四川凉山不同流行水平地区HIV/AIDS病人自我管理现状及影响因素
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摘要
目的调查四川凉山不同流行区艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)自我管理现状,探讨其影响因素。方法采取分层随机抽样的方法,在四川凉山高流行区和低流行区,各随机抽取一个县作为代表县,在每个县通过方便抽样抽取研究对象。采用自行设计的一般资料调查表和HIV/AIDS病人自我管理量表及医疗社会支持量表对HIV/AIDS病人进行调查。结果高、低流行区HIV/AIDS病人自我管理总分分别为(36.28±5.91)分和(42.93±7.73)分。多重线性回归分析显示,居住地、实际性支持、社会互动性合作、病程及感染途径是高流行区HIV/AIDS病人自我管理的影响因素(P<0.05);讯息及情绪性支持是低流行区HIV/AIDS病人自我管理的影响因素(P<0.05)。结论四川凉山地区HIV/AIDS病人的自我管理水平较低,且高流行区低于低流行区,因此,对凉山地区尤其是高流行地区及农村HIV/AIDS病人,应加大艾滋病疾病知识及疾病自我管理的宣传,加强随访服务、给予医疗和信息支持。
Objective To assess the current status and influencing factors of self-management of people living with HIV/AIDS(PLWH)in the areas with different HIV/AIDS epidemics in Yi autonomous prefecture of Liangshan.Methods Stratified random sampling was adopted to randomly select one county as the representative in the high-epidemic area and another in the low-epidemic area,and the research objects were selected through convenience sampling in each county.The self-designed questionnaire,HIV self-management scale and medical outcomes study social support survey(MOS-SSS-C)were used to evaluate PLWH.Results The total score of self-management among PLWH in high and low epidemic areas were 36.28±5.91 and 42.93±7.73.Multiple linear regression model demonstrated that resident place,disease duration,infection route,essential support and positive interaction were the contributors to self-management in the high epdemic area(all P<0.05).Emotional support and information were the influencing factors of self-management in the low epdemic area.Conclusion The self-management of PLWH in Yi autonomous prefecture is at low level.The self-management in the high epidemic area is lower than that in the low epedemic area.We should pay attention to PLWH in Liangshan especially in the high epidemic and rural areas.The publicity of AIDS and self-management knowledge should be increased and the follow-up service be strengthened to provide medical treatment and information support to them.
Objective To assess the current status and influencing factors of self-management of people living with HIV/AIDS(PLWH)in the areas with different HIV/AIDS epidemics in Yi autonomous prefecture of Liangshan.Methods Stratified random sampling was adopted to randomly select one county as the representative in the high-epidemic area and another in the low-epidemic area,and the research objects were selected through convenience sampling in each county.The self-designed questionnaire,HIV self-management scale and medical outcomes study social support survey(MOS-SSS-C)were used to evaluate PLWH.Results The total score of self-management among PLWH in high and low epidemic areas were 36.28±5.91 and 42.93±7.73.Multiple linear regression model demonstrated that resident place,disease duration,infection route,essential support and positive interaction were the contributors to self-management in the high epdemic area(all P<0.05).Emotional support and information were the influencing factors of self-management in the low epdemic area.Conclusion The self-management of PLWH in Yi autonomous prefecture is at low level.The self-management in the high epidemic area is lower than that in the low epedemic area.We should pay attention to PLWH in Liangshan especially in the high epidemic and rural areas.The publicity of AIDS and self-management knowledge should be increased and the follow-up service be strengthened to provide medical treatment and information support to them.
引文
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[12]郝阳,崔岩,孙新华,等.“四免一关怀”政策实施十年来中国艾滋病疫情变化及特征分析[J].中华疾病控制杂志,2014,18(5):369-374.
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[14]赵群,李晓铭,方晓义,等.艾滋病"四免一关怀"政策对农村家庭及其子女的影响[J].中国农村卫生事业管理,2009,29(9):708-711.
[15]谭祈炜.四川凉山彝族地区吸毒问题调查思考[J].民族学刊,2012,3(6):95-99,108.
[16]Ncama BP,Mcinerney PA,Bhengu BR,et al.Social support and medication adherence in HIV disease in KwaZulu-Natal,South Africa[J].Int J Nurs Stud,2008,45(12):1757-1763.
[17]Raffaelli M,Andrade FCD,Wiley AR,et al.Stress,Social Support,and Depression:A Test of the Stress-Buffering Hypothesis in a Mexican Sample[J].J Res Adolesc,2013,23(2):283-289.
[2]杨淑娟,罗敏,张素华,等.凉山彝族相关文化习俗与艾滋病流行的关系及干预对策[J].中国艾滋病性病,2017,23(3):271-272.
[3]朱成华,宋秀霞,姜庆五.四川省凉山州艾滋病流行原因及防治状况进展[J].复旦学报(医学版),2015,42(5):675-679.
[4]Webel AR,Asher A,Cuca Y,et al.Measuring HIV Self-Management in Women Living with HIV/AIDS:A Psychometric E-valuation Study of the HIV Self-Management Scale[J].J Acquir Immune Defic Syndr,2012,60(3):e72.
[5]Sherbourne CD,Stewart AL.The MOS social support survey[J].Soc Sci Med,1991,32(6):705-714.
[6]黎欢.医疗社会支持量表简体中文版在艾滋病患者中的心理测量学评定及应用研究[D].长沙:中南大学,2012.
[7]Kim GS,Chu SH,Park Y,et al.Psychometric Properties of the Korean Version of the HIV Self-Management Scale in Patients with HIV[J].J Korean Acad Nurs,2015,45(3):439-448.
[8]Webel AR,Cuca Y,Okonsky JG,et al.The impact of social context on self-management in women living with HIV[J].Soc Sci Med,2013,87(6):147-154.
[9]莫色打尔,张建华,龚煜汉.艾滋病、性病对凉山彝族传统性习俗的挑战与威胁[J].预防医学情报杂志,2003,19(s1):91.
[10]马林英,罗凉昭.凉山彝区教育发展现状调查及对策建议[J].西南民族大学学报(人文社科版),2000(s3):31-38.
[11]黄琴,关建萍,李晓春,等.240例HIV/AIDS患者自我管理能力现状及影响因素分析[J].护理学报,2017,24(22):46-49.
[12]郝阳,崔岩,孙新华,等.“四免一关怀”政策实施十年来中国艾滋病疫情变化及特征分析[J].中华疾病控制杂志,2014,18(5):369-374.
[13]宗先顺.对艾滋病患者实行“四免一关怀”政策的社会学意义[J].医学与社会,2006,19(2):12-13.
[14]赵群,李晓铭,方晓义,等.艾滋病"四免一关怀"政策对农村家庭及其子女的影响[J].中国农村卫生事业管理,2009,29(9):708-711.
[15]谭祈炜.四川凉山彝族地区吸毒问题调查思考[J].民族学刊,2012,3(6):95-99,108.
[16]Ncama BP,Mcinerney PA,Bhengu BR,et al.Social support and medication adherence in HIV disease in KwaZulu-Natal,South Africa[J].Int J Nurs Stud,2008,45(12):1757-1763.
[17]Raffaelli M,Andrade FCD,Wiley AR,et al.Stress,Social Support,and Depression:A Test of the Stress-Buffering Hypothesis in a Mexican Sample[J].J Res Adolesc,2013,23(2):283-289.