Ugandan Study Participants Experience Electronic Monitoring of Antiretroviral Therapy Adherence as Welcomed Pressure to Adhere.
Ugandan Study Participants Experience Electronic Monitoring of Antiretroviral Therapy Adherence as Welcomed Pressure to Adhere.
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乌干达研究参与者将抗逆转录病毒治疗依从性电子监测视为受欢迎的依从压力。
DOI：
10.1007/s10461-018-2200-8
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发表时间：
2018-10
影响因子：
4.4
通讯作者：
Haberer JE
中科院分区：
文献类型：
--
作者：
Campbell JI;Eyal N;Musiimenta A;Burns B;Natukunda S;Musinguzi N;Haberer JE
许多新技术监测患者和研究参与者的医疗依从性。有些人警告说，这些设备侵犯了个人自主权和道德。但他们会吗？这项定性研究探讨了乌干达的研究参与者如何看待他们坚持抗逆转录病毒治疗（ART）的电子监控的影响，他们的自由是不遵守和追求其他活动，监测可能会无意中暴露。2014年8月至2015年6月，我们采访了60名乌干达艾滋病毒感染者，并参加了乌干达艾滋病农村治疗结果（UARTO）研究，这是一项纵向观察性研究，涉及电子依从性监测器（EAM），以评估ART依从性。我们还采访了6名UARTO研究助理。直接和间接的内容分析被用来解释采访成绩单。我们发现，监测产生了一种坚持ART的压力感，一些参与者将其描述为“迫使”他们坚持。然而，即使是那些认为监测迫使他们服用药物的参与者，也认为使用EAM有助于他们实现高ART依从性的基本目标。总体而言，即使监督可能限制了参与者不遵守的实际自由，但参与者欢迎任何此类影响。没有一个与会者以环境资产管理办法会限制这种有效的自由为理由而拒绝这一办法。监测与服药无关的行为改变的报告很少。研究人员应该继续对行为健康监测影响自主性的方式保持警惕，但也应该认识到，即使是限制自主性的监测策略也可能使参与者实现自己的目标。
Many new technologies monitor patients’ and study participants’ medical adherence. Some have cautioned that these devices transgress personal autonomy and ethics. But do they? This qualitative study explored how Ugandan study participants perceive the effect of electronic monitoring of their adherence to antiretroviral therapy (ART) on their freedoms to be nonadherent and pursue other activities that monitoring may inadvertently expose. Between August 2014 – June 2015, we interviewed 60 Ugandans living with HIV and enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO) study, a longitudinal, observational study involving electronic adherence monitors (EAMs) to assess ART adherence. We also interviewed 6 UARTO research assistants. Both direct and indirect content analysis were used to interpret interview transcripts. We found that monitoring created a sense of pressure to adhere to ART, which some participants described as “forcing” them to adhere. However, even participants who felt that monitoring forced them to take medications perceived using the EAM as conducive to their fundamental goal of high ART adherence. Overall, even if monitoring may have limited participants’ effective freedom to be non-adherent, participants welcomed any such effect. No participant rejected the EAM on the grounds that it would limit that effective freedom. Reports that monitoring altered behaviors unrelated to pill-taking were rare. Researchers should continue to be vigilant about the ways in which behavioral health monitoring affects autonomy, but should also recognize that even autonomy-limiting monitoring strategies may enable participants to achieve their own goals.
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影响因子：
8.4
作者：
Atkins, Louise;Fallowfield, Lesley
通讯作者：
Fallowfield, Lesley
影响因子：
0.9
作者：
Behrens, K. G.
通讯作者：
Behrens, K. G.
DOI：
10.1080/09540129408258647
发表时间：
1994-01-01
影响因子：
1.7
作者：
CATALN, J;BRENER, N;GAZZARD, B
通讯作者：
GAZZARD, B
影响因子：
4.1
作者：
Holm, S
通讯作者：
Holm, S
影响因子：
--
作者：
Ho, Ming-Jung;Alkhal, Abdullatif;Konopasek, Lyuba
通讯作者：
Konopasek, Lyuba