伊犁哈萨克自治州乡级艾滋病治疗机构AIDS病人生存质量及相关因素

Status of life quality and its influencing factors among AIDS patients at township level of Ili Kazak autonomous prefecture

目的了解伊犁州乡级艾滋病(AIDS)治疗机构的AIDS病人生存质量状况,分析影响生存质量的相关因素,为进一步改善其生存质量提供依据。方法以三个乡级艾滋病治疗服务机构为研究现场,以正在接受抗病毒治疗且年龄在18岁以上的AIDS病人为研究对象,在取得知情同意后,采取问卷调查和查询艾滋病信息管理系统相结合的方式收集资料,内容包括社会人口学特征、生存质量评定、抗病毒治疗相关知识和治疗依从性、吸烟和饮酒行为、抑郁和焦虑症状等。结果在412名调查对象中,平均年龄为41.1岁,男性占60.9%(251名);已婚者占63.8%(263名),初中及以下文化程度者占80.6%(332名);调查对象生存质量总评分为(54.16±7.71)分,已婚或同居者生存质量在社会关系领域、环境领域和生存质量总评分均较高。多因素分析结果显示,调查对象生存质量评分随着漏服药次数的增加(β=-0.021,P <0.001)而降低;个人年收入更高(β=0.003,P=0.028)、确证HIV感染时间越长(β=0.006,P=0.007)以及抗病毒治疗知识掌握更充分者(β=0.021,P <0.001)生存质量更高。通径分析结果显示,抑郁症状对生存质量的直接和间接效应分别为-0.43和0.31,焦虑症状对生存质量的直接和间接效应分别为-0.17和-0.19;漏服药次数对生存质量的直接效应为-0.2。结论伊犁州乡级艾滋病治疗机构的AIDS病人生存质量较高,提高患者抗病毒治疗依从性和社会心理支持有助于进一步改善其生存质量。

Objective To investigate the status of life quality among HIV infected people with antiretroviral therapy(ART) at town level in Yili Kazakh autonomous prefecture(Yili) and to analyze its influencing factors to improve care services for them. Methods A cross-sectional survey was conducted by one-on-one interview and data were collected from the three centers providing ART services at town level in Yili. Those infected with HIV, aged 18 years or above, and receiving ART were recruited to know their demographic characteristics, quality of life, knowledge related ART and adherence of ART, smoking and drinking behavior as well as depression and anxious symptoms. Results Totally, 412 participants completed the survey and the mean of age was(41.1±8.0) years old. 60.9% were male, 63.8% were married and 80.6% were under the education of junior middle school. The result showed that the average score of life quality was(54.16±7.71). The score of married people or cohabiting couples was higher in the dimensions of social relations, environment and quality of life. The result of generalized linear mixed model analyses showed that scores of life quality decreased with the number of missed medications(β =-0.021, p < 0.001). People with higher personal income(β =0.003, P=0.028) and better awareness of ART knowledge(β =0.006, P =0.007) got more scores. Patients diagnosed of HIV for a longer time had significantly increased scores of quality of life(β =0.006, P =0.007). Path analyses showed that the direct and indirect effects of depressive symptoms on quality of life were-0.43 and 0.31 respectively. The direct and indirect effects of anxiety symptoms on quality of life were-0.17 and-0.19. The direct effect of missed doses on quality of life was-0.2. Conclusion Quality of life among the patients in Yili is higher than that of others. ART adherence and social psychological support will be helpful in improving the life quality of AIDS patients.