艾滋病患者抗病毒治疗依从性的支撑性结构及其对防治工作的启示  

A hierarchical supporting structure for antiretroviral therapy adherence and its implications for HIV/AIDS prevention and control efforts

作　　者：文毅[1,2] Roger Detels 张福杰[1] 

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]加州大学洛杉矶分校流行病学系,美国洛杉矶90095

出　　处：《中华疾病控制杂志》2012年第12期1075-1078,共4页Chinese Journal of Disease Control & Prevention

基　　金：美国加州大学洛杉矶分校/福格迪艾滋病国际培训与研究项目(D43 TW000013)

摘　　要：目的了解艾滋病患者抗病毒治疗依从性的支撑性结构,为开展有针对性的依从性教育提供依据。方法使用定性访谈的方法对来自云南省潞西市的20名在治病人以及21位治疗病人的家属进行了深入访谈。访谈内容主要包括治疗的一般情况、服药的依从情况、影响服药的主要因素、治疗中遇到主要困难等。使用编码和概念框架的方法对发现的影响因素以及各因素间的相互关系进行分析和整理。结果强烈的求生欲望和对家庭的担心是良好依从性的最主要动机和基础;良好的环境因素和有效的提醒方法是支撑依从性的两个支柱;在各种因素的综合影响下,按时服药可以变成患者生活的一部分,进而形成支撑依从性的第三个支柱。结论了解抗病毒治疗依从性的支撑性结构可以帮助治疗项目的管理者发现关键的干预目标,进而开展有针对性的干预活动,提高治疗质量。Objective To understand the supporting structure of treatment adherence and provide evidence to focused adherence education.Methods Qualitative in-depth interviews were conducted with 20 currently treated HIV/AIDS patients and 21 family members from Luxi City,Yunnan Province.Broad questions were asked about their treatment experiences,treatment adherence,main factors affecting adherence and difficulty they had during treatment.A code system and a concept framework were used to analyze and understand the affecting factors and their relationships.Results A strong desire to stay alive and concerning about the family were the two most important motivations for adhering to treatment.Good environmental factors and effective reminder methods were two supporting pillars for treatment adherence.Under the influence of various factors,taking medicine on time could become a deeply ingrained habit wihch forms the third supporting pillar.Conclusions Understanding the hierarchical supporting structure for treatment adherence can help program managers to be aware of the key elements for successful treatment programs and targets for further improvement.

关 键 词：抗病毒药 病人依从 危险因素 

分 类 号：R512.91[医药卫生—内科学]