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1.
BACKGROUND: Functional health literacy is associated with illness-related knowledge, understanding, and treatment perceptions for several chronic illnesses. This study examined health literacy in relation to knowledge and understanding of HIV/AIDS. METHODS: Persons living with HIV/AIDS recruited from AIDS service organizations and HIV clinics completed the Test of Functional Health Literacy for Adults (TOFHLA) reading comprehension scale and measures of health status, knowledge and understanding of health status, perceptions of primary care givers, and perceptions of anti-HIV treatments. RESULTS: Eighteen percent of the sample scored below the cutoff for marginal functional health literacy on the TOFHLA. Controlling for years of education, persons of lower health literacy were significantly less likely to have an undetectable HIV viral load, somewhat less likely to know their CD4 cell count and viral load, and lower health-literacy persons who knew their CD4 count and viral load were less likely to understand their meaning. Lower health literacy was also related to misperceptions that anti-HIV treatments reduce risks for sexually transmitting HIV and beliefs that anti-HIV treatments can relax safer-sex practices. CONCLUSIONS: Poor health literacy creates barriers to fully understanding one's health, illness, and treatments. Misperceptions of treatment in the case of HIV infection creates danger for potentially transmitting treatment-resistant strains of HIV. These results have implications for patient education and treatment programming for people who have poor health-literacy skills and are living with HIV/AIDS.  相似文献   

2.
The relationship between mindfulness and self-compassion is explored in the health care literature, with a corollary emphasis on reducing stress in health care workers and providing compassionate patient care. Health care professionals are particularly vulnerable to stress overload and compassion fatigue due to an emotionally exhausting environment. Compassion fatigue among caregivers in turn has been associated with less effective delivery of care. Having compassion for others entails self-compassion. In Kristin Neff's research, self-compassion includes self-kindness, a sense of common humanity, and mindfulness. Both mindfulness and self-compassion involve promoting an attitude of curiosity and nonjudgment towards one's experiences. Research suggests that mindfulness interventions, particularly those with an added lovingkindness component, have the potential to increase self-compassion among health care workers. Enhancing focus on developing self-compassion using MBSR and other mindfulness interventions for health care workers holds promise for reducing perceived stress and increasing effectiveness of clinical care.  相似文献   

3.
Knowledge of partner risk and secondary transmission of HIV   总被引:2,自引:0,他引:2  
BACKGROUND: The number and proportion of people living longer with HIV and the proportion of people infected heterosexually have increased. We measured the frequency with which people with heterosexually acquired AIDS knew their partners' risk behaviors, the extent of secondary heterosexual transmission of HIV, and characterized people at risk for secondary heterosexual transmission. METHODS: For each of five sites (Alabama, California, Florida, New Jersey, and Texas) and for New York City, a sample of adults with AIDS was interviewed. Primary heterosexual transmission was contact with a partner who had a known risk factor for HIV infection. Secondary transmission was contact with an HIV-positive partner not known to have a risk for HIV. RESULTS: Among men, 35% knew that a sexual partner was HIV infected, 56% of women knew that a sexual partner was HIV infected. Among women, 12% knew that a partner was bisexual. Overall, 79% (460 of 581) reported a partner with a primary risk for HIV; among men, 236 of 293 (81%), and among women, 224 of 288 (78%) reported a partner with a primary risk. People categorized with secondary transmission were significantly more likely to be black and never married. People categorized with secondary transmission were more frequently women (53%), had less than a high school education (48%), and a history of drug use (52%). Men categorized with secondary transmission of HIV had a mean of 22 heterosexual partners; women had a mean of 16 partners. CONCLUSIONS: We found that many heterosexuals with AIDS did not know their sexual partners' risk for HIV, and that secondary heterosexual transmission probably results in a small proportion of all AIDS cases in the U.S.  相似文献   

4.

PURPOSE

Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians.

METHODS

A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures.

RESULTS

Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales—Emotional Exhaustion (P =.009), Depersonalization (P = .005), and Personal Accomplishment (P <.001); (2) on the Depression (P =.001), Anxiety (P =.006), and Stress (P = .002) subscales of the Depression Anxiety Stress Scales-21; and (3) for perceived stress (P = .002) assessed with the Perceived Stress Scale. There were no significant changes on the 14-item Resilience Scale and the Santa Clara Brief Compassion Scale.

CONCLUSIONS

In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.  相似文献   

5.
Mindfulness, a practice of non-judgmental awareness of present experience, has been associated with reduced eating psychopathology and emotion-driven eating. However, it remains unclear whether mindfulness relates to diet quality. Thus, the purpose of this study was to examine whether dispositional mindfulness is associated with diet quality and to explore psychological factors relating dispositional mindfulness to diet quality. Community-dwelling adults (N = 406; Mage = 43.19, SD = 7.26; Mbody mass index [BMI] = 27.08, SD = 5.28; 52% female) completed ratings of dispositional mindfulness, depressive symptoms, perceived stress, positive affect (PA), and negative affect (NA). Dietary intake was assessed using the Block Food Frequency Questionnaire, from which the 2015 Healthy Eating Index was derived. Analyses were conducted using the “lavaan” package in R with bias-corrected bootstrapped confidence intervals (BootCI). Age, sex, race, education, and BMI were entered as covariates in all models. Higher dispositional mindfulness was associated with higher diet quality (β = 0.11, p = 0.03), and this effect was mediated through lower depressive symptoms (indirect effect β = 0.06, p = 0.02, BootCI = 0.104–1.42, p = 0.03). Dispositional mindfulness was negatively correlated with perceived stress (β = −0.31, p < 0.01) and NA (β = −0.43, p < 0.01), as well as positively correlated with PA (β = −0.26, p < 0.01). However, these factors were unrelated to diet quality. These cross-sectional data provide initial evidence that dispositional mindfulness relates to diet quality among midlife adults, an effect that may be explained in part by less depressive symptomatology. Given that lifestyle behaviors in midlife are leading determinants of risk for cardiovascular disease and neurocognitive impairment in late life, interventions to enhance mindfulness in midlife may mitigate disease risk. Additional research assessing the impact of mindfulness interventions on diet quality are warranted.  相似文献   

6.
目的了解2017年浙江省台州市青年学生艾滋病(AIDS)知识知晓、性行为现状及人类免疫缺陷病毒(HIV)检测意愿及接受检测情况,为开展青年学生艾滋病健康教育工作提供线索。方法在浙江省台州市采用分阶段整群抽样的方法,选取1所本科院校、1所专科院校在校学生开展调查。结果共调查1 210名青年学生,最近一年接受过预防艾滋病的宣传服务的为52.1%;艾滋病相关知识总体知晓率为79.5%;有过性行为经历的为8.9%,男生多于女生(13.3%与6.1%,χ2=18.614,P < 0.001),专科院校学生高于本科院校学生(13.4%%与6.6 %,χ2=15.373,P < 0.001);首次性行为平均年龄为(18.65±1.68)岁,安全套使用率为70.4%。最近一年与固定异性性伴、临时性伴、商业性伴及同性性伴(仅询问男性)发生性行为的比例分别为50.0%、14.8%、0.17%及3.2%,每次性行为均使用安全套的分别为64.8%、37.5%、100.0%及50.0%。84.7%的调查对象愿意接受艾滋病检测服务,但只有3.1%的调查对象曾经接受过艾滋病检测。本次研究中共有1 185人接受了抽血检测,HIV、梅毒均未检出。结论台州市青年学生人群艾滋病相关知识总体知晓率偏低,安全套使用率较低,应开展针对性的艾滋病防治健康教育活动,提高学生自我保护意识。  相似文献   

7.

Background:

Importance of nutrition in human immunodeficiency virus (HIV) is well-established; however, the information regarding the diet quality of people living with HIV (PLHIV) especially in India is lacking.

Objectives:

The objective of this study is to assess the anthropometric and nutritional profile of Indian PLHIV.

Material and Methods:

The study was performed on 400 adult PLHIV registered at the Antiretroviral Center (ART) center in New Delhi, India. Anthropometric data including height, weight, waist, hip, mid arm, and calf circumferences, were collected; 1-day 24-h dietary recall was done to gather nutrient intake from which nutrient adequacy ratios were computed. Mini Nutritional Assessment (MNA) was also conducted.

Results:

The mean body mass index (BMI) of the sample was 19.73 ± 3.55 kg/m2 with around 40% having BMI <18.5 kg/m2 . All anthropometric measurements were found to correlate positively and significantly with CD4 count (P < 0.05). The sample consumed poor quality of diet as they could not meet even the 2/3rd of the Indian Council of Medical Research (2010) requirements for energy, protein, calcium, iron, riboflavin, niacin, folic acid, B12, copper, and zinc. Classification of subjects according to MNA indicated that more than 50% of the sample was at-risk of malnutrition and 34% were malnourished. With 40% of sample having BMI less than normal, 50% at risk of malnutrition together with poor nutrient intakes over a long period of time could contribute to further worsening of the nutritional status.

Conclusion:

There is a need to develop a database on nutritional profile of PLHIV in India which reinforces the need for development of effective strategies to improve their nutritional status.  相似文献   

8.
目的 了解海南地区无偿献血人群人类免疫缺陷病毒(HIV)感染情况,为优化献血者招募和强化血液安全管理提供决策依据。方法 对2013—2017年海南地区无偿献血者血液筛查标本进行HIV项目常规检测,对其中HIV确认阳性者资料进行回顾性调查分析。结果 共检测无偿献血者470 975例次,HIV确认阳性103例,阳性率为0.22‰。不同年份、地域的献血者HIV确认阳性率比较,差异均无统计学意义(均P>0.05)。103例HIV阳性确认者中以18~30岁组居多(65例,占63.11%),阳性率为0.33‰。不同年龄段无偿献血者HIV阳性率比较,差异有统计学意义(χ2=22.379,P<0.001)。HIV阳性确认者中男性95例,女性8例,男性献血者HIV确认阳性率(0.29‰)高于女性(0.06‰),差异有统计学意义(χ2=23.003,P<0.001)。HIV确认阳性者的职业类型主要为职工(20例,占19.42%),其次为学生(16例,占15.53%)及无业人员(6例,占5.83%)。结论 海南地区无偿献血者中HIV感染形势依然严峻,应通过加强献血前干预、采用更先进的检测技术以及建立联网数据库等多种措施来保障血液安全。  相似文献   

9.
娱乐场所预防艾滋病行为干预的试点研究   总被引:16,自引:0,他引:16  
目的 探讨在娱乐场所服务小姐中开展预防艾滋病的健康教育和行为干预的方法、效果及可行性。方法 调查员深人现场,采用面对面的深人访谈与咨询,免费分发宣传材料和避孕套,演示避孕套正确使用方法等,运用封闭式调查问卷和定性访谈方法,评价干预效果。结果 干预前后分别调查385人和399人。通过干预,服务小姐艾滋病预防知识水平有显提高,对避孕套预防艾滋病经性传播的态度和信念有明显转变。在与固定和非固定性伴性行为中,最近一次避孕套的使用率分别为63.9%和89.0%;最近三次性行为中,每次都使用避孕套的分别达到39.1%和64.2%,较干预前均有显提高。结论 在娱乐场所服务小姐中开展预防艾滋病的健康教育和行为干预是可行的而且是有效的。  相似文献   

10.
目的:了解艾滋病流行区村干部艾滋病健康教育干预效果,为探索适合农村艾滋病预防控制措施提供依据。方法:选取安徽省艾滋病流行区郎溪县和濉溪县各2个乡镇村干部147人,进行艾滋病健康干预,并比较干预前后艾滋病知识、态度和行为的差异。结果:村干部的艾滋病知识的最主要来源为广播电视,其次为报刊杂志和宣传画。干预前后村干部艾滋病知识知晓率分别为73.5%和89.1%(X^2=67.22,P〈0.001)。干预后村干部对AIDS/HIV抱有同情心的比例高达89.8%;觉得艾滋病病人或感染者很可怕的比例从48.3%下降到33.3%(X^2=7.2,P〈0.001);感觉处于感染“艾滋病”危险之中的比例从89.8%下降到22.4%(X^2=143.17,P〈0.001);同意公布AIDS/HIV名单让人们躲避的比例从23.1%下降到17.0%(X^2=111.84,P〈0.001);愿意到AIDs/HIV处买菜或购物的比例从30.6%上升到57.8%(X^2=23.33,P〈0.001)。结论:在农村艾滋病流行区应充分发挥村干部在当地开展艾滋病预防和控制的作用。  相似文献   

11.
社区女性性工作者性病艾滋病知识与性行为特征分析   总被引:10,自引:2,他引:10  
了解社区女性性工作者性病艾滋病(STD/AIDS)知识知晓程度、艾滋病相关危险行为特征,为制定社区STD/AIDS的防治策略提供依据。方法对广东省中部某镇的女性性工作者进行面对面的问卷调查。结果共调查139名研究对象,艾滋病基本知识的知晓率为33.1%,对男、女性病症状的知晓率分别为18.0%和14.4%;安全套使用率为86.1%。结论社区女性性工作者对STD/AIDS知识了解甚少,艾滋病相关危险行为发生率高,应加强STD/AIDS的宣传教育和行为干预,减缓和阻止艾滋病病毒(HIV)通过性乱人群向一般人群传播。  相似文献   

12.
目的 了解海南地区无偿献血人群人类免疫缺陷病毒(HIV)感染情况,为优化献血者招募和强化血液安全管理提供决策依据。方法 对2013—2017年海南地区无偿献血者血液筛查标本进行HIV项目常规检测,对其中HIV确认阳性者资料进行回顾性调查分析。结果 共检测无偿献血者470 975例次,HIV确认阳性103例,阳性率为0.22‰。不同年份、地域的献血者HIV确认阳性率比较,差异均无统计学意义(均P>0.05)。103例HIV阳性确认者中以18~30岁组居多(65例,占63.11%),阳性率为0.33‰。不同年龄段无偿献血者HIV阳性率比较,差异有统计学意义(χ2=22.379,P<0.001)。HIV阳性确认者中男性95例,女性8例,男性献血者HIV确认阳性率(0.29‰)高于女性(0.06‰),差异有统计学意义(χ2=23.003,P<0.001)。HIV确认阳性者的职业类型主要为职工(20例,占19.42%),其次为学生(16例,占15.53%)及无业人员(6例,占5.83%)。结论 海南地区无偿献血者中HIV感染形势依然严峻,应通过加强献血前干预、采用更先进的检测技术以及建立联网数据库等多种措施来保障血液安全。  相似文献   

13.
目的 评价医疗卫生机构为HIV/AIDS患者提供转介服务的效果,为建立一个有效的艾滋病转介服务体系提供科学依据。 方法 从艾滋病综合防治数据信息系统中,获得HIV/AIDS患者的CD4检测率、抗病毒治疗覆盖率、单阳家庭配偶HIV抗体检测率;通过15个县、区上报的转介报表,收集转介情况,追踪转介人群到位治疗情况;通过对建立艾滋病转介服务体系前后防治艾滋病的各项考核指标和HIV/AIDS患者的有效转介情况进行比较分析,评估转介服务模式的效果。 结果 建立转介服务体系后,在当年新发现报告病例中,转介率由76.89%提高到99.48% (χ2=462.757, P<0.001);成功转介治疗率由57.02%提高到82.42%(χ2 =244.632,P<0.001);CD4检测率由61.46%提高到98.70%(χ2=813.233, P<0.001);当年接受抗病毒治疗比例由56.04%提高到83.35%(χ2=290.756, P<0.001),差异均有统计学意义。当年发现报告并已抗病毒治疗病例确证距治疗平均天数由(26.37±12.64)天缩短为(17.11±6.37)天, 差异有统计学意义(U=20.74, P<0.001)。在累计报告当年存活未治疗的病例中,转介率由26.09%提高到59.48%(χ2=370.243, P<0.001);成功转介治疗率由17.01%提高到52.42%(χ2=137.647, P<0.001);CD4检测率由37.49%提高到51.73%(χ2=67.444, P<0.001),差异均有统计学意义。在当年存活可随访的病例中,CD4检测率由77.56%提高到87.21%(χ2=331.498, P<0.001);抗病毒治疗覆盖率由77.08%提高到83.54%(χ2=226.009, P<0.001);HIV/AIDS患者的配偶或固定性伴HIV检测率由76.29%提高到90.49%(χ2=179.660, P<0.001),差异均有统计学意义。 结论 广西南宁市HIV/AIDS患者转介服务模式是有效的。今后进一步加强存活未治疗病例的管理和提高医疗机构结果告知服务质量,以确保HIV/AIDS患者的有效管理和治疗,防止HIV的二代传播。  相似文献   

14.
目的探讨艾滋病(AIDS)合并肺孢子菌肺炎(PCP)患者的临床特点、诊断及治疗转归。方法通过计算机病案信息系统搜索AIDS合并PCP患者,并对其临床资料进行回顾性分析,将患者分为呼吸衰竭组(11例)与无呼吸衰竭组(12例),比较两组患者动脉血氧分压(PaO2)值、血氧饱和度(SaO2)、CD4+T淋巴细胞及乳酸脱氢酶(LDH)。结果 23例AIDS合并PCP患者常见的症状为体重减轻,口腔黏膜白斑,气促、呼吸困难,发热,咳嗽,咳痰。23例患者PaO2值为(78.65±30.85)mmHg,二氧化碳分压(PaCO2)为(24.42±5.60)mmHg,pH值为(7.43±0.79),SaO2为(91.16±9.55)%;呼吸衰竭组SaO2、PaO2值低于无呼吸衰竭组,差异有统计学意义(均P0.05)。肺部CT主要表现为两肺不同程度磨玻璃样改变。21例患者使用复方磺胺甲口恶唑片抗PCP治疗,1例使用复方磺胺甲口恶唑片+克林霉素治疗,1例单用克林霉素治疗,17例患者加用肾上腺糖皮质激素治疗;治疗后20例患者好转,2例死亡,1例放弃治疗。结论 AIDS合并PCP患者常见症状为亚急性进行性呼吸困难、发热、干咳,肺部CT常显示磨玻璃样改变,可予以复方磺胺甲口恶唑片或复方磺胺甲口恶唑片+克林霉素联合治疗,肾上腺糖皮质激素可明显缓解患者症状。  相似文献   

15.
Background: Mindfulness is an emergent construct with implications for our understanding of approaches to engagement in human occupation. Little is known about how mindfulness is being applied and what its possibilities are in the occupation-based disciplines.

Objective: The purpose of this scoping review was to summarize, describe, and identify gaps in the existing literature on mindfulness in relation to human occupation.

Material and Method: A scoping review, guided by Arksey and O’Malley’s methodological framework was undertaken. The initial search yielded 929 articles; 20 articles met the criteria for inclusion. Articles included peer review and gray literature published in English between 2006-2016. Articles addressed mindfulness in OT or OS and included the terms ‘human occupation’, ‘occupational therapy’ and/or ‘occupational therapist’, and ‘mindfulness’ and/or ‘meditation’ or ‘yoga’.

Findings: The qualitative thematic analysis identified an overarching theme of mindful occupation, with 5 sub-themes including occupational presence; occupational awareness; occupational engagement; occupational well-being; and occupational fulfillment.

Conclusions and Significance: The findings have important implications for practice, education, theory and research. Future directions should focus on more depth and breadth of empirical research about mindful engagement in human occupation that can be used to implement and evaluate mindfulness in occupation-based theory and practice.  相似文献   


16.

PURPOSE

The purpose of this study was to determine the relationship between the number of patients under a primary care physician’s care (panel size) and primary care quality indicators.

METHODS

We conducted a cross-sectional, population-based study of fee-for-service and capitated interprofessional and non-interprofessional primary health care practices in Ontario, Canada between April 2008 and March 2010, encompassing 4,195 physicians with panel sizes ≥1,200 serving 8.3 million patients. Data was extracted from multiple linked, health-related administrative databases and covered 16 quality indicators spanning 5 dimensions of care: access, continuity, comprehensiveness, and evidence-based indicators of cancer screening and chronic disease management.

RESULTS

The likelihood of being up-to-date on cervical, colorectal, and breast cancer screening showed relative decreases of 7.9% (P <.001), 5.9% (P = .01), and 4.6% (P <.001), respectively, with increasing panel size (from 1,200 to 3,900). Eight chronic care indicators (4 medication-based and 4 screening-based) showed no significant association with panel size. The likelihood of individuals with a new diagnosis of congestive heart failure having an echocardiogram, however, increased by a relative 8.1% (P <.001) with higher panel size. Increasing panel size was also associated with a 10.8% relative increase in hospitalization rates for ambulatory-care–sensitive conditions (P = .04) and a 10.8% decrease in non-urgent emergency department visits (P = .004). Continuity was highest with medium panel sizes (P <.001), and comprehensiveness had a small decrease (P = .03) with increasing panel size.

CONCLUSIONS

Increasing panel size was associated with small decreases in cancer screening, continuity, and comprehensiveness, but showed no consistent relationships with chronic disease management or access indicators. We found no panel size threshold above which quality of care suffered.  相似文献   

17.
18.
目的 探讨AIDS相关肝脏淋巴瘤的超声特征性表现,以提高对该病的认识。方法 回顾性分析5例经病理证实的AIDS相关肝脏淋巴瘤患者的超声影像及临床资料。结果 5例患者均为弥漫大B细胞淋巴瘤,均合并全身其他器官或淋巴组织淋巴瘤,血清LDH明显升高,肿瘤标志物癌胚抗原、糖类抗原199及AFP值均在正常范围。5例患者中,4例呈多发结节型,1例呈单发肿块型;多发结节型表现为肝内多个低-极低回声结节,部分结节回声接近囊肿样无回声;单发肿块型表现为肝右叶巨大低回声,内见血管穿梭征;病灶后方回声均轻度增强;彩色多普勒血流显像提示病灶内部可见少许条状血流信号;5例患者肝静脉、门静脉、胆道未见瘤栓。结论 AIDS相关肝脏淋巴瘤有特定的超声声像图特征,结合LDH升高及肿瘤标志物阴性情况,可提升肝脏淋巴瘤的诊断准确率。  相似文献   

19.
抗反转录病毒治疗(antiretroviral therapy, ART)虽然能有效抑制HIV 1型(HIV-1),但不能根治AIDS。AIDS功能性治愈须为停止ART后患者体内HIV-1 RNA长期低于检测下限, CD4+ T淋巴细胞数量和机体免疫功能保持正常,这一直是全球研究热点和难点。近年来,AIDS功能性治愈研究在HIV-1储存库激活和清除、免疫治疗、干细胞移植、基因编辑等方面取得了长足进步,本文就此进行综述,为进一步研究提供理论指导。  相似文献   

20.
目的分析安徽省艾滋病病毒1型(human immunodeficiency virus 1,HIV-1)在原发感染人群中耐药毒株变异情况,为全省艾滋病抗病毒及耐药性监测方案的制定提供科学依据。方法参照世界卫生组织提出的HIV耐药警戒线调查方法(HIV drug resistance threshold survey,HIVDR-TS)指导方案,采用横断面调查,收集安徽省2008年度检测的58名小于25岁的HIV-1感染者血浆样本,进行HIV-1 POL区亚型及耐药基因型分析。结果获得49份样本,POL区29个有效序列中,B/C重组亚型比例最大,达44.8%,其次为B亚型,占37.9%。没有针对PR区的主要耐药性基因突变,PR区耐药株流行率为0。29个序列中针对核苷酸反转录酶区(NRTI)的耐药突变有2例,非核苷酸反转录酶区(NNRTI)有4例,仅V179D突变对依非韦仑(EFV)和奈韦拉平(NVP)出现潜在耐药,RT区耐药株流行率为3.4%,均属于低度流行(<5%)。结论安徽省未经抗病毒治疗新发HIV-1感染者中已经出现POL区耐药突变株,但传播水平尚处于低流行状态,治疗前尚不需要进行大规模耐药性监测。  相似文献   

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