某市艾滋病患者及其子女生活质量分析
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摘要
目的
     了解艾滋病患者及其子女的生活质量,分析影响艾滋病患者及其子女生活质量的因素,探讨艾滋病患者及其子女生活质量间的关系,为制定提高艾滋病患者及其子女生活质量的有效措施提供科学依据。
     方法
     以河南某市为研究地点,采用多级抽样的方法确定12个行政村的402名艾滋病患者及其103名子女(年龄在13~18岁之间)作为研究对象。对于艾滋病患者选用世界卫生组织生活质量量表、社会支持评定量表和简易应对方式量表进行相应指标的测定,并用流式细胞仪测定CD4+细胞数量;对艾滋病患者子女选用儿童生活质量普适性核心量表、青少年社会支持量表和中学生应对方式量表,进行相应指标测定;另选398名成年人、102名儿童作为对照。使用EpiData3.1建立数据库并进行双录入,用SPSS17.0对数据进行处理和分析。
     结果
     1艾滋病患者生活质量状况艾滋病患者生活质量总分为(75.51+13.41)分;4个领域的得分分别为生理领域(22.99+4.51)分,心理领域(17.93+4.51)分,社会关系领域(10.23±1.95)分,环境领域(24.37±4.61)分;生活质量总分、生理领域、心理领域得分均低于对照组,差异有统计学意义(P<0.05)。
     2艾滋病患者子女生活质量状况艾滋病患者子女生活质量总分为(74.82±13.84)分;4个领域的得分分别为:生理功能(83.56±14.09)分,情感功能(65.53±22.30)分,社会功能(76.72±18.41)分,学校表现(68.54±15.62)分;生活质量总分、情感功能、学校表现得分均低于对照组儿童,差异有统计学意义(P<0.05)。
     3艾滋病患者子女生活质量与患者生活质量的相关性子女生活质量总分与艾滋病患者生活质量总分呈显著正相关(r=0.540,P<0.05)。子女生活质量总分与患者生活质量的心理领域(r=0.625,P<0.05)、生理功能(r=0.229,P<0.05)、情感功能(r=0.725,P<0.05)、社会功能(r=0.644,P<0.05)、学校表现(r=0.359,P<0.05)均呈]正相关关系。
     4艾滋病患者生活质量影响因素多重线性回归分析结果显示,艾滋病患者生活质量总分的主要影响因素为:社会支持(B=2.83,t=4.159,P<0.001)、积极应对(B=0.332,t=3.995,P<0.001)、家庭人均年收入(B=0.009,t=3.317,P<0.001)、吸烟(B=-4.369,t=-3.510,P<0.001)。
     5患者子女生活质量影响因素多重线性回归分析结果显示,子女生活质量总分的主要影响因素为:单亲/离异家庭(B=-6.252,t=-4.064,P<0.001)、性别(B=-5.896,t=-2.435,P=0.015)、逃避(B=-1.380,t=-2.477,P=0.017)、是否知道父母患病(B=6.495,t=2.207,P=0.030)。
     结论
     1艾滋病患者及其子女的生活质量较差,二者均低于相应的对照组。
     2子女的生活质量与艾滋病患者生活质量存在正相关关系。
     3家庭人均年收入、社会支持、积极应对等为艾滋病患者生活质量的主要影响因素;单亲/离异家庭、是否知道父母患病、性别、逃避等为其子女生活质量的主要影响因素。
Objective:
     To study the life quality of HIV/AIDS patients and their children; Analyze the factors which impact their life quality; Explore the relationship between the quality of life of patients and children; Some effective measures are provided to improve their life quality.
     Methods:
     Take randomly city, Henan province as a study site sample. According to the epidemic data, randomly sampling method is used to select402HIV patients and their103children in12villages are randomly selected for this study. They were assessed with World Health Organization Quality of Life Assessment (WHOQOL-BREF), Social Support Rating Scale (SSRS) and Simplified Coping S (SCSQ) Method on the spot. Chileren were assessed with PedsQLTM4.0, Social Support Rating Scale and Dealing Method about child on the spot. Double input the data Build the database by EpiData3.1and use SPSS17.0to process and analyze the data.
     Results:
     1State of HIV patient living quality, support from the society and dealing method:The scores of four areas for the quality of life in patients with AIDS were physiological areas (22.99±4.51) points, psychology domain (17.93±4.51), the field of social relations (10.23±1.95), the field of the environment (24.37±4.61). The scores of physiological areas and psychology domains are smaller then compare sample group, the difference was statistically significant (P<0.05).
     2Quality of life for children from the HIV patients'family:The scores of four areas for the children from HIV patients' family are physiological function (83.56±14.09), emotional function (65.53±22.30), social function (76.72±18.41) and school function (68.54±15.62). The scores of emotional function and school function of children affected from HIV/AIDS patient family are lower than that of the normal compare group. The difference was statistically significant (P<0.05).
     3The life quality between HIV patients and their children:Quality of life of AIDS patients and their children's life quality scores are significantly positively correlated (r=0.540, P<0.05). The field of psychological quality of life of AIDS patients and their children in the home emotional function, social function, school performance showed a positive correlation (r=0.725, P<0.05;r=0.644, P<0.05; r=0.359, P<0.05).
     4The life quality of influence factors for HIV patients:Single factor analysis indicates that:age, gender, marriage status, education level, per capita annual incomes, smoking drinking, compliance of patients taking antiviral drugs, CD4+T cell counting number, coping style and social support are related to quality of life (P<0.05).Multiple linear regression analysis indicates that:SSRS (B=2.83,t=4.159, P<0.001) positive reply (B=0.332,t=3.995, P<0.001)、per capita annual incomes (B=0.009,t=3.317, P<0.001)、smoking (B=-4.369,t=-3.510, P<0.001).
     5Influence factors to life quality for children from the HIV patients' family:Single factor analysis indicates that:gender, age, children known their parents illness or not, single parent/divorced family, subject support, accompany time are the factors which influence the life quality of children from HIV patients' family (P<0.05). Multiple linear regression analysis indicates that, single parent/divorced family (B=-6.252, t=-4.064, P<0.001)、gender (B=-5.896,t=-2.435, P=0.015)、 escape (B=-1.380, t=-2.477, P=0.017)、children known their parents illness or not (B=6.495, t=2.207, P=0.030)。
     Conclusions:
     1The life quality, support from society, dealing method for patient and their children are in poor condition.
     2There is a significant positive correlation between the life quality of AIDS patients and their children.
     3per capita annual incomes, support from society, positive reply are the factors which influence their life quality. Single parent/divorced families, known their parents conditions or not, Gender, escape are the factors which influence the children life quality from HIV patients family.
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