"High blood pressure comes from thinking too much": Understandings of illness among couples living with cardiometabolic disorders and HIV in Malawi.
"High blood pressure comes from thinking too much": Understandings of illness among couples living with cardiometabolic disorders and HIV in Malawi.
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DOI：
10.1371/journal.pone.0296473
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
高血压和糖尿病等心脏代谢疾病 (CMD) 在撒哈拉以南非洲地区日益普遍，使艾滋病毒感染者面临心血管疾病的风险，并威胁到艾滋病毒治疗的成功。配偶通常是 CMD 患者的主要照顾者，了解患者和伴侣对 CMD 的看法可以为护理提供信息。我们对 25 对夫妇进行了半结构化访谈，他们的伴侣患有艾滋病毒且患有高血压或糖尿病。从马拉维的艾滋病毒诊所招募了一些夫妇，并接受了采访，询问他们对 CMD 的症状、因果关系、预防和治疗的看法。使用框架分析和克莱曼解释模型理论作为透镜，在个体和二元层面上对数据进行分析。参与者平均年龄 51 岁，结婚 21 年。大约 57%、14% 和 80% 患有高血压、糖尿病和艾滋病毒。夫妇们认可生物医学解释模型（关于身心健康的信念）和传统解释模型（关于宗教和自然疗法的信念）的结合，尽管倾向于强调生物医学模型。一半的夫妇认为压力是高血压的主要原因。对于糖尿病，饮食被认为是一个常见原因。在预防方面，最常提到的是饮食改变和身体活动。对于疾病管理，强调药物依从性和饮食调整，一些夫妇还支持草药疗法、减轻压力和信仰上帝作为策略。参与者普遍更关心 CMD 而不是 HIV，因为 CMD 药物的获取渠道较差，并且相信 CMD 可能导致猝死。在夫妻中，伴侣往往持有许多相同的信念，但在哪些病因或预防因素最重要（例如，压力与饮食）以及 CMD 的最佳饮食方面存在分歧。健康教育计划应让主要合作伙伴参与建立 CMD 知识并解决与 HIV 的重叠问题，并加强有关预防和治疗 CMD 的生活方式因素的准确信息。
Cardiometabolic disorders (CMD) such as hypertension and diabetes are increasingly prevalent in sub-Saharan Africa, placing people living with HIV at risk for cardiovascular disease and threatening the success of HIV care. Spouses are often the primary caregivers for people living with CMD, and understanding patients’ and partners’ conceptions of CMD could inform care. We conducted semi-structured interviews with 25 couples having a partner living with HIV and either hypertension or diabetes. Couples were recruited from HIV clinics in Malawi and were interviewed on beliefs around symptoms, causation, prevention, and treatment for CMD. Data were analyzed at the individual and dyadic levels using framework analysis and Kleinman’s theory of explanatory models as a lens. On average, participants were 51 years old and married for 21 years. Approximately 57%, 14%, and 80% had hypertension, diabetes, and HIV. Couples endorsed a combination of biomedical explanatory models (beliefs around physical and mental health) and traditional explanatory models (beliefs around religion and natural remedies), although tended to emphasize the biomedical model. Half of couples believed stress was the main cause of hypertension. For diabetes, diet was believed to be a common cause. In terms of prevention, dietary changes and physical activity were most frequently mentioned. For disease management, medication adherence and diet modifications were emphasized, with some couples also supporting herbal remedies, stress reduction, and faith in God as strategies. Participants were generally more concerned about CMD than HIV due to poor access to CMD medications and beliefs that CMD could lead to sudden death. Within couples, partners often held many of the same beliefs but diverged around which etiological or preventive factors were most important (e.g., stress versus diet) and the best diet for CMD. Health education programs should involve primary partners to build knowledge of CMD and address overlap with HIV, and reinforce accurate information on lifestyle factors for the prevention and treatment of CMD.
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影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
婚姻不忠，粮食不安全和情侣不稳定：抗逆转录病毒疗法周围二元协调的挑战网络。
DOI：
10.1016/j.socscimed.2018.08.006
发表时间：
2018-10
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Conroy AA;McKenna SA;Comfort ML;Darbes LA;Tan JY;Mkandawire J
通讯作者：
Mkandawire J
影响因子：
1.7
作者：
Stonbraker S;Sanabria G;Cunto-Amesty S;Alcántara C;Abraído-Lanza AF;Rowell-Cunsolo T;Halpern M;Bakken S;Schnall R;George M
通讯作者：
George M
成年马拉维人在艾滋病毒护理中的高血压，糖尿病和心血管危险因素的负担：综合服务的后果。
影响因子：
4.5
作者：
Divala OH;Amberbir A;Ismail Z;Beyene T;Garone D;Pfaff C;Singano V;Akello H;Joshua M;Nyirenda MJ;Matengeni A;Berman J;Mallewa J;Chinomba GS;Kayange N;Allain TJ;Chan AK;Sodhi SK;van Oosterhout JJ
通讯作者：
van Oosterhout JJ
影响因子：
4.5
作者：
通讯作者：
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