Becoming a " treatment success": What helps and what hinders patients from achieving and sustaining undetectable viral loads
Becoming a " treatment success": What helps and what hinders patients from achieving and sustaining undetectable viral loads
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DOI：
10.1089/apc.2006.20.326
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发表时间：
2006-05-01
影响因子：
4.9
通讯作者：
Montaner, JSG
中科院分区：
文献类型：
--
作者：
Alfonso, V;Geller, J;Montaner, JSG
高活性抗逆转录病毒治疗（HAART）依从性研究主要集中在临床结果不佳的个体上;因此，对维持不可检测病毒载量的个体的经历知之甚少。本研究使用定性方法来探索持续检测不到病毒载量的个体如何解释他们的成功，并确定持续成功的挑战以及可能的需求。参与者是在一个城市中心的门诊传染病诊所的20名患者。参与者完成了两个60分钟的采访。关键事件技术用于识别和分类与持续治疗成功相关的关键事件。在收集的438起重大事件中，316起被确定为有帮助，122起被确定为没有帮助。有用的类别包括解决矛盾心理，利用个人优势，培养有益的关系。无益的类别是情绪，缺乏社会支持，经济困难和药物因素。做好抗逆转录病毒治疗是一个动态的过程，需要患者和护理提供者的持续关注。这项研究的结果突出了患者为保持健康所做的努力，并提醒护理提供者不要认为患者没有面临持续的挑战。本研究的结果表明，心理社会因素确实有助于改善HAART患者的临床结局。
Highly active antiretroviral therapy (HAART) adherence research has focused predominantly on individuals with less than optimal clinical outcomes; therefore, little is known about the experiences of individuals who sustain undetectable viral loads. The present study used a qualitative method to explore how individuals who have sustained undetectable viral loads account for their success, and to identify challenges, as well as possible needs, for continued success. Participants were 20 patients at an outpatient infectious disease clinic in an urban center. Participants completed two 60-minute interviews. The Critical Incident Technique was used to identify and classify critical incidents linked with sustaining treatment success. Of the 438 critical incidents collected, 316 were identified as helpful and 122 were identified as unhelpful. Helpful categories included resolving ambivalence, using personal strengths, and fostering helpful relationships. Unhelpful categories were mood, lack of social support, financial difficulties, and medication factors. Doing well on antiretroviral therapy is a dynamic process that requires ongoing attention from both the patient and care provider. The results of this study highlight the efforts of patients to maintain their health and remind care providers not to assume that patients are not facing continuous challenges. Findings from the present study suggest that psychosocial factors do contribute to improved clinical outcomes in patients taking HAART.