Effects of Depression Alleviation on ART Adherence and HIV Clinic Attendance in Uganda, and the Mediating Roles of Self-Efficacy and Motivation.
Effects of Depression Alleviation on ART Adherence and HIV Clinic Attendance in Uganda, and the Mediating Roles of Self-Efficacy and Motivation.
复制标题
抑郁症减轻对乌干达艺术依从性和艾滋病毒诊所出勤的影响，以及自我效能和动机的中介作用。
DOI：
10.1007/s10461-016-1500-0
复制
发表时间：
2017-06
影响因子：
4.4
通讯作者：
Akena D
中科院分区：
文献类型：
--
作者：
Wagner GJ;Ghosh-Dastidar B;Robinson E;Ngo VK;Glick P;Mukasa B;Musisi S;Akena D
已知抑郁会阻碍HIV护理的坚持和保留，我们研究了抑郁缓解是否能改善这些疾病管理行为。在乌干达，1028名艾滋病患者参加了两种抑郁症治疗模式的随机对照试验，并进行了为期12个月的调查。系列回归分析检验了抑郁缓解是否与自我报告的抗逆转录病毒治疗（ART）依从性和第12个月的诊所出勤率有关，以及这些关系是否由自我效能感和动机介导。在重度抑郁症患者中，抑郁缓解与更好的抗逆转录病毒治疗依从性和第12个月的诊所出勤率相关；第12个月的自我效能感完全介导了这些关系，而依从性动机部分介导了抑郁缓解和ART依从性之间的关系。当两种介质同时输入时，只有自我效能感是显著的预测因子，并且仍然完全介导抑郁缓解和依从性之间的关系。这些发现表明，抑郁症的缓解对抗逆转录病毒治疗的依从性和就诊率都有好处，这在很大程度上是通过提高参与这些疾病管理行为的信心和动机来实现的。
With depression known to impede HIV care adherence and retention, we examined whether depression alleviation improves these disease management behaviors. A sample of 1028 depressed HIV clients in Uganda enrolled in a cluster randomized controlled trial of two depression care models, and were surveyed over 12 months. Serial regression analyses examined whether depression alleviation was associated with self-reported antiretroviral therapy (ART) adherence and clinic attendance at month 12, and whether these relationships were mediated by self-efficacy and motivation. Among those with major depression, depression alleviation was associated with better ART adherence and clinic attendance at month 12; these relationships were fully mediated by self-efficacy at month 12, while adherence motivation partially mediated the relationship between depression alleviation and ART adherence. When both mediators were entered simultaneously, only self-efficacy was a significant predictor and still fully mediated the relationship between depression alleviation and adherence. These findings suggest that depression alleviation benefits both ART adherence and clinic attendance, in large part through improved confidence and motivation to engage in these disease management behaviors.