基于结构方程模型的云南省四州市HIV感染者生命质量影响因素分析  

Factors influencing the quality of life among HIV-infected individuals in four cities/prefectures in Yunnan Province based on a structural equation model

作　　者：霍俊丽[1] 廖若冰 韩瑜[1] 杨志敏[1] 张小波[1] 徐诺雅[1] 黎萍 安晓静[1] 施玉华[1] HUO Junli;LIAO Ruobing;HAN Yu;YANG Zhimin;ZHANG Xiaobo;XU Nuoya;LI Ping;AN Xiaojing;SHI Yuhua(Yunnan Center for Disease Control and Prevention,Kunming 650022,Yunnan,China)

机构地区：[1]云南省疾病预防控制中心,昆明650022

出　　处：《中国艾滋病性病》2025年第1期63-69,共7页Chinese Journal of Aids & STD

基　　金：国家“十三五”科技重大专项(2018ZX10715006)。

摘　　要：目的采用结构方程模型分析云南省四州市HIV感染者生命质量的影响因素。方法采用方便抽样法,选择云南省昆明、德宏、保山和昭通的HIV感染者为调查对象,调查内容包括人口学资料、社会支持、应对方式和生命质量,采用健康调查简表(SF-36)测评感染者的生命质量,采用Amos28.0软件构建影响生命质量的结构方程模型。结果本研究共纳入700名研究对象,其中昆明280名,德宏140名,保山140名,昭通140名。生理健康得分335.00(60.00)分,心理健康得分336.00(81.00)分,生命质量得分661.50(132.30)分。多重线性回归分析结果显示,人均年收入、社会支持、应对方式、cART情况和CD4细胞为生命质量的影响因素(P<0.05)。结构方程模型显示,人均年收入、cART情况、CD4细胞和积极应对均可直接影响生理健康和心理健康(P<0.05);消极应对直接影响心理健康(P<0.05),也可以通过cART情况间接影响生理健康(P<0.05);社会支持直接影响生理健康(P<0.05),也可以通过应对方式间接影响生理健康和心理健康(P<0.05)。结论HIV感染者生命质量的影响因素可通过结构方程进行验证;社会支持、人均年收入、cART情况、CD4细胞和应对方式是生命质量的主要影响因素。Objective To analyze the factors influencing the quality of life(QoL)among HIV-infected individuals in four cities/prefectures of Yunnan Province using a structural equation model(SEM).Methods A convenience sampling method was used to recruit HIV-infected individuals from Kunming,Dehong,Baoshan,and Zhaotong in Yunnan Province.Data on demographics,social support,coping strategies,and QoL were collected.The Short Form-36 Health Survey was used to evaluate QoL,and the Amos 28.0 software was used to construct the SEM.Results In total,700 participants were included in the study:280,140,140,and 140 from Kunming,Dehong,Baoshan,and Zhaotong,respectively.The scores for physical health,mental health,and overall QoL were 335.00(60.00),336.00(81.00),and 661.50(132.30),respectively.Multiple linear regression analysis identified annual per capita income,social support,coping strategies,combination antiretroviral therapy(cART)status,and CD4 cell count as significant factors influencing QoL(P<0.05).SEM indicated that annual per capita income,cART status,CD4 cell count,and positive coping strategies directly affected both physical and mental health(P<0.05).Negative coping strategies directly influenced mental health(P<0.05)and indirectly affected physical health through cART status(P<0.05).Social support had a direct effect on physical health(P<0.05)and an indirect impact on both physical and mental health through coping strategies(P<0.05).Conclusions SEM can effectively validate the factors influencing Qo L among HIV-infected individuals.The key determinants included social support,annual percapita income,c ART status,CD4 cell count,and coping strategies.

关 键 词：艾滋病病毒感染者 生命质量 结构方程模型 影响因素 

分 类 号：R373.9[医药卫生—病原生物学] R512.91[医药卫生—基础医学]