个案管理对男男性行为者中新诊断HIV感染者焦虑抑郁心理及睡眠质量影响研究  

Effect of case management on newly diagnosed HIV/AIDS anxiety,depression and sleep quality among men who have sex with men

作　　者：谢年华[1] 刘莉 闫晗 吴斯[1] 胡雪姣 马红飞 阮连国 王夏[1] XIE Nianhua;LIU Li;YAN Han;WU Si;HU Xuejiao;MA Hongfei;RUAN Lianguo;WANG Xia(Wuhan Center for Disease Control and Prevention,Wuhan 430024,China;Wuhan Jin Yin-tan Hospital,Wuhan 430013)

机构地区：[1]武汉市疾病预防控制中心,武汉430024 [2]武汉市金银潭医院,武汉430013

出　　处：《中国艾滋病性病》2021年第11期1258-1262,共5页Chinese Journal of Aids & STD

基　　金：武汉市卫生计生委医学科研计划资助项目(WG18A06)。

摘　　要：目的探索个案管理对改善MSM中新诊断HIV感染者焦虑、抑郁心理及睡眠质量的影响。方法按照随机分组方法,在ART定点医院采用医院焦虑抑郁量表(HADS)和匹兹堡睡眠质量指数(PSQI)重复测量个案管理组(个案组)和非个案管理组(对照组)MSM中新诊断HIV感染者的情绪状态和睡眠质量,采用广义估计方程(GEE)分析比较1年随访期内两组患者在焦虑、抑郁心理及睡眠质量方面改善有无差异。结果个案组患者焦虑阳性、抑郁阳性及睡眠障碍比例分别由治疗前的46.4%、30.0%和60.0%下降至1年后的12.5%、13.5%和14.6%,对照组患者焦虑阳性、抑郁阳性及睡眠障碍比例分别由治疗前的41.3%、30.3%和59.3%下降至1年后的32.5%、30.1%和39.8%,个案组病例在焦虑、抑郁及睡眠质量方面的改善优于对照组(P<0.05)。结论基于心理行为干预的个案管理服务可以明显改善MSM中新诊断HIV感染者焦虑、抑郁心理和睡眠质量,应尽早识别新诊断患者可能存在的心理状态及睡眠障碍,为该人群提供基于个案管理服务的社会心理综合关怀,提高生存质量。Objective To explore the effect of case management on anxiety,depression,and sleep quality of newly diagnosed HIV-infected men who have sex with men.Methods According to the random grouping method,110 cases in the case management group and 109 cases in the control group were repeatedly measured with Hospital Anxiety and Depression Scale(HADS)and Pittsburgh sleep quality index(PSQI)in the designated hospital for antiviral treatment.Generalized Estimated Equation(GEE)was used to analyze the difference in improving HIV/AIDS anxiety,depression,and sleep quality after a 1-year follow-up from the two groups.Results In the case management group,the proportion of HIV/AIDS anxiety positive,depression positive,and sleep disorder decreased from 46.4%,30.0%,and 60.0%before treatment to 12.5%,13.5%,and 14.6%after one 1 year,respectively.In the control group,the proportion of HIV/AIDS anxiety positive,depression positive,and sleep disorder decreased from 41.3%,30.3%,and 59.3%before treatment to32.5%,30.1%,and 39.8%after one year,respectively.The improvement of the case management group was better than that of the control group(P<0.05).Conclusions The case management service based on psychological behavior intervention can significantly improve the anxiety and depression status and sleep quality of newly diagnosed HIVinfected MSM.Therefore,it is necessary to identify the possible psychological level and sleep disorders of newly diagnosed HIV/AIDS as soon as possible and provide comprehensive social psychological care based on case management services for HIV/AIDS to improve their quality of life.

关 键 词：艾滋病 男男性行为者 个案管理 焦虑 抑郁 睡眠质量 

分 类 号：R373.9[医药卫生—病原生物学]