HIV感染者和艾滋病患者生存质量的评估

迄今为止，人类尚未研制出杀灭人免疫缺陷病毒(HIV)的有效药物，因此病毒将在感染者体内长期存在，并不断破坏其免疫系统，严重影响到艾滋病(AIDS)患者的生存质量。近年来，国外关于HIV／AIDS生存质量的研究报道较多，并已开发出一些疾病特异性量表，用于预测艾滋病患者病情进展，评价药物疗效和选择治疗方案等各个方面。本文对有关研究进展作了综述。     

HIV感染者/艾滋病患者的生存质量和社会支持度分析

目的了解HIV感染者/AIDS患者的生存质量和社会支持度,更好地预防和控制艾滋病。方法于2012年4月-2013年4月对229例HIV感染者/AIDS患者使用MOS-HIV生存质量表和社会支持度量表进行面对面调查。结果生存质量得分为（68.64±11.76）分,其中HIV感染者（71.31±10.10）分,已达到服药阶段HIV感染者（65.59±13.49）分,AIDS患者（66.52±12.10）分,HIV感染者、已达到服药阶段HIV感染者和AIDS患者的得分在社会功能、疼痛、精力和情绪功能上差异有统计学意义（P〈0.05）。HIV感染者/AIDS患者的社会支持度得分为（46.32±12.48）分,其中HIV感染者（46.91±12.76）分,已服药HIV感染者（45.12±12.21）分,AIDS患者（46.26±12.32）分。结论随着疾病进展,艾滋病病人的生存质量逐步下降,而社会支持度不因疾病的发展而下降。     

HIV感染者／AIDS病人生存质量研究进展

阐述了HIV感染者／AIDS病人生存质量研究的背景，介绍了HIV感染者／AIDS病人生存质量的测定内容、测定量表，目前国际上生存质量在艾滋病研究领域的应用现状及存在的问题。     

河南省HIV感染者/AIDS患者生存质量评价

目的 了解河南省HIV感染者/AIDS患者生存质量状况及其影响因素,为改善HIV感染者/AIDS患者生存质量提供参考依据.方法 采用世界卫生组织艾滋病生存质量简表对河南省艾滋病高发区112例HIV感染者/AIDS患者生存质量及相关因素进行问卷调查.结果 HIV感染者/AIDS患者生存质量总分为(72.00±10.10)分;HIV感染者/AIDS患者得分除精神支柱/个人信仰领域高于中国常模外(P<0.05),其他领域得分及总评分均低于中国常模,差异有统计学意义(P<0.05);不同抑郁状况(t=-6.31,P=0.00)、相关症状数(t=-2.32,P=0.02)、家庭支持度(t=3.66,P=0.00)HIV感染者/AIDS患者生存质量比较,差异有统计学意义.结论 HIV感染者/AIDS患者的生存质量低于一般人群,对HIV感染者/AIDS患者医疗救助的同时进行心理咨询可以提高其生存质量.     

HIV感染者/AIDS病人生存质量研究进展

阐述了HIV感染者/AIDS病人生存质量研究的背景,介绍了HIV感染者/AIDS病人生存质量的测定内容、测定量表,目前国际上生存质量在艾滋病研究领域的应用现状及存在的问题.     

写给HIV感染者和艾滋病病人

如果你感染了艾滋病病毒（HIV）或是艾滋病患者，你一定很害怕、痛苦和无奈。但请你相信，在你的身边会有很多人同情你、理解你、帮助你。国家对此出台了很多政策和法规，这些是你们生活与治疗的政策和法律保障。只要我们能正确面对。同样可以享受美好的生活。下面是一些经常会遇到的问题，读过后或许会有所帮助。[编者按]     

对HIV感染者及艾滋病病人家庭护理的探讨

目前,艾滋病疾病除了到定点医疗机构接受对症治疗外,家庭人员对病人的科学有效的护理也是减轻病人痛苦,延长患者生命,提高病人的生命质量、以及防止该病传播的重要措施.     

广东省HIV感染者/艾滋病患者生活质量及其影响因素分析

目的了解广东省HIV感染者／艾滋病患者(HIV／AIDS)生活质量,并探讨其影响因素。方法采用H1V／AIDS生活质量量表(HAT-OoL),对在广州市第八人民医院和深圳市第三人民医院就诊的443例年龄≥18岁HIV／AIDS进行生活质量评价,采用非参数检验方法对生活质量各维度的影响因素进行单因素分析,采用多元线性逐步回归方法进行多因素分析。结果HIV／AIDS生活质量的总体功能、用药感受、暴露担忧、健康担忧、医生信任度、经济担忧、HIV掌握率、生活满意度和性生活9个维度的平均得分分别为59.89±23.35、62.9l±24.01、19.97±23.04、54.05±12.24、68.72±26.17、35.94±26.45、61.46±25.72、56.90±25.30和50.82±23.86。单因素和多元线性回归分析结果表明,性别、年龄、户籍类型、教育程度、工作状态、有无伴偶、是否有并发症、是否抗病毒治疗、感染方式、感染时间等因素,与H1V／AIDS的生活质量各个维度有关。结论广东省HIV／AIDS生活质量偏低,尤以暴露担忧和经济担忧为甚,社会人口学和HIV感染状况等因素在不同方面影响HIV感染者的生活质量,应加强低文化程度、低收人和缺少家庭支持人群的医疗和社会支持。     

淮安市HIV感染者／AIDS患者生存质量调查及其影响因素

目的了解淮安市人类免疫缺陷病毒（HIV）感染者／艾滋病（AIDS）患者的生存质量,找出影响他们生存质量的主要因素,为在当地更好地落实国家“四免一关怀”政策提供科学依据。方法采用整群抽样的方法,利用汉化版AIDS患者生存质量量表、社会支持评定量表及自制问卷对淮安市196例HIV感染者／MDS患者的生存质量及可能对其生存质量造成影响的因素进行调查。结果HIV感染者／AIDS患者的生理健康总分为（56．02±8．21）分,心理健康总分为（48．13±9．85）分;多因素分析发现,月收入、近1个月有无不适感、近半年有无临床症状、近1个月是否感到郁闷或焦虑几个因素,对生理健康总分影响的差异有统计学意义;近半年有无临床症状、近1个月是否感到郁闷或焦虑、近1个月是否感觉到失落或绝望、目前对待自己感染H1V的态度对心理健康总分影响的差异有统计学意义。结论淮安市HIV感染者／AIDS患者的生存质量较低,需注重对其劳动技能的培训,特别是在精神层面上给予更多的关怀和支持。     

辽宁省艾滋病感染者及患者生命质量调查

艾滋病在中国已进入广泛流行期[1].截至201 1年底,估计中国存活的艾滋病病毒感染者和艾滋病患者78万人(62～94万人),艾滋病患者15.4万人(14.6 ～16.2万人);全人群感染率为0.058％(0.046％～0.070％)[2].为了解该人群的生命质量现状及其相关危险因素,为进一步的干预治疗提供科学依据,于2011年12月-2012年3月对辽宁省沈阳、大连、抚顺、丹东4市的775例艾滋病病毒感染者和艾滋病患者进行调查,现将结果报告如下.     

无锡市HIV/AIDS患者生活质量及其影响因素调查

目的：调查无锡市艾滋病病毒感染者和艾滋病患者的生活质量,分析其影响因素,为更好地进行关怀干预提供依据。方法：采用健康状况调查问卷（SF-36）加上艾滋病相关条目作为调查问卷,对208例HIV/AIDS患者进行调查。结果：HIV/AIDS患者SF-36的生理健康和心理健康平均得分为53.2±5.9和50.0±11.8;文化程度、工作状况、CD4＋T细胞计数、机会性感染、抗病毒治疗、社会支持等因素,对HIV/AIDS患者的生活质量有影响。结论：艾滋病问题严重影响HIV/AIDS患者的生活质量,应针对其主要的影响因素,加强关怀与干预工作。     

河南省农村64名艾滋病患者生存质量评价

目的了解河南省艾滋病(AIDS)患者生存质量现状,为采取相应措施提高生存质量提供参考依据。方法采用多阶段抽样的方法,利用WHO的QOL-HIV量表对64名艾滋病患者进行入户调查。结果64名AIDS患者生存质量6个维度的得分及与常模比较的结果分别为,生理维度:10.84±2.68(t=12.71,P=0.001);心理维度:11.74±2.11(t=8.50,P=0.001);独立性维度:10.96±2.47(t=2.98,P=0.004);社会关系维度:13.09±2.16(t=3.12,P=0.003);环境维度:12.15±1.61(t=0.032,P=0.974);精神支柱和个人信仰维度:10.45±2.52(t=1.89,P=0.063)。结论AIDS患者在生理、心理、独立性和社会关系等4个维度的生存质量得分低于常模,在环境与精神支柱个人信仰2个维度的生存质量得分与常模比较差异无统计学意义。     

艾滋病患者生存质量的调查与分析

目的调查与评价艾滋病患者生存质量的情况,分析影响艾滋病患者生存质量的因素。方法用SF_36健康调查表加上艾滋病相关条目,对120例艾滋病患者与50名正常人进行调查。结果艾滋病患者各方面得分均显著低于正常组(P<0.01)。总体健康、健康感觉、最近一个月的生活状况、健康改善、经济影响等的得分低于60分,精力/疲劳、躯体机能、心理机能、食欲、睡眠、社会机能等的得分在60～80之间,只有日常活动、疼痛、认知机能三项的得分在80～90之间。结论艾滋病患者总体生存质量较差。影响患者生存质量主要因素为CD4细胞计数等。     

艾滋病患者生存质量心理护理研究进展

提高艾滋病患者的生存质量,不仅需要积极有效的药物治疗,还需要必要的心理护理。此文系统介绍了艾滋病患者生存质量的主要影响因素,包括自我效能感、应对方式、社会支持、健康信念模式和心理控制源;同时,探讨了目前应用较为广泛的心理护理措施,包括认知疗法、音乐疗法、团体心理护理以及其他综合性干预措施的最新研究进展,以此有效改善患者的负性情绪,提高患者免疫功能。     

自我管理在艾滋病患者自我效能与生活质量间的中介效应研究

目的 探讨艾滋病患者自我管理、自我效能与生活质量之间的关系。方法 选择2019年4月至2021年2月在四川大学华西医院接受抗病毒治疗的135例艾滋病患者作为对象,采用慢性病自我效能表、HIV感染者/AIDS患者自我管理量表及艾滋病病人生存质量量表对患者进行调查。结果 艾滋病患者生存质量得分为（77.00±9.78）分,自我管理行为得分为（120.04±23.85）分,自我效能得分为（43.74±11.09）分;艾滋病患者自我效能、自我管理能力及生存质量之间具有相关性（P＜0.001）;自我效能对生存质量的直接效应为0.602,间接效能为0.384,总效应为0.986,中介效应占总效应的比例38.95%,自我管理在自我效能与生存质量间起部分中介作用。结论 艾滋病患者的自我效能感、自我管理能力和生存质量需进一步提升,艾滋病患者的自我管理能力在自我效能感和生存质量之间起部分中介作用,通过提高患者自我效能感、增加其自我管理能力可有效改善患者的生存质量。     

Association between diarrhea and quality of life in HIV-infected patients receiving highly active antiretroviral therapy

Diarrhea is a common symptom that many HIV patients experience either as a consequence of HIV infection or of highly active antiretroviral therapy (HAART). A multicenter, prospective observational study was conducted in 11 AIDS clinics in Italy to determine the effect of diarrhea on health-related quality of life among patients receiving HAART. The study enrolled 100 consecutive HIV positive patients who had diarrhea while on HAART. For each enrolled patient a control patient with matching disease stage who did not have diarrhea was identified using existing data from another prospective observational study conducted in 34 AIDS clinics (including the 11 in current study). Quality of life was measured by MOS-HIV Health Survey (MOS-HIV). Paired t-test and multiple regression analysis were used to compare the quality of life among patients with and without diarrhea. Mean patient age was 40 +/- 7 years; 69% were male. Mean CD4 cell count was 342 +/- 239 cells/mm3; 59% had AIDS. Of the cases, 49 patients had severe diarrhea (> 5 bowel movements or > 3 watery per day) and 46 patients had moderate diarrhea (3-5 bowel movements). Compared to matched control patients, cases experiencing diarrhea while on HAART had significantly lower MOS-HIV scores in all domains. The significant adverse effect of diarrhea on quality of life should be considered when choosing the appropriate antiretroviral drugs regimen.     

A validation of the MOS-HIV quality of life measure in HIV-infected patients in Mexico]

OBJECTIVE: To validate the Medical Outcomes Study HIV Health Survey (MOS-HIV) quality of life instrument for its application in clinical research in Mexico. METHODS: The data for this study were collected between April, 2002, and February, 2004. An expert committee combined two Spanish-language translations of the MOS-HIV questionnaire. The new questionnaire's feasibility was assessed in a group of 32 HIV-infected persons by measuring how long they took to complete the questionnaire and the numbers of items they left unanswered. The questionnaire was then applied to a group of 120 HIV-positive patients and to a control group of 102 HIV-negative individuals. The following questionnaire characteristics were evaluated: (1) internal reliability (Cronbach alpha coefficient), (2) discriminant validity (the receiver operating characteristic (ROC) curves derived from the scores of the two groups), and (3) convergent validity (the Spearman correlation coefficients for the scores of the HIV-positive patients on the 11 MOS-HIV dimensions and their scores on the analog visual scale of the European Quality of Life 5-Dimensional format (EQ-5D) questionnaire, a list of symptoms, the viral load, and the CD4 cell count). RESULTS: The mean response time with the questionnaire was 10 minutes and 22 seconds, and the mean number of unanswered items was 0.62. With each of the 11 dimensions of the questionnaire, the Cronbach alpha coefficient was at least 0.75. The mean scores obtained by the two groups were different for 9 of the 11 dimensions, and the 95% confidence intervals of the areas under the ROC curves did not include the value of 0.5 for 8 of the dimensions. The absolute value of the Spearman correlation coefficient was less than 0.3 for the CD4 cell count and for the viral load, and it was greater than 0.3 for each dimension and the scores on the list of symptoms and on the analog visual scale of the EQ-5D questionnaire. CONCLUSIONS: The MOS-HIV measure is valid for use in clinical research among HIV-infected persons in Mexico.     

艾滋病患者抗病毒治疗依从性和生活质量现状及相关性探讨

目的了解艾滋病患者抗病毒治疗依从性及生活质量现状,探讨其相关性。方法采用美国社区艾滋病临床研究抗病毒用药自陈式问卷和SF-36生活质量问卷,整群抽取合肥市某区25例接受免费抗病毒治疗的患者进行问卷调查。结果本组患者的抗病毒治疗服药平均依从性为99.39%,艾滋病患者在SF-36生活质量各领域得分均低于常模,与健康人群在躯体功能（PF）、总体健康（GH）、社会功能（SF）以及精神健康（MH）等领域差异有统计学意义（P〈0.05）。结论接受抗病毒治疗的艾滋病患者生活质量得分偏低,应采用综合干预措施改善其生活质量。     

Gender differences in health-related quality of life in patients with HIV/AIDS

Background: In studies evaluating the general US population, patients in primary care, and patients with chronic conditions, women consistently report poorer health-related quality of life (HRQoL) than men; however, studies evaluating HRQoL in patients with HIV/AIDS have not completely corroborated those findings. The objective of this study was to evaluate gender differences in HRQoL for participants in a large randomized trial comparing antiretroviral regimens. Methods: AIDS Clinical Trials Group (ACTG) 320 was a randomized, blinded, placebo-controlled trial comparing the 3-drug regimen of indinavir + zidovudine (or stavudine) + lamivudine with the 2-drug combination of zidovudine (or stavudine) + lamivudine in subjects with CD4 cell counts less than 200 cells/l and no prior treatment with protease inhibitors. Nine quality of life domains scored on 0–100 scales were assessed using the ACTG QOL 601-602 Health Survey at 3 points in the trial: baseline, 24 weeks and 40 weeks. Differences between men and women in HRQoL scores were assessed using the Wilcoxon rank-sum test and generalized estimating equation (GEE) models. Results: Overall, 202 females and 976 males were randomized to one of two treatment arms. Female participants were more likely to be black or Hispanic and tended to be younger. At baseline, females reported lower HRQoL scores than males in all of the domains except social functioning, and at week 40, women scored lower in all of the domains except overall health. In repeated measures models, women were found to score lower in all HRQoL domains except overall health, with significant differences of 3.5–6.7 points in 3 of the 9 quality of life domains: physical functioning, pain, and energy/fatigue. HRQoL scores improved for participants in the study over time and in response to potent treatment, and the improvements were similar for men and women. Conclusions: Women with HIV/AIDS report substantially poorer HRQoL than men with HIV/AIDS in several HRQoL domains. However, changes in domain scores over time and in response to treatment do not differ significantly by gender, implying that changes in domain scores may be better HRQoL outcomes to compare between HIV-infected men and women in clinical trials than mean domain scores.