152例艾滋病合并结核病患者服药依从性及其影响因素分析
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摘要
目的探讨艾滋病合并结核病患者服药依从性并分析其影响因素。方法便利抽取2017年5月-2018年5月新疆某三级甲等传染病专科医院的152例艾滋病合并结核病患者,采用一般资料调查表、艾滋病合并结核病服药依从性问卷、社会支持量表对其进行调查。结果 152例调查对象中,服药依从性好的为115例(75.7%)。忘记服药的时间发生频次最高的是夜里(40.6%)。而患者忘记服药的原因排在前三位的是:外出(21.6%)、忘记吃药(18.9%)及我不想让其他人知道我在吃药(16.2%)。不同服药依从性的患者社会支持得分比较差异均有统计学意义(P<0.05)。logistic回归显示,年龄大(OR=1.590)、家庭收入水平低(OR=2.035)是患者服药依从性的危险因素;而文化程度高(OR=1.532)、社会支持利用度高(OR=1.113)是患者服药依从性的保护性因素(P<0.05)。结论艾滋病合并结核病患者服药依从性总体较低,医护人员在治疗患者疾病的同时,应根据患者的不同需求进行个体化管理,加强出院随访次数和健康宣教,不断提高患者的服药依从性和生活质量。
Objective To explore the drug compliance of AIDS patients with tuberculosis, and to analyze its influencing factors. Methods We selected 152 AIDS patients with tuberculosis in a grade-A tertiary hospital which was specialized in infectious diseases in Xinjiang from May 2017 to May 2018. General information questionnaire, the questionnaire on drug compliance of AIDS patients with tuberculosis, and the Social Support Scale were used to conduct the investigation. Results Among the 152 surveyed subjects, 115(75.7%) had good compliance. The frequency of forgetting to take medicines at night was the highest(40.6%). The top three reasons for the patients to forget to take medicines were as follows: going out(21.6%), forgetting to take medicines(18.9%) and I didn't want other people to know that I was on medication(16.2%). The scores of social support in patients with different drug compliance were statistically significant different(P<0.05). Logistic regression analysis showed that advanced age(OR=1.590) and low family income(OR=2.035) were the risk factors for drug compliance of the patients, while high educational level(OR=1.532) and high utilization of social support(OR=1.113) were the protective factors for drug compliance. Conclusions Drug compliance of the patients with AIDS and tuberculosis is generally low. Medical professionals should treat the patients' diseases based on individualized management according to the patients' different needs and strengthen the frequency of follow-up visits and health propaganda and education so as to continuously improve the patients' drug compliance and quality of life.
Objective To explore the drug compliance of AIDS patients with tuberculosis, and to analyze its influencing factors. Methods We selected 152 AIDS patients with tuberculosis in a grade-A tertiary hospital which was specialized in infectious diseases in Xinjiang from May 2017 to May 2018. General information questionnaire, the questionnaire on drug compliance of AIDS patients with tuberculosis, and the Social Support Scale were used to conduct the investigation. Results Among the 152 surveyed subjects, 115(75.7%) had good compliance. The frequency of forgetting to take medicines at night was the highest(40.6%). The top three reasons for the patients to forget to take medicines were as follows: going out(21.6%), forgetting to take medicines(18.9%) and I didn't want other people to know that I was on medication(16.2%). The scores of social support in patients with different drug compliance were statistically significant different(P<0.05). Logistic regression analysis showed that advanced age(OR=1.590) and low family income(OR=2.035) were the risk factors for drug compliance of the patients, while high educational level(OR=1.532) and high utilization of social support(OR=1.113) were the protective factors for drug compliance. Conclusions Drug compliance of the patients with AIDS and tuberculosis is generally low. Medical professionals should treat the patients' diseases based on individualized management according to the patients' different needs and strengthen the frequency of follow-up visits and health propaganda and education so as to continuously improve the patients' drug compliance and quality of life.
引文
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[7] 王红红,周俊,黄玲,等.吸毒感染艾滋病患者高高效抗逆转录病毒服药依从性及相关因素研究[J].中国行为医学科学,2008,17(10):881-883.
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[10] 肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994,4(2):98-100.
[11] 张传芳,张贻瑞,范江静,等.湖南省TB/HIV双感患者服药依从性调查及影响因素分析[J].实用预防医学,2013,20(12):1439-1441.
[12] 葛锐,罗建勇,徐文贤,等.嘉兴市艾滋病患者抗病毒治疗服药依从性及其影响因素分析[J].中华疾病控制杂志,2015,19(2):206-208.
[13] Gare J,Kelly-Hanku A,Ryan CE,et al.Factors influencing antiretroviral adherence and virological outcomes in people living with HIV in the highlands of Papua New Guinea[J].PLoS One,2015,10(8):e0134918.
[14] MacDonell K,Naar-King S,Huszti H, et al. Barriers to medication adherence in behaviorally and perinatally infected youth living with HIV[J].AIDS Behav,2013,17(1):86-93.
[15] 李炎炎. 督导员制度与艾滋病患者服药依从性的相关问题研究[D].开封:河南大学,2014.
[16] 秦英梅,杜丽群,黄绍标,等.手机短信提醒方式应用于艾滋病患者抗病毒治疗的研究[J].广西医科大学学报,2013,30(1):74-76.
[17] 赵希畅,朱黎丹,辛辛, 等.浦东新区艾滋病患者抗病毒治疗信心及服药依从性调查[J].实用预防医学,2018,25(3):336-338.
[18] 赵文宇,俞海亮,叶少东,等.中国三省386例HIV感染者和艾滋病患者抗病毒治疗服药依从性及其影响因素分析[J].中华预防医学杂志,2016,50(4):334-338.
[19] 薛晓,周林,成诗明.结核分枝杆菌和艾滋病病毒双重感染患者服药依从性检测方法及影响因素[J].中国防痨杂志,2011,78(6):380-384.
[20] 陈艳霞,刘钟应,李星明,等.HIV/AIDS病人服药依从性现状及影响因素分析[J].中国艾滋病性病,2015,21(4):268-272.
[21] 刘阳.艾滋病病人服药依从性与社会支持相关性研究[D].郑州:郑州大学,2016.
[22] 姚刚,朱克京,杜曼, 等.珠海市艾滋病患者高效抗逆转录病毒治疗免疫学效果及影响因素分析[J].实用预防医学,2018,25(3):294-297.
[23] 魏洪霞,柏春琴,还锡萍,等.南京市HIV/AIDS病人服药依从性及影响因素分析[J].中国艾滋病性病,2018,24(1):36-39.
[2] Getahun H, Gunneberg C, Granich R, et al.HIV infection-associated tuberculosis:the epidemiology and the response[J].Clin Infect Dis, 2010,50(3):201-207.
[3] 王宇.全国第五次结核病流行病学调查抽样调查资料汇编[M].北京:军事医学出版社,2011:2-5.
[4] 陈敬芳,王惠珍.263例艾滋病患者社会支持与服药依从性的相关性研究[J].护理学报,2014,21(1):1-3.
[5] 邵一鸣,康来仪,汪宁, 等.艾滋病和艾滋病病毒感染诊断标准[J].中国艾滋病性病,2012,18(4):272-275.
[6] 中华人民共和国卫生行业标准.WS 288-2017肺结核诊断[S].中华人民共和国国家卫生和计划生育委员会发布,2017:1-4.
[7] 王红红,周俊,黄玲,等.吸毒感染艾滋病患者高高效抗逆转录病毒服药依从性及相关因素研究[J].中国行为医学科学,2008,17(10):881-883.
[8] Mannheimer S, Thackeray L, Huppler Hullsiek K, et al. A randomized comparison of two instruments for measuring self-reported antiretroviral adherence[J]. AIDS Care,2008,20(2):161-169.
[9] Li L,Ji G,Ding Y, et al. Perceived burden in adherence of antiretroviral treatment in rural China[J].AIDS Care,2012,24(4):502-508.
[10] 肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994,4(2):98-100.
[11] 张传芳,张贻瑞,范江静,等.湖南省TB/HIV双感患者服药依从性调查及影响因素分析[J].实用预防医学,2013,20(12):1439-1441.
[12] 葛锐,罗建勇,徐文贤,等.嘉兴市艾滋病患者抗病毒治疗服药依从性及其影响因素分析[J].中华疾病控制杂志,2015,19(2):206-208.
[13] Gare J,Kelly-Hanku A,Ryan CE,et al.Factors influencing antiretroviral adherence and virological outcomes in people living with HIV in the highlands of Papua New Guinea[J].PLoS One,2015,10(8):e0134918.
[14] MacDonell K,Naar-King S,Huszti H, et al. Barriers to medication adherence in behaviorally and perinatally infected youth living with HIV[J].AIDS Behav,2013,17(1):86-93.
[15] 李炎炎. 督导员制度与艾滋病患者服药依从性的相关问题研究[D].开封:河南大学,2014.
[16] 秦英梅,杜丽群,黄绍标,等.手机短信提醒方式应用于艾滋病患者抗病毒治疗的研究[J].广西医科大学学报,2013,30(1):74-76.
[17] 赵希畅,朱黎丹,辛辛, 等.浦东新区艾滋病患者抗病毒治疗信心及服药依从性调查[J].实用预防医学,2018,25(3):336-338.
[18] 赵文宇,俞海亮,叶少东,等.中国三省386例HIV感染者和艾滋病患者抗病毒治疗服药依从性及其影响因素分析[J].中华预防医学杂志,2016,50(4):334-338.
[19] 薛晓,周林,成诗明.结核分枝杆菌和艾滋病病毒双重感染患者服药依从性检测方法及影响因素[J].中国防痨杂志,2011,78(6):380-384.
[20] 陈艳霞,刘钟应,李星明,等.HIV/AIDS病人服药依从性现状及影响因素分析[J].中国艾滋病性病,2015,21(4):268-272.
[21] 刘阳.艾滋病病人服药依从性与社会支持相关性研究[D].郑州:郑州大学,2016.
[22] 姚刚,朱克京,杜曼, 等.珠海市艾滋病患者高效抗逆转录病毒治疗免疫学效果及影响因素分析[J].实用预防医学,2018,25(3):294-297.
[23] 魏洪霞,柏春琴,还锡萍,等.南京市HIV/AIDS病人服药依从性及影响因素分析[J].中国艾滋病性病,2018,24(1):36-39.
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