安徽省艾滋病抗病毒治疗病人生活质量与社会支持典型相关分析

目的了解接受抗病毒治疗的艾滋病病人的生活质量和社会支持现况及其相关性。方法采用简明健康调查量表（the MOS item short from health survey,SF-36）和社会支持评定量表（social science research solutions,SSRS）对选定人群进行生活质量和社会支持的调查及典型相关分析。结果抗病毒治疗艾滋病病人生活质量和社会支持得分均低于一般人群（均有P〈0.05）。病人社会支持与生活质量之间存在典型相关关系（F=7.48,P〈0.001）。反映生活质量的第一典型变量V1主要由心理健康和情绪角色限制决定;反映社会支持的第一典型变量W1主要由主观支持和对支持的利用度决定。结论抗病毒治疗艾滋病病人生活质量差,社会支持水平低。病人获得的主观支持越多或对支持的利用度越高,则其心理健康状况越好;越少或越低,则由情感问题所造成的职能限制越大。     

Country watch: Cuba

Health authorities in Cuba made a serious effort to fight HIV/AIDS in their country. In 1986, the government launched a National Programme of Control and Prevention of HIV/AIDS, aimed at controlling the epidemic and providing quality of care for HIV-positive people. Initially, people with HIV/AIDS (PHA) were interned in sanitariums to prevent HIV infection from spreading further. The sanitariums provided good medical and psychological support. However, ambulatory care was introduced in 1993, mitigating the mandatory character of the original system and focusing more on PHA. Additional services were made available to PHA in December 1998 with the creation of a National Centre for the Prevention of Sexually Transmitted Disease/HIV/AIDS, an integral part of the Ministry of Public Health. The center offers an AIDS prevention hotline and counseling services that include a pilot project, ?Mobile Project?, an outreach project for people at risk. The PHA Project was launched in March 1999 with a workshop for 30 PHA from Havana; a guide, "Living with HIV", was created to address the problem of unavailability of information concerning the disease. The guide discusses basic clinical information about HIV/AIDS; PHA and their social environment; nutrition, diet, and hygiene; sexuality; and legal aspects.     

上海市HIV感染者/AIDS病人心理健康状况研究

目的 运用症状自评量表（SCL-90）、抑郁自评量表（SDS）和焦虑自评量表（SAS）评价HIV感染者/AIDS病人心理健康状况.方法 对来自参加上海市静安区爱之家关怀活动的HIV感染者/AIDS病人和部分来自上海市公共卫生临床中心门诊部的136例HIV感染者/AIDS病人进行调查,采用基本信息表、SCL-90量表、SDS量表和SAS量表进行统一问卷调查,采用SPSS16.0进行统计分析.结果 HIV感染者/AIDS病人的心理健康状况明显比国内正常人群差,SCL-90总分、总均分及除人际关系因子分之外的各因子评分均高于全国常模（P＜0.001）,阳性症状总检出率超过40.0％;检出率较高的是抑郁、焦虑等症状,SDS总分为（53.73±12.93）分,高于国内常模（P＜0.001）,有60.3％的调查对象有抑郁症状;SAS总分为（48.79±8.76）分,高于国内常模（P＜0.001）,有41.9％的调查对象有焦虑症状.结论 针对HIV感染者/AIDS病人心理健康状况的现状,提出了在艾滋病防治工作中增加心理支持的内容,对HIV感染者/AIDS病人采用心理学量表进行筛查和评估,并根据其心理健康状况提供适宜的心理关爱和情感支持;加强医疗机构、疾病预防机构和专业心理咨询机构的合作,以便为HIV感染者/AIDS病人提供可及性更好更专业的心理健康支持服务.     

Exploring Pathways Between HIV+ Status and Excellent Overall Health Among Kenyan Women: Family Functioning,Meaningfulness of Life,Seroconcordance, Social Support and Considering the Need for Integrated Care

As people living with HIV/AIDS (PLWHA) live longer, and HIV incidence declines, health systems are transitioning from vertical-only care delivery to horizontal integration with social and other services. This is essential to responding to the chronic nature of the disease, and health systems must respond to full-breadth of socio-economic conditions facing PLWHA. We use excellent self-rated health as a referent, and assess the role of non-biomedical conditions in mediating HIV+ status and excellent overall health among a large community sample of Kenyan women. After controlling for age and wealth, we found significant mediation by social support, partner HIV status, meaningfulness of life, family functioning, food sufficiency, and monthly income. If the goal of health systems is to help all people attain the highest level of health, integrating vertical HIV services with socio-economic support and empowerment may be required. Further investigation of the relative contribution of social support, family functioning, food and financial sufficiency should be conducted longitudinally, ideally in collaboration with HIV clinical services.     

Providing support to caregivers and self-care

The evolution of HIV/AIDS care has resulted in a wide range of caregivers who work out of public and private hospital facilities, nongovernmental organizations (NGOs) and community-based facilities. Others are volunteers and community health and social workers based at facilities or community sites. Many caregivers are family members or part of a client's close social network. Additionally, people living with HIV/AIDS (PHA) themselves engage in self-care and provide support to other PHA through support groups. In the best-case scenario the services of these caregivers are sometimes provided free of charge at one site by a specialized NGO. In many cases, however, a person wishing to gain access to care and social services may need an understanding how the systems and procedures of various institutions operate. Many PHA are unprepared for the administrative, financial, and legal barriers that they may encounter. To cope with this need, a new type of support service called the "buddy" system has emerged. Buddies are individuals who are less directly involved with, but who know about HIV/AIDS, the services available and the rights of PHA. A buddy is close enough for the PHA to approach, has sufficient time to devote to him/her and can be asked almost everything. The article on the Rio de Janeiro Buddy Project provides an example of a project for gay men in Brazil. In other parts of the world where the buddy system is non-existent, the PHA must often rely on support provided by family and friends.     

Relationship between physicians and HIV patients: influence on adherence and quality of life

OBJECTIVE: To assess the influence of the relationship between people living with HIV/AIDS and health care providers on treatment adherence and quality of life. METHODS: Qualitative study conducted in Mexico, in 2003, with informants recruited from HIV/AIDS support groups, non-governmental organizations, and infectious disease clinics in public hospitals. A total of 40 people living with HIV/AIDS and five support group leaders were interviewed. Data were collected using sociodemographic questionnaires and in-depth interviews exploring the experience of living with HIV/AIDS, including treatment, disease perception, quality of life, physical and emotional health, and relationship with physicians. Responses were recorded, transcribed and organized thematically based on codes using an inductive analysis. RESULTS: Most respondents aged between 26 and 45 years. The main obstacles to care were related to lack of risk awareness and information among people living with HIV/AIDS and physicians. Physicians proved not to be well trained on HIV/AIDS care. During the follow-up care, most problems were related to inadequate treatment adherence mainly caused by poor communication with physicians and discrimination in public services. CONCLUSIONS: Overall the problems identified were related to information deficiencies, physicians' lack of training and paternalism, and social stigmatization of people living with HIV/AIDS associated with the epidemic.     

河南省HIV/AIDS社会支持与社会适应能力现况

目的 分析河南省HIV/AIDS社会支持与社会适应能力的现状及其相关关系,为提高HIV/AIDS生活质量提供参考依据。方法 采取多阶段分层随机抽样方法,按照河南省18个地级市HIV/AIDS流行分布特点选择6个研究现场,包括驻马店市上蔡县和周口市沈丘县（高流行区）、驻马店市确山县和商丘市永城市（中流行区）、济源市和三门峡市（低流行区）,以我国艾滋病防治基本信息系统中截至2017年河南省6个研究现场累计报告HIV/AIDS存活者为目标人群,根据估算样本量528例,采用随机数字表抽取研究对象。采用社会支持量表和社会适应能力量表,分别收集HIV/AIDS的客观支持、主观支持及支持的利用度3个维度、认知意愿、社会交往及角色适应3个维度的信息,分析其社会支持与社会适应能力的特点及相关关系。结果 共调查506例HIV/AIDS,其社会支持总分为36.30±9.34,其中客观支持得分为7.48±3.01,主观支持得分为22.35±5.79,对支持的利用度得分为6.28±2.38,HIV/AIDS的社会支持总分及3个维度得分均低于全国常模分值,差异有统计学意义（P<0.05）;HIV/AIDS社会适应能力总分为39.10±7.10,其中认知意愿得分为9.96±3.23,社会交往得分为18.57±3.25,角色适应得分为10.57±2.52,HIV/AIDS的社会适应平均得分不足总分的2/3,认知意愿得分不足其维度总分的1/2。不同性别、年龄、婚姻状况、职业、传播途径、症状数的HIV/AIDS在社会支持及社会适应能力得分的差异均有统计学意义（P<0.05）。HIV/AIDS社会支持与社会适应能力之间存在相关性（r=0.14,P<0.05）。结论 HIV/AIDS存在社会支持和社会适应能力偏低的现状,社会支持可能为HIV/AIDS社会适应能力的促进因素。     

安徽省艾滋病病毒感染儿童的生活质量评价

目的用“儿科健康相关生活质量普适性核心量表4.0”评价安徽省儿童艾滋病病毒感染者/病人（简称艾滋病儿童）的生活质量。方法采用普查方法,对安徽省所有艾滋病儿童及其监护人进行问卷调查。结果共调查艾滋病儿童60人,平均年龄（10.23±3.25）岁;男性32人（53.3%）;艾滋病病人48人（80.0%）。大多数艾滋病儿童认为自己的身体较好或一般,近四成的孩子在最近两周内生过病,两周患病率为38.3%。艾滋病儿童的生理、情感、社会和角色功能的得分分别是75.2、85.0、77.6和70.8分;后三项构成心理领域,平均为78.5分;生活质量总平均为77.8分。与一般儿童相比,除情感功能外,艾滋病儿童在各方面得分均较低,且差异具有统计学意义。儿童艾滋病病毒感染者与儿童艾滋病病人相比,生理功能上两组儿童差异有统计学意义;而在其他方面、整个心理领域以及总体得分等指标上,两组儿童差异无统计学意义。艾滋病儿童生理功能同年龄、家庭经济状况和儿童的身体状况有关联关系;社会功能与家庭经济状况和儿童的身体状况有关联关系;心理领域同家庭经济状况有关联关系;生活质量总分同家庭经济状况和儿童的身体状况有关联关系。结论安徽省儿童艾滋病病毒感染者/病人的生活质量受到严重影响,亟需干预措施改善生活质量。     

抗病毒治疗患者家属的HIV感染状况及其生活质量影响因素的研究

目的了解抗病毒治疗患者家属的感染状态、生活质量以及相关影响因素。方法对云南省德宏州302名接受抗病毒治疗的病人家属进行问卷调查,收集的信息包括家庭成员的基本人口学特征、HIV感染状况、照顾患病家人的负担情况、以及生活质量等。结果在302名家庭成员中有117人同样为HIV感染者,其中72人也在接受抗病毒治疗。与生理评分正相关的因素包括更好的经济状况、更轻的照顾负担、HIV阴性以及家中患者有更好的生活质量。与精神评分正相关的因素包括更好的经济状况、更多的情感支持、更轻的照顾负担以及家中患者有更好的生活质量。结论为了全面提高感染者和其家庭成员的生活质量,我国的抗病毒治疗工作需要整合更多的关怀和支持服务。在设计、实施感染者关怀和支持项目时,服务的方式和服务的内容同等重要。     

Position of The Canadian Dietetic Association and The American Dietetic Association: nutrition intervention in the care of persons with human immunodeficiency virus infection

The goals of nutrition intervention in HIV disease include early assessment and treatment of nutrient deficiencies, the maintenance and restoration of lean body mass, and support for activities of daily living and quality of life. The maintenance and restoration of nutritional stores is closely interrelated and interdependent with each of the other recommended medical therapies. Therefore, it is vital to the health of persons with HIV/AIDS to have access to the services of a registered dietitian, who is the essential member of the health care team for providing nutrition care (48). The registered dietitian should take an active role in developing nutrition care protocols for HIV/AIDS in their practice setting. The dietetic professional must take responsibility for obtaining and maintaining current knowledge in this area and take the lead in translating current nutrition knowledge and research into practical and realistic nutrition guidelines for the individual with HIV/AIDS. Further research is needed in the area of HIV/AIDS and nutrition. Registered dietitians and other members of the health care team are encouraged to conduct nutrition research in the area of nutrition interventions and outcomes of nutrition therapy. Additionally, government health related agencies, national AIDS-related organizations, and private industry should be encouraged to provide funding sources and support to the issue of research in nutrition related problems and interventions in HIV/AIDS.     

ＨＩＶ 感染者／ＡＩＤＳ患者的生存质量及其影响因素分析

摘要：目的　了解ＨＩＶ 感染者／ＡＩＤＳ患者的生存质量及其影响因素,更好的预防和控制艾滋病。方法　于
２０１２年４月至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,其中ＨＩＶ 感染者７１．３１±１０．１０、已达到服药阶
段的ＨＩＶ 感染者６５．５９±１３．４９、ＡＩＤＳ患者６６．５２±１２．１０,差异有统计学意义;ＨＩＶ 感染者、已达到服药
阶段的ＨＩＶ 感染者和ＡＩＤＳ患者的得分在社会功能、疼痛、精力和情绪功能差异有统计学意义。ＨＩＶ 感染
者／ＡＩＤＳ患者的社会支持度得分为４６．３２±１２．４８, 其中ＨＩＶ 感染者４６．９１±１２．７６、已达到服药阶段的
ＨＩＶ 感染者４５．１２±１２．２１、ＡＩＤＳ患者４６．２６±１２．３２。多因素分析表明生存质量跟年龄、民族、有否其他
慢性疾病和社会支持度有关。结论　要更加重视ＨＩＶ 感染者／ＡＩＤＳ患者在感染ＨＩＶ 的同时是否还有其他
慢性疾病和其社会支持情况,切实提高ＨＩＶ 感染者／ＡＩＤＳ患者的生存质量。
关键词：ＨＩＶ;生存质量;因素
中图分类号：Ｒ５１２．９１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０５ ０４６９ ０４     

艾滋病病毒感染者/艾滋病患者及其家属生活质量和社会支持的研究

目的了解皖北农村地区艾滋病病毒感染者/艾滋病患者(HIV/AIDS)及其家属的生活质量和社会支持现状,分析其相关的影响因素。方法通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷(GQOLI-74)和社会支持评定量表(SSS)对331名HIV/AIDS及其家属148名进行调查。结果单因素分析显示,不同性别、不同乡镇、不同文化程度的HIV/AIDS及其家属的GQOLI-74总分差异有统计学意义(P<0.05);不同年龄、不同乡镇HIV/AIDS的SSS总分差异有统计学意义(P<0.05)。多元线性回归分析结果表明,高年龄、负性生活事件是影响HIV/ AIDS及其家属生活质量的不利因素,而高文化程度、好的邻里关系、烦恼诉说是影响HIV/AIDS及其家属生活质量的有利因素。结论诸多因素在不同层面影响皖北农村地区HIV/AIDS及其家属的生活质量和社会支持,农村现有的艾滋病社区关爱、社会支持工作还亟需加大力度,以家庭、邻里为依托的社区关爱模式有待建立。     

艾滋病医护人员社会支持在工作压力源与工作倦怠关系中的调节作用

目的了解社会支持各维度在工作压力与工作倦怠之间的调节作用。方法采用艾滋病医护人员工作压力源调查问卷、社会支持问卷和中式工作倦怠量表对342名艾滋病医护人员进行测试,运用SPSS 11.5管理并进行分析。结果(1)艾滋病医护人员的工作压力和工作倦怠显著正相关,工作压力越大,工作倦怠程度越深(P﹤0.01)。(2)社会支持的调节作用主要体现在支持利用和主观支持方面。面对职业风险和社会排斥,高支持利用和高主观支持医护人员的情感耗竭低于具有低支持利用和低主观支持的人员。但人际排斥压力增大时,高主观支持个体的情感耗竭水平上升更快。结论社会支持是工作压力和工作倦怠的有效调节变量,其中支持利用和主观支持的调节作用更显著。     

HIV/AIDS病人生活质量及社会支持调查

目的 了解皖北农村地区人类免疫缺陷病毒（HIV）感染者／艾滋病（AIDS）病人的生活质量和社会支持现状，分析其相关的影响因素。方法 通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷（GQOLI-74）和社会支持评定量表（SSS）对85名HIV感染者／AIDS病人进行调查。采用单因素方差和多元线性回归方法对调查结果进行分析。结果 单因素分析显示，不同性别、不同文化程度的HIV感染者／AIDS病人GQOLI-74总分差异有统计学意义（P〈0．05）；不同乡镇的HIV感染者／AIDS病人SSS总分差异有统计学意义（P〈0．05）。多元线性回归分析结果表明，负性生活事件是影响HIV感染者／AIDS病人社会支持的不利因素。而好的邻里关系、烦恼诉说是影响HIV感染者／AIDS病人生活质量的有利因素。结论 诸多因素影响皖北农村地区HIV感染者／AIDS病人的生活质量和社会支持，农村应加强艾滋病社区关爱、社会支持工作，建立以家庭、邻里为依托的社区关爱模式。     

Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa

AIDS stigmas interfere with HIV prevention, diagnosis, and treatment and can become internalized by people living with HIV/AIDS. However, the effects of internalized AIDS stigmas have not been investigated in Africa, home to two-thirds of the more than 40 million people living with AIDS in the world. The current study examined the prevalence of discrimination experiences and internalized stigmas among 420 HIV-positive men and 643 HIV-positive women recruited from AIDS services in Cape Town, South Africa. The anonymous surveys found that 40% of persons with HIV/AIDS had experienced discrimination resulting from having HIV infection and one in five had lost a place to stay or a job because of their HIV status. More than one in three participants indicated feeling dirty, ashamed, or guilty because of their HIV status. A hierarchical regression model that included demographic characteristics, health and treatment status, social support, substance use, and internalized stigma significantly predicted cognitive-affective depression. Internalized stigma accounted for 4.8% of the variance in cognitive-affective depression scores over and above the other variables. These results indicate an urgent need for social reform to reduce AIDS stigmas and the design of interventions to assist people living with HIV/AIDS to adjust and adapt to the social conditions of AIDS in South Africa.     

Psychosocial Differences Between Urban and Rural People Living With HIV/AIDS

Abstract: During the past decade, many investigations have examined the life circumstances of people living with HIV disease. Most of these studies, however, have focused on HIV-infected people in large metropolitan areas. This study compares the psychosocial profiles of rural and urban people living with HIV disease. Anonymous, self-administered surveys were completed by 276 people with HIV/AIDS in a Midwestern state. The assessment instrument measured respondents' quality of life, perceptions of loneliness, social support, experiences with AIDS-related discrimination, access to services, and illness-related coping strategies. Compared with their urban counterparts, rural people with HIV reported a significantly lower satisfaction with life, lower perceptions of social support from family members and friends, reduced access to medical and mental health care, elevated levels of loneliness, more community stigma, heightened personal fear that their HIV serostatus would be learned by others, and more maladaptive coping strategies. Programs that are designed to improve the life circumstances of people with HIV disease in rural areas—particularly those that facilitate access to adequate health care, increase perceptions of social support, and improve illness-related coping—are urgently needed.     

菏泽市艾滋病病毒感染者生存现状的研究

[目的]了解HIV感染者及AIDS病人的生存环境和生活质量,以建立适合我市实际的家庭和社会关怀及支持体系。[方法]采取典型调查的方式调查已确认的HIV/AIDS患者,在知情、保密的情况下进行个人访谈;另外采用现况调查的方法,选择存在HIV感染者和AIDS病人的村庄或附近村庄的居民,调查社区内存在的相关歧视及原因。[结果]HIV/AIDS患者存在着健康状况恶化、就医困难、经济窘迫、遭受歧视等的生存危机。[结论]应有计划、有步骤地扩大全民健康教育;认识和重视歧视及不尊重HIV/AIDS病人权利的危害性,真正消除对艾滋病恐惧;建立对感染者和病人的保护机制;提供关怀、护理、社会和情感支持等的预防控制措施。     

中老年艾滋病感染者生命质量及其影响因素研究

目的 调查四川省中老年艾滋病高流行区泸县50岁以上的HIV/AIDS患者的生命质量,并分析不同因素对生命质量的影响,为今后提高HIV/AIDS患者的生命质量提供参考依据。方法 截至2018年6月,根据纳入和排除标准在四川省泸县共纳入50岁以上的HIV/AIDS患者共计228例。采用自行设计的问卷收集一般人口学信息、艾滋病抗病毒治疗信息,采用SF - 12调查患者的生命质量,采用多元线性回归方法分析生命质量的影响因素。结果 中老年HIV/AIDS患者的躯体健康总评（PCS）和心理健康总评（MCS）分别为（45.60±11.88）分和（54.17±11.70）分。通过多元线性回归分析发现,经济收入（β = 1.49）、现在正在接受治疗（β = 8.62）与患者PCS评分呈现正相关,而是否患有慢性病（β = - 10.55）与患者PCS评分呈现负相关。年龄与MCS评分呈正相关（β = 0.35）,而分居/离异/丧偶（β = - 3.91）,是否患有慢性病（β = - 4.79）、现在正在接受治疗（β = - 19.12）与患者的MCS评分呈现负相关。结论 中老年HIV/AIDS患者PCS评分较低,而MCS评分较高。低收入、未接受抗病毒治疗、患有慢性病、婚姻状况为分居、离异或丧偶的患者,生命质量较低,应积极采取措施提高中老年HIV/AIDS的生命质量。     

Determination of Quality of Life and Their Perceived Social Support from Family of Patients with HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a significant disease which affects the individual physically, emotionally, and socially. The aim of this study was to determine the relationship between the quality of life and social support of patients with HIV/AIDS. 49 patients with HIV/AIDS who applied to the Infectious Diseases Polyclinics of the university hospital between November 2010 and December 2011 were enrolled in study. All the data were collected using a personal information form, SF 36 quality of life scale (QOL) and perceived social support from the family scale (PSS-Fa). Average age of patients was 41.23 ± 10.62, 65.3 % of them were male. It was found that the diagnosis period for 55.1 % of patients was 24 months or longer, and 55.1 % of them were diagnosed at a university hospital, 81.6 % received a treatment. When the average scores of QOL was analyzed, it was found that the average score of functional status subscale was 39.35 ± 8.90, well-being subscale was 42.59 ± 14.70, general health perception subscale was 19.18 ± 6.25 and global quality of life score was 33.70 ± 9.31. The mean PSS-Fa score of patients was 28.65 ± 9.56. Comparing socio-demographic and clinical characteristics of patients and average scores of QOL and PSS-Fa, there was not a statistically significant relation (p > 0.05). No statistically significant correlation was found between the average scores of QOL and PSS-Fa. These results showed that quality of life was poor and perceived social support was moderate in patients with HIV/AIDS. According to these results, it is recommended that patients with HIV/AIDS should be supported in this regard.     

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。