Health-related quality of life among adult HIV positive patients: assessing comprehensive themes and interrelated associations
Health-related quality of life among adult HIV positive patients: assessing comprehensive themes and interrelated associations
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DOI：
10.1007/s11136-019-02203-y
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发表时间：
2019-10-01
影响因子：
3.5
通讯作者：
Brinkman, K.
中科院分区：
文献类型：
--
作者：
den Daas, C.;van den Berk, G. E. L.;Brinkman, K.
目的我们选择并评估了一套全面的主题，包括艾滋病毒患者的健康相关生活质量（HRQOL），使临床医生能够根据个人需求量身定制护理，方法两个荷兰HIV诊所的HIV患者（N = 250）被邀请完成一项在线调查，经验证的问卷（改编），测量八个主题，包括一般健康（SF-12）、耻辱（短耻辱量表），社会支持（SSL 12-I），自尊（SISE），性问题，焦虑和抑郁（HADS），睡眠困难（SCL 90-睡眠）和感知的副作用。（应答率68%）患者（男性= 159，94.1%）显示问卷具有高的内部一致性，并且大多数主题在预期方向上显著相关（r = 0.21至-0.69，p <0.05）。探索截止评分显示，有显著比例的患者在单一主题上的评分超出了预期范围（16.0 - 73.1%），许多患者同时在多个主题上（8.9%在5个或更多主题上）。回归分析显示，社会支持、自尊和性问题与总体健康状况相关（R = 0.48，R-2 = 0.23，F（4，145）= 10.57，p <0.001）;加上焦虑和抑郁、睡眠困难和自觉的副作用，共解释了51.2（R = 0.72，Delta R-2 = 0.29，F（3，142）= 27.82，p <0.001）。结论我们成功开发了一份全面评估HRQOL的问卷。大多数荷兰HIV患者的HRQOL可以得到改善。这些主题相互影响很大，因此对任何主题的见解都可以为改善HRQOL的干预措施提供信息，并在患者和医疗保健专业人员之间的常规咨询中增加对这些主题的关注。
Purpose We selected and evaluated a comprehensive set of themes that encompass health-related quality of life (HRQOL) among HIV patients, which enables clinicians to tailor care to individual needs, follow changes over time and quantify returns on health care investments and interventions.Methods HIV patients (N = 250) of two Dutch HIV clinics were invited to complete an online survey comprised of a set of (adaptations of) validated questionnaires measuring eight themes, including general health (SF-12), stigma (short stigma scale), social support (SSL12-I), self-esteem (SISE), sexuality problems, anxiety and depression (HADS), sleeping difficulties (SCL90-Sleep) and perceived side-effects.Results Findings from 170 (response rate 68%) patients (Male = 159, 94.1%) showed that questionnaires had high internal consistency, and most themes significantly correlated (r's .21 to - .69, p < .05) in the expected directions. Exploring cut-off scores shows that a significant proportion of patients score outside of the desired range on single themes (between 16.0 and 73.1%), and many patients on multiple themes simultaneously ( 8.9% on 5 or more themes). Regression analysis showed that social support, self-esteem and sexuality problems were associated with general health (R = .48, R-2 = .23, F(4,145) = 10.57, p < .001); adding anxiety and depression, sleeping difficulties and perceived side-effects explained 51.2% of the variance in total (R = .72, Delta R-2 = .29, F(3, 142) = 27.82, p < .001).Conclusions We succeeded in developing a questionnaire that comprehensively assesses HRQOL. HRQOL of the majority of Dutch HIV patients could be improved. The themes strongly influenced each other, therefore insights into any of the themes could inform interventions to improve HRQOL, and increase attention to these themes in routine consultations between patients and health care professionals.