个性化护理干预对男同性恋HIV/AIDS患者服药依从性和自我管理能力与生存质量的影响

Effect of personalized nursing intervention on drug compliance,self-management ability,and quality of life of gay patients with HIV/AIDS

目的探讨个性化护理干预对男同性恋艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者治疗依从性、自我管理能力与生活质量的作用效果,为制定HIV/AIDS患者随访关怀策略提供参考。方法2019年9月至2020年12月,按照随机化原则在广州市番禺区登记在册且处于可随访状态的本地户籍及现住址均在当地的艾滋病患者中,选取经男男性接触感染、18岁≤年龄≤60岁、无认知交流障碍者200例,随机数字表法分为试验组和对照组,各100例。为对照组提供个案建档、定期随访关怀等常规服务;为试验组提供知识宣教,膳食、运动、用药、社交、健康生活行为方式指导,心理、网络干预和社会支持等个性化护理干预。采用SPSS 25.0比较干预前后两组服药依从性、自我管理能力和干预后生活质量水平。结果试验组HIV感染者62例、AIDS患者38例,年龄(34.27±9.45)岁;对照组HIV感染者66例、AIDS患者34例,年龄(32.28±8.87)岁。干预前,试验组和对照组服药依从性、HIV感染者/AIDS患者自我管理量表(HIVSMS)评分差异均无统计学意义(均P>0.05)。干预后,试验组服药依从性高于对照组[93.94%(93/99)比76.77%(76/99)],差异有统计学意义(χ^(2)=11.676,P=0.001);试验组HIVSMS评分高于对照组,差异有统计学意义(t=6.303,P<0.001);试验组在艾滋病患者生存质量量表的总体健康评分(t=3.182,P=0.002)、躯体健康评分(t=3.202,P=0.002)、躯体角色评分(t=3.819,P<0.001)、社会功能评分(t=3.689,P<0.001)、认知功能评分(t=4.744,P<0.001)、肌体疼痛评分(t=3.030,P=0.003)、心理健康评分(t=2.615,P=0.010)、生命力评分(t=2.409,P=0.017)、健康压力评分(t=2.587,P=0.010)、生命质量评分(t=4.450,P<0.001)、生理领域总分(t=6.641,P<0.001)、心理领域总分(t=5.738,P<0.001)均高于对照组。结论对男同性恋HIV/AIDS患者采取个性化护理干预,可有效提高患者治疗依从性及自我管理能力,改善患者生活质量,可进一步实施推广。

Objective To explore the effect of personalized nursing intervention on the treatment compliance,self-management ability,and quality of life of gay patients with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS),and to provides references for the development of follow-up care strategies for HIV/AIDS cases.Methods From September,2019 to December,2020,in accordance with the principle of randomization,200 AIDS patients by male contact infection,who registered at Panyu District,Guangzhou,were in a follow-up state of local household registration,and had local current addresses,were selected;they were 18-60 years old,and had no cognitive communication disorders.They were divided into an experimental group and a control group by the random number table method,with 100 cases in each group.The control group were provided with case files,regular follow-up care,and other routine services;and the experimental group took personalized nursing interventions,such as knowledge education,guidance of diet,exercise,medication,social communication,and healthy life behaviors,psychological and network interventions,social support,etc.SPSS 25.0 was used to compare the medication compliance and self-management ability before and after the interventions and quality of life after the interventions between these two groups.Results In the experimental group,there were 62 cases of HIV infection and 38 AIDS patients,and they were(34.27±9.45)years old.In the control group,there were 66 cases of HIV infection and 34 AIDS patients,and they were(32.28±8.87)years old.There were no statistical differences in medication compliance and HIVSMS(HIV/AIDS Patients'Self-Management Scale)scores between these two groups before the intervention(all P>0.05).After the interventions,the medication compliance of the experimental group was higher than that of the control group[93.94%(93/99)vs.76.77%(76/99);χ^(2)=11.676,P=0.001];the HIVSMS score of the experimental group was higher than that of the control group(t=6.303,P<0.001);the scores of overall health(t=3.182,P=0.002),physical health(t=3.202,P=0.002),body role(t=3.819,P<0.001),social function(t=3.689,P<0.001),cognitive function(t=4.744,P<0.001),muscle pain(t=3.030,P=0.003),mental health(t=2.615,P=0.010),vitality(t=2.409,P=0.017),health stress(t=2.587,P=0.010),and quality of life(t=4.450,P<0.001),the total physiological score(t=6.641,P<0.001),and the total score in the psychological field(t=5.738,P<0.001)of MOS-HIV in the experimental group were higher than those in the control group.Conclusion Personalized nursing intervention for gay patients with HIV/AIDS can effectively improve their treatment compliance,self-management ability,quality of life,so it is worth being generalized.