299例人类免疫缺陷病毒感染者生命质量的调查

目的用定性访谈和36条目简明量表（short form-36,SF-36）定量调查的方法研究人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者的生命质量,评价HIV感染者的敌意心理趋势。方法在四川、湖北和贵州抽取299例HIV感染者,用SF-36调查其生命质量,并进行信度效度分析。对感染者和防治人员进行访谈,以了解感染者目前最关注的内容。SF-36曾用于与本次调查对象具有相似经济文化背景的四川普通农村居民（1603例）,将两次调查的结果进行比较。通过与相关专家及防治人员进行小组讨论,设计7个条目以评价感染者的敌意心理趋势。结果SF-36共有8个维度,各维度内部一致性信度系数范围0．75～0．90,重测信度系数范围0．54～0．80（40例）。条目与其维度的相关系数范围为0．46～0．97。HIV感染者各个维度平均得分在28．50～77．87之间,四川普通农村居民各个维度平均得分在70．27～91．87之间,各维度得分经Mann-Whitneytest检验,U值在-17．43～-23．87之间,P值均〈0．01。评价敌意心理趋势的7个条目平均得分范围为46．21～82．89。结论HIV感染带来生命质量的严重恶化。SF-36可用于HIV感染者生命质量的研究。

Quality of life and hostile mentality trend among 299 patients living with HIV/AIDS

OBJECTIVE: To assess the quality of life (QOL) and hostile mentality trend (HMT) of 299 patients living with HIV/AIDS (Human immunodeficiency virus/Acquired immune deficiency syndrome) in three provinces in China, and to understand the major concerns of the these patients. METHODS: The SF-36 (short form -36) was used for assessing the QOL among 299 HIV-infected patients in Sichuan, Hubei and Guizhou provinces. Reliability and validity of SF-36 were evaluated. Consulting with experts and professionals, seven additional items were developed to evaluate the HMT. Mean scores of the 8 scales were compared between the patients and general rural residents in Sichuan province. RESULTS: For SF-36, internal consistent coefficients (Cronbach's alpha) of the 8 scales were between 0.75 to 0.90, test-retest reliability coefficient ranged from 0.54 to 0.80. The item-subscale correlation coefficients ranged from 0.46 to 0.97. Mean scores of the 8 scales of the patients ranged from 28.50 to 77.87, and 70.27 to 91.87 for the general rural residents. The variations of the scales were tested by means of Mann-Whitney test with u value ranged from -17.43 to -23.87. The QOL of the patients living with HIV/AIDS were significantly inferior to those of general population (all P < 0.01). The mean scores of the seven items to evaluate HMT ranged from 46.21 to 82.89. The major concerns of the patients living with HIV/AIDS included financial insecurity and family responsibilities, followed by death threat and no cure of HIV/AIDS. CONCLUSION: The SF-36 is a reliable instrument for assessing QOL of patients living with HIV/AIDS. The QOL of the patients living with HIV/AIDS in China is poor.