自我管理和服药依从性在HIV感染者D型人格与病毒载量间的中介效应  

Mediating effects of self-management and medication adherence between type D personality and viral load in HIV-infected individuals

作　　者：季艳萍[1] 丁庆彬[2] 卜天一 王琨[4] 王雪[1] 张静[1] Ji Yanping;Ding Qingbin;Bu Tianyi;Wang Kun;Wang Xue;Zhang Jing(Infection Department Three,the Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Emergency Operating Room,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Center for Psychological Science and Health Management,Harbin Medical University,Harbin 150081,China;Hospital Administration Office,the 2nd Affiliated Hospital of Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属第四医院感染三科,哈尔滨150001 [2]哈尔滨医科大学附属第一医院急诊手术室,哈尔滨150001 [3]哈尔滨医科大学心理科学与健康管理中心,哈尔滨150081 [4]哈尔滨医科大学附属第二医院院办,哈尔滨150081

出　　处：《中华现代护理杂志》2025年第4期514-519,共6页Chinese Journal of Modern Nursing

基　　金：2024年度哈尔滨医科大学青年基金临床护理专项。

摘　　要：目的探讨自我管理和服药依从性在HIV感染者D型人格与病毒载量间的中介效应。方法采用便利抽样法,选取2023年10月—2024年3月在哈尔滨医科大学附属第四医院黑龙江省艾滋病诊疗中心初次确诊HIV感染后接受抗病毒治疗的患者为研究对象。采用D型人格量表(DS-l4)、艾滋病患者自我管理能力量表(HIVSMS)、8条目Morisky服药依从性量表(MMAS-8)进行调查,并检测HIV-1病毒载量。采用Pearson相关分析探讨D型人格、自我管理、服药依从性、病毒载量之间的相关性。采用SPSS软件宏程序Process V4.0检验中介效应。结果共发放问卷318份,回收有效问卷313份,问卷有效回收率为98.43%。313例HIV感染者的DS-l4得分为(33.39±4.98)分、HIVSMS得分为(29.84±4.41)分、MMAS-8得分为(6.11±1.29)分;病毒载量为(1803.19±870.81)拷贝/ml。Pearson相关分析结果显示,D型人格与自我管理、服药依从性均呈负相关(r值分别为-0.307、-0.208,P<0.01),与病毒载量呈正相关(r=0.213,P<0.01);服药依从性与病毒载量呈负相关(r=-0.232,P<0.01);自我管理与服药依从性呈正相关(r=0.353,P<0.01)。中介效应检验结果显示,自我管理和服药依从性在D型人格和病毒载量间具有链式中介效应,中介效应值为0.016,占总效应的8.08%。结论D型人格不仅可以直接影响HIV感染者的病毒载量,还可以通过自我管理和服药依从性的中介作用间接影响病毒载量。Objective To explore the mediating effects of self-management and medication adherence between type D personality and viral load in HIV-infected individuals.Methods HIV patients who were newly diagnosed and undergoing antiretroviral therapy(ART)at the Heilongjiang AIDS Treatment Center of the Fourth Hospital of Harbin Medical University from October 2023 to March 2024 were enrolled by convenience sampling.Data were collected using the Type D Personality Scale-14(DS-14),HIV Self-Management Scale(HIVSMS),and 8-item Morisky Medication Adherence Scale(MMAS-8).HIV-1 viral load was also measured.Pearson correlation analysis explored the relationships among type D personality,self-management,medication adherence,and viral load.The SPSS Process V4.0 macro was used to test the mediating effects.Results A total of 318 questionnaires were distributed and 313 valid responses were collected(effective response rate:98.43%).The mean scores for the 313 HIV-infected individuals were as follows:DS-14(33.39±4.98),HIVSMS(29.84±4.41),and MMAS-8(6.11±1.29).The mean viral load was(1803.19±870.81)copies/ml.Pearson correlation analysis showed that type D personality was negatively correlated with self-management and medication adherence(r=-0.307,-0.208,respectively;P<0.01)and positively correlated with viral load(r=0.213;P<0.01).Medication adherence was negatively correlated with viral load(r=-0.232;P<0.01),while self-management was positively correlated with medication adherence(r=0.353;P<0.01).The mediation analysis revealed that self-management and medication adherence played a chain mediating role between type D personality and viral load,with a mediation effect value of 0.016,accounting for 8.08%of the total effect.Conclusions Type D personality directly influences the viral load of HIV-infected individuals and indirectly affects it through the mediating effects of self-management and medication adherence.

关 键 词：HIV感染 D型人格 病毒载量 自我管理 用药依从性 

分 类 号：R512.91[医药卫生—内科学]