Longitudinal study of mental health and psychosocial predictors of medical treatment adherence in mothers living with HIV disease
Longitudinal study of mental health and psychosocial predictors of medical treatment adherence in mothers living with HIV disease
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DOI：
10.1089/108729103322277420
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发表时间：
2003-08-01
影响因子：
4.9
通讯作者：
Chesney, MA
中科院分区：
文献类型：
--
作者：
Mellins, CA;Kang, E;Chesney, MA
迄今为止，研究抗逆转录病毒药物依从性的社会心理相关因素的横断面研究还没有充分解决长期依从性的挑战。这项纵向研究探讨了心理健康，药物滥用，长期坚持抗逆转录病毒药物和医疗预约的HIV血清阳性的母亲从一个大型城市医疗中心的传染病诊所招募的心理社会预测。在基线和两个随访点（入组后8至18个月）进行个人访谈。基于健康行为模型，我们研究了随着时间的推移，坚持抗逆转录病毒药物治疗和医疗预约的精神和社会心理预测因素。精神疾病、负性生活事件、家庭成员多和养育压力的存在与随访时漏服药物和错过医疗预约显著相关。基线药物滥用与随访时漏服药物有关，基线时缺乏对家庭成员的披露与随访时漏诊有关。这些研究结果表明，综合心理健康，药物滥用和医疗保健的干预措施可能是重要的，以提高医疗依从性和健康的艾滋病毒血清阳性的妇女，特别是在多重压力的人口与大量的生育和其他生活需求。
Cross-sectional studies to date that examine psychosocial correlates of antiretroviral adherence have insufficiently addressed the challenges of long-term adherence. This longitudinal study examined mental health, substance abuse, and psychosocial predictors of long-term adherence to antiretroviral medications and medical appointments among HIV-seropositive mothers recruited from an infectious disease clinic of a large urban medical center. Individual interviews were conducted at baseline and two follow-up points, 8 to 18 months after enrollment. Based on a model of health behavior, we examined psychiatric and psychosocial predictors of adherence to antiretroviral medications and medical appointments over time. Presence of a psychiatric disorder, negative stressful life events, more household members, and parenting stress were significantly associated with both missed pills and missed medical appointments at follow-up. Baseline substance abuse was associated with missed pills at follow-up and lack of disclosure to family members at baseline was associated with missed medical appointments at follow-up. These findings suggest that interventions that integrate mental health, substance abuse and medical care may be important to improving the medical adherence and health of HIV-seropositive women, particularly in multistressed populations with substantial caregiving and other life demands.