高病人服药依从性的对策,将其运用于实际工作中,以此提高HAART病人服药依从性,提高疗效。方法随机抽取HAART病人为研究对象,对在治的及已经终止治疗但仍存活的病人进行问卷调查,对已经死亡的病人逐一分析死亡原因,使用SPSS 16对数据进行统计分析,并采用Logistic回归方法分析数据。结果共随机抽取300名HAART病人,其中150人因各种原因已经终止治疗,死亡48人;150名在治的及102名已经终止治疗但仍存活的病人接受了问卷调查,有有效数据的195人进入统计。同伴教育、不良反应的出现、偷吸毒品、迁居、CD4淋巴细胞计数的变化、服药过程中喝酒以及家人的关怀和支持等7个因素,最终进入回归模型的变量分析,其回归系数Wald检验结果P≤0.069,按进入水准a=0.05,剔除水准b=0.10,可认为7个变量的回归系数均有统计学意义。其中不良反应的出现、偷吸毒品、患者迁居和在服药过程中喝酒等变量,与患者的服药依从性呈负相关,而同伴教育、对CD4淋巴细胞计数变化的关注、家人的关怀和支持以及艾滋病病毒(HIV)相关疾病导致的死亡等因素,与患者服药依从性呈正相关。结论有效提高患者服药依从性的措施,包括聘请同伴教员,严格按要求采集标本,提高医务人员诊疗水平,组织家属培训班和小组活动,设立美沙酮治疗门诊及消除歧视等,并将此运用于HAART治疗管理中,从一定程度上提高了病人的服药依从性,进而提高了HAART的疗效。 Objective To analyze impact factors associated with HIV patients's compliance with highly active antiretro viral therapy (HAART), and explore relevant interventions to improve HAART compliance and its efficacy. Methods HAART patients were randomly selected as the subjects, questionnaire survey was conducted among those who were under HAART and those who terminated the treatment but survived. Deceased cases were studied one by one. SPSS 16 was used for statistical analysis and logistic regression was used for data analysis. Results Totally 300 patients undertaking HAART were selected. Of them 150 were under treatment , while 150 terminated treatment for this or other reason, and 48 died; 150 treated cases and 102 cases who terminated treatment but survived were subject to a questionnaire survey. One hundred and ninety five valid questionnaires were statistically analyzed. Seven factors including peer education, side-effects, relapse of drug use, resettlement, change of CD4 cell counting, drinking during HARRT and family care and support finally en tered the regression model, and regression coefficient Wald P≤ 0. 069. Taking a= 0.05, b= 0.10, regression coefficient of seven variables were statistically significant, of which variables of side-effeets, relapse of drug use, resettlement, drink ing during HAART had negative correlation with HAART compliance, while peer education, concern over the change of CD4 cell counting, family care and support and death of HIV related diseases were positively correlated with patients ' eompliance with HARRT. Conclusion The effective interventions included involvement of peer educators, proper collection of blood samples, improvement of health workers' ability and skills, training courses for family members and group activities, establishment of methadone treatment clinics and elimination of discrimination. All these interventions will improve patients' compliance with HAART and its efficacy.
出处 《中国艾滋病性病》 CAS 2013年第3期166-168,共3页 Chinese Journal of Aids & STD
基金 国家十一五科技重大专项综合示范项目:云南省防治艾滋病规模化现场流行病学和干预研究(项目编号:2009zx10004-902)~~
关键词 艾滋病 高效抗反转录病毒治疗 依从性影响因素 干预对策 AIDS HAART Impact factors associ- ated with HAART compliance Interventions
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  • 1张福杰.国家免费艾滋病抗病毒药物治疗手册(二版)[M].北京:人民卫生出版社,2008:56-59,86-88,109-112.
  • 2Paterson DJ, Swindells S, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection[J]. Ann In- tern Med, 2000,133(1) :21-30.

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