HIV感染者/AIDS患者对其他专科医护人员披露诊断时心理体验的质性研究  

A qualitative study on the psychological experience of HIV/AIDS patients for the disclosing of HIV to non-AIDS professionals

作　　者：黄莺[1] 王华芬 邵丽芳[1] 楼方圆 孙丹萍[1] 詹晓琴 HUANG Ying;WANG Huafen;SHAO Lifang;LOU Fangyuan;SUN Danping;ZHAN Xiaoqin

机构地区：[1]浙江大学医学院附属第一医院感染科,杭州市310003 [2]浙江大学医学院附属第一医院护理部,杭州市310003

出　　处：《中华护理杂志》2023年第12期1483-1488,共6页Chinese Journal of Nursing

基　　金：浙江省教育厅抗疫专项项目(Y202043394);浙江省医药卫生科技计划青年创新项目(2023RC164)。

摘　　要：目的深入了解HIV感染者/AIDS患者对其他专科医护人员披露HIV诊断时的心理体验,为提升患者HIV诊断披露意愿及医患双方诊治的有效性和安全性提供参考依据。方法采用目的抽样法,对2021年2月-2022年3月在浙江省某三级甲等医院随访管理的12例HIV感染者/AIDS患者进行半结构化深度访谈,采用Colaizzi资料分析法转录、分析并提炼资料。结果HIV感染者/AIDS患者对其他专科医护人员披露诊断时的体验可归纳为3个主题:担心遭受医护人员双重污名,潜意识里并存自我污名;担心损害个人诊疗权益;希望体现个人诚信品质。结论HIV感染者/AIDS患者对其他专科医护人员披露诊断时普遍存在病耻感,谨慎披露和隐蔽的披露方式可避免披露不当而遭受歧视或侮辱,可尝试实施综合姑息治疗干预措施,减少患者污名化体验,加强对HIV污名认知和应对技能的培训,同时呼吁政府和医院相关职能部门加强执法监督,保障医患权利,为患者营造舒心的就医环境,从而减轻患者披露负担,提升患者披露意愿。Objective To understand the psychological experience of HIV/AIDS patients for the disclosing of HIV to non-AIDS professionals,so as to provide references for promoting patients’willingness to disclose HIV,and effectiveness and safety of diagnosis and treatment by both medical staff and patients.Methods From February 2021 to March 2022,by using purposive sampling method,semi-structured in-depth interviews were conducted with 12 HIV/AIDS patients in a tertiary hospital in Zhejiang,China.The data was transcribed,analyzed,and refined by the Colaizzi’s method.Results The experience of HIV/AIDS patients to disclose HIV to non-AIDS professionals can be summarized into 3 themes.HIV/AIDS patients worried that the HIV disclosure would make them suffer from double stigma by medical staff,and there was self-stigma existing in the patient’s subconsciousness.They also feared that the HIV disclosure would damage the interests of individual to receive medical treatment.They hoped that the HIV disclosure reflect patients’personal integrity.Conclusion HIV/AIDS patients generally have stigma when disclosing HIV to other specialized medical personnel.Cautious and concealed disclosure can avert discrimination or insult caused by improper disclosure.It is recommended to implement integrated palliative care intervention to reduce the stigmatization experience of patients,strengthen the training of HIV stigma awareness and coping skills,and call on the relevant functional departments of government and hospital to strengthen law enforcement supervision,guarantee the rights of doctors and patients,and create a comfortable medical environment for patients,so as to reduce the disclosure burden of HIV/AIDS patients and enhance the willingness of patients to disclose HIV.

关 键 词：HIV感染 获得性免疫缺陷综合征 披露 体验 心理护理 质性研究 

分 类 号：R473.5[医药卫生—护理学]