基于保护动机理论的HIV/AIDS病人ART依从性状况分析  

Analysis on medication adherence of HIV/AIDS patients based on the protection motivation theory

作　　者：肖琛嫦[1] 陈雪梅[1] 王棠 刘漫[3] 李十月[1] 燕虹[1] 

机构地区：[1]武汉大学健康学院,武汉430071 [2]湖北省卫生和计划生育委员会,武汉430079 [3]湖北省疾病预防控制中心,武汉430079

出　　处：《中国艾滋病性病》2017年第6期503-506,541,共5页Chinese Journal of Aids & STD

基　　金：湖北省2013年央专艾滋病防治购买社会组织服务项目资助(HBYZAF-2013-01)

摘　　要：目的从社会心理学的角度,探讨艾滋病病毒(HIV)感染者的保护动机与抗病毒治疗(ART)服药依从性的关系,为针对该人群的行为干预提供依据。方法 2014年12月至2015年3月,对到湖北省随州市疾病预防控制中心领药、检测或治疗的206名HIV感染者进行匿名问卷调查。采用SPSS 17.0软件对数据进行统计分析,分析方法主要包括秩和检验和Logistic回归分析。结果 206名HIV感染者中,ART依从性良好者占87.38%。ART依从性良好的保护动机评分为(77.46±9.91)分,高于ART依从性不好的(69.80±8.48)分(U=1 234.00,P<0.01),其中威胁评估和应对评估评分分别为(35.14±6.09)分和(42.31±5.82)分,均高于ART依从性不好的感染者(30.28±4.56和39.23±5.05)分(U=1 197.46,P<0.01;U=1 471.50,P<0.01)。Logistic回归分析结果表明,年龄、文化程度、ART时间与服药依从性有关[比值比(OR)=0.92,95%可信区间(CI):0.85~0.99;OR=8.88,95%CI:1.44~54.79;OR=4.97,95%CI:1.17~21.03],保护动机中威胁评估与ART依从性有关(OR=1.14,95%CI:1.04~1.25),主要通过易感性和内部奖励起作用(OR=1.30,95%CI:1.03~1.65;OR=1.36,95%CI:1.06~1.75)。结论 HIV感染者保护动机水平越高,ART依从性越好。可基于保护动机理论对HIV感染者的服药依从性状况进行识别、预测和干预。Objective To explore the relationship between the protection motivation and medication adherence of antiviral therapy （ART） among HIV/AIDS patients from perspective of social psychology. Methods 206 HIV/ AIDS patients in Suizhou, Hubei province were surveyed anonymously from Dec. 2014 to Mar. 2015, and the data was analyzed with SPSS 17.0. Results Out of the 206 HIV/AIDS patients, 87. 38% with good medication adherence had higher score of protection motivation （77.46 ± 9.91） than those with poor adherence （69.80 ±8.48） （U= 1234.00, P〈0.01）, and had higher scores of threat appraisal （35. 14±6.09） and coping appraisal （42.31±5.82） than those with poor adherence （30.28±4.56 and 39.23±5.05） （U=1197.46, P（0.01; U=1471.50, P〈0.01） ± Logistic regression analysis showed that the adherence was correlated with age, education and duration of ART （OR=0.92, 95%CI： 0.85-0.99 OR=8.88, 95%CI： 1.4±54.79; OR=4.97, 95%CI： 1.17-21.03）. The threat appraisal of protection motivation was associated with the adherence （OR= 1.14, 95 ± CI： 1.0-1.25）, which was mainly affected through vulnerability and intrinsic reward （OR = 1.30, 95 % CI： 1.03-1.65 ; OR= 1.36, 95 % CI： 1.06-1.75）. Conclusion The higher the level of protection motivation is, the better the adherence among HIV/ AIDS patients will be. Vulnerability and intrinsic reward are associated with the adherence. We can have recognition, prediction and interventions on the adherence of HIV/AIDS patients according to protection motivation.

关 键 词：艾滋病病毒感染者/艾滋病病人 保护动机 抗病毒治疗 依从性 易感性 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]