艾滋病患者及其直系亲属心理健康状况与抗病毒治疗依从性的相关性

The mental health status of HIV/AIDS patients and their immediate family members and its correlation with the compliance of antiretroviral therapy

目的 了解艾滋病患者及其直系亲属心理健康状况以及患者抗病毒治疗依从性与心理健康状况的关系.方法 选取92例艾滋病患者及92名直系亲属进行问卷调查,采用症状自评量表和Morisky问卷（8条目版本）进行心理健康状况和患者治疗依从性评估,并进行皮尔逊积差相关性分析.结果 艾滋病患者的躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对性、恐怖、偏执和精神病性得分都显著高于国内常模（t=6.64、4.45、11.54、4.88、18.80、11.15、18.49、7.21和11.57,P均＜0.01）;艾滋病患者直系亲属的人际关系敏感、抑郁、焦虑、敌对性、恐怖和偏执上的得分显著高于国内常模（t=7.16、3.66、13.61、17.60、2.48和8.09,P＜0.01或0.05）.艾滋病患者抗病毒治疗依从性得分为4.00（3.05,5.00）,且在性别、文化程度、婚姻状况、有无工作等因素上的差异无统计学意义（Z=0.33、0.31、0.38和0.28,P均＞0.05）.患者抗病毒治疗依从性与本人在躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对性、恐怖、偏执和精神病性上的心理健康状况呈显著负相关（r=-0.503、-0.653、-0.752、-0.722、-0.770、-0.654、-0.652、-0.676和-0.575,P均＜0.01）;同时,患者抗病毒治疗依从性与其直系亲属的人际关系敏感、抑郁、焦虑、敌对性和偏执存在显著的负相关（r=-0.423 、-0.255 、-0.371、-0.380、-0.388,P均＜0.01）.结论 艾滋病患者抗病毒治疗依从性较差,且与患者本人及其直系亲属的心理健康状况密切相关,因此我们有必要通过心理干预改善患者直系家属心理健康状况,从而提高艾滋病患者抗病毒治疗的依从性.

Objective To investigate the mental health status of HIV/AIDS patients and their immediate family members,and its relationship with HIV/AIDS patients＇ compliance to antiretroviral therapy （ART）.Methods There were 92 AIDS/HIV patients and 92 family members enrolled to fill out questionnaires.Symptom checklist-90 （SCL-90）and Morisky Medication Adherence Scale 8-item version （MMAS-8）were adopted to evaluate mental health status and ART compliance,respectively.Pearson＇s Correlation Coefficient was used to analyze the data.Results The scores of somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,phobia,paranoia and psychoticism of HIV/AIDS patients were all significantly higher than those of the domestic norm （t=6.64,4.45,11.54,4.88,18.80,11.15,18.49,7.21 and 11.57,P all〈0.01）.The scores of interpersonal sensitivity,depression,anxiety,hostility,phobia and paranoia of family members were also higher than those of the domestic norm （t =7.16,3.66,13.61,17.60,2.48 and 8.09,P〈0.01 or 0.05）.The average score of HIV/AIDS patients＇ compliance to ART was 4.00 （3.05,5.00）,and there was no statistically significant difference in gender,degree of education,marital status,and work or not （Z=0.33,0.31,0.38 and 0.28,P all〉0.05）.Patients＇ compliance to ART was negatively correlated to their negative mental status such as somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,phobia,paranoia and psychoticism （r=-0.503,-0.653,-0.752,-0.722,-0.770,-0.654,-0.652,-0.676 and -0.575,P〈0.01）.At the same time,patients＇ compliance to ART was also negatively correlated to family members＇negative mental status such as interpersonal sensitivity,depression,anxiety,hostility and paranoia （r=-0.423,-0.225,-0.371,-0.380 and-0.388,P〈0.01）.Conclusions HIV/AIDS patients＇ compliance to ART is poor and closely correlated to the mental health of HIV/AIDS patients and their immediate family.Therefore,it is necessary to improve the mental health status of the immediate family members through psychological intervention,so as to improve the compliance of ART in HIV/AIDS patients.