Changes in symptoms and health-related quality of life in a nationally representative sample of adults in treatment for HIV
Changes in symptoms and health-related quality of life in a nationally representative sample of adults in treatment for HIV
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DOI：
10.1007/s11136-005-6010-x
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发表时间：
2006-08-01
影响因子：
3.5
通讯作者：
Hays, Ron D.
中科院分区：
文献类型：
--
作者：
Lorenz, Karl A.;Cunningham, William E.;Hays, Ron D.
为监测和改善艾滋病毒感染者的健康状况，需要采取以患者为中心的功能和福祉措施。我们估计了HIV感染者HRQOL和症状之间随时间的关系，并对人口统计学和临床特征进行了调整，采用了一项纵向研究，对1996年和1998年接受调查的2267名接受HIV感染治疗的全国代表性队列患者进行了调查。我们使用了HRQOL（总体健康和总体生活质量）的两种全球测量方法，在样本中得分的平均值为50，标准差为10。在此期间，症状总数减少（-1.29,p < 0.001），总体健康状况（1.09,p < 0.001）和总体生活质量（1.31,p < 0.001）得到改善。控制基线症状和HRQOL，随访时的每一个附加症状（B=-1.14, p < 0.001）与整体健康状况恶化和整体生活质量恶化相关（B=-0.95, p < 0.001）。另外两种症状与总体HRQOL较低的关联程度与具有显著抑郁症状或诊断为艾滋病的影响相似。总之，在hiv感染患者中，随着时间的推移，症状与HRQOL显著相关。艾滋病毒患者的功能和福祉与他们所经历的症状有着密不可分的联系。
Patient-centered measures of functioning and well-being are needed to monitor and improve health for HIV-infected persons. We estimated the associations between HRQOL and symptoms over time in HIV-infected persons, adjusting for demographic and clinical characteristics using a longitudinal study of a nationally representative cohort of 2267 patients in care for HIV infection surveyed in 1996 and again in 1998. We used two global measures of HRQOL (overall health and overall quality of life) scored to have a mean of 50 and standard deviation of 10 in the sample. The total number of symptoms decreased (-1.29, p < 0.001 for the difference), and overall health (1.09, p < 0.001 for the difference) and overall quality of life (1.31, p < 0.001 for the difference) improved over the period. Controlling for baseline symptoms and HRQOL, each additional symptom at follow-up (B=-1.14, p < 0.001) was associated with worsened overall health and worsened overall quality of life (B=-0.95, p < 0.001). The association of two additional symptoms with lower global HRQOL was similar in magnitude to the effect of having significant depressive symptoms or the diagnosis of AIDS. In conclusion, among HIV-infected patients, symptoms are significantly related to HRQOL over time. The functioning and well-being of patients with HIV is inextricably linked to the symptoms they experience.