湖南省HIV感染者/AIDS患者疾病自我管理现状及影响因素研究

Study on the status of disease self-management in People Living With HIV in Hunan province and its influencing factors

目的:分析湖南省HIV感染者/AIDS患者的疾病自我管理现状和其影响因素,以及疾病自我管理与生活质量之间的关系,为提高该人群疾病自我管理水平提供参考。方法:在2018年9-12月之间,采用连续抽样的方法抽取湖南省某院HIV门诊就诊的HIV感染者/AIDS患者555例,采用一般资料问卷、疾病相关资料问卷和HIV感染者/AIDS患者自我管理量表、世界卫生组织HIV感染者生存质量量表简表进行调查。运用方差分析和Pearson/Spearman相关分析进行单因素分析,采用广义多元线性回归模型进行多因素分析。结果:HIV感染者/AIDS患者的自我管理得分为(170.50±22.98)分,得分率为69.6%,位于中等水平;其疾病自我管理水平越高,生活质量越好。多因素分析显示性取向、是否正在接受抗逆转录病毒治疗、是否合并其他疾病以及从知晓其病情的人中获得的支持和受到的歧视程度与HIV感染者/AIDS患者的疾病自我管理有关。结论:HIV感染者/AIDS患者的疾病自我管理与生活质量密切相关且有待进一步提升,在制定干预措施时需要纳入更为复杂的管理知识和技巧,以应对合并症管理、抗逆转录病毒治疗管理、感染状态告知等问题。

Objective:To analyze the status quo of disease self-management and related factors in People Living With HIV(PLWH),as well as the relationship between disease self-management and quality of life,and to provide reference for improving the level of disease self-management in this population.Methods:From September to December 2018,we consecutively recruited 555 PLWHs from an HIV clinic in Hunan province.General information questionnaire,and HIV related clinical data questionnaire,self-management scale for PLWH and WHO QOL-HIV BRIEF scale were used to collect data.Bivariate analysis was used to explore the related factors,and multivariable generalized linear regression was conducted to confirm the related factors to self-management.Results:The total score of self-management was 170.50±22.98,with a score rate of 69.6%,which was at the moderate.The level of self-management of diseases was positively related to quality of life.Multi-factor analysis showed that sexual orientation,taking antiretroviral therapy,having comorbidities,and perceived support or stigma from people who know their HIV status were significantly associated with self-management in people living with HIV.Conclusion:The self-management of PLWHs is related to the quality of life and needs to be promoted.Interventions needs to incorporate more complex management knowledge and techniques should be included to help PLWH coping with comorbidities,antiretroviral therapy,and infection status disclosure,etc.