"Getting me back on track": The role of outreach interventions in engaging and retaining people living with HIV/AIDS in medical care
"Getting me back on track": The role of outreach interventions in engaging and retaining people living with HIV/AIDS in medical care
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DOI：
10.1089/apc.2007.9990
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发表时间：
2007-06-01
影响因子：
4.9
通讯作者：
Holbert, Tim
中科院分区：
文献类型：
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作者：
Rajabiun, Serena;Mallinson, R. Kevin;Holbert, Tim
本研究从艾滋病病毒感染者/艾滋病患者（PLWHA）的角度，对艾滋病医疗服务参与过程进行了定性研究。对六个城市的76名参与者进行了深入访谈。所有参与者都被认为是服务不足，因为药物使用，精神疾病，监禁，无家可归或传统医疗保健系统的文化障碍的历史。一个半结构化的采访指南引出了有关医疗保健和程序干预措施的作用，以促进获得医疗保健的叙述。数据分析显示，参与者循环进出护理，这一过程受到以下因素的影响：（1）他们对被诊断患有艾滋病毒的接受程度，（2）他们科普物质使用，精神疾病和耻辱的能力，（3）他们的医疗保健提供者关系，（4）外部支持系统的存在，以及（5）他们克服护理实际障碍的能力。外联干预措施通过消除神话和提高对艾滋病毒的认识，促进获得艾滋病毒护理和治疗，提供支持和减少护理障碍，在将参与者与护理联系起来方面发挥了作用。研究结果表明，外展方案可以中断这一周期性过程，促进对得不到充分服务的艾滋病毒感染者/艾滋病患者的持续、定期艾滋病毒护理，方法是进行以客户为中心的风险评估，以确定和减少不稳定的来源，提高提供者关系的质量;实施促进健康做法的战略;在社区建立支助服务网络;并通过频繁的药物随访和预约来支持依从性。
This qualitative study investigated the process of engagement in HIV medical care from the perspective of people living with HIV/ AIDS ( PLWHA). In- depth interviews were conducted with 76 participants in six cities. All participants were considered underserved because of histories of substance use, mental illness, incarceration, homelessness, or cultural barriers to the traditional health care system. A semistructured interview guide elicited narratives related to health care and the role of program interventions in facilitating access to care. Data analysis revealed that participants cycled in and out of care, a process that was influenced by ( 1) their level of acceptance of being diagnosed with HIV, ( 2) their ability to cope with substance use, mental illness, and stigma, ( 3) their health care provider relationships, ( 4) the presence of external support systems, and ( 5) their ability to overcome practical barriers to care. Outreach interventions played a role in connecting participants to care by dispelling myths and improving knowledge about HIV, facilitating access to HIV care and treatment, providing support, and reducing the barriers to care. The findings suggest that outreach programs can interrupt this cyclical process and foster sustained, regular HIV care for underserved PLWHA by conducting client- centered risk assessments to identify and reduce sources of instability and improve the quality of provider relationships; implementing strategies that promote healthy practices; creating a network of support services in the community; and supporting adherence through frequent follow- ups for medication and appointment keeping.