HIV暴露后预防首次就诊者恐惧体验的质性研究

A qualitative study of fear experiences among new patients for HIV post-exposure prophylaxis

目的了解HIV暴露后预防(PEP)首次就诊者恐惧体验,以期为改善其恐惧制定个性化的干预措施提供依据。方法采用质性研究中的现象学研究方法,选取2022年6-10月南京市某艾滋病定点诊疗机构首次进行PEP的就诊者进行半结构式访谈,用Colaizzi现象学资料分析法对访谈资料进行分析,提炼主题。结果13名访谈对象中男性10名,女性3名。共提炼出5个主题:暴露后结局的不确定感与害怕(对PEP效果的不确定感、对阻断药安全性的质疑及不良反应影响的担心、对死亡的恐惧)、信息及支持系统匮乏(疾病相关知识缺乏、社会支持欠缺、医疗资源可及性受限)、多维负性体验(负性心理体验、歧视感知、机体应对失衡)、害怕隐私泄露、担心经济负担重。结论医护人员应重视PEP首次就诊者恐惧状况,及时为其提供专业化的医疗服务以改善其恐惧体验,有利于高效阻断HIV感染和传播。

Objective To comprehend the level of fear experiences of new patients for HIV post-exposure prophylaxis clinics to provide the basis for developing tailored interventions to alleviate fears.Methods New patients to HIV post-exposure prophylaxis clinics at an AIDS-designated medical institution in Nanjing were selected for semistructured interviews from June to October 2022 using the phenomenological research method.The interview data were analyzed by Colaizzi analysis to refine the themes.Results Among the 13 interviewees,10 were males and 3 were females.Five themes were extracted:1)uncertainty and fear of the outcome after exposure(uncertainty about the effect of PEP,doubt about the safety of medicine,fear of adverse effects,fear of death);2)lack of information and support systems(lack of disease related knowledge,lack of social support,limited access to medical resources),3)multi-dimensional negative experiences(negative psychological experience,discrimination perception,imbalance in body response);4)fear of privacy disclosure;and 5)fear of heavy economic burden.Conclusions The medical staff should be aware of the fears of new patients for the HIV post-exposure prophylaxis and provide prompt,specialized medical services to soothe concerns in order to effectively prevent HIV infection and transmission.