The association between life chaos, health care use, and health status among HIV-Infected persons
The association between life chaos, health care use, and health status among HIV-Infected persons
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DOI：
10.1007/s11606-007-0265-6
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发表时间：
2007-09-01
影响因子：
5.7
通讯作者：
Cunningham, William E.
中科院分区：
文献类型：
--
作者：
Wong, Mitchell D.;Sarkisian, Catherine A.;Cunningham, William E.
背景：稳定且可预测的生活方式是否与艾滋病毒患者的医疗保健使用和健康状况相关尚不清楚。目的：开发和测试衡量成人艾滋病毒感染者生活混乱程度的可靠性和有效性，并检查其与医疗保健使用和健康状况的关系。设计：前瞻性队列研究。参与者：从流动检测车中检测呈阳性的人和为低收入人群服务的艾滋病毒诊所招募的 220 名艾滋病毒感染者。测量：参与者每 6 个月完成一次调查，评估他们的医疗保健使用情况、SF-12 精神和身体健康状况以及生活混乱情况。结果：六项混乱衡量标准的 Cronbach's alpha 为 0.67。那些没有配偶或伴侣的人以及那些有一项或多项社会服务需求（例如住房或交通）未得到满足的人的混乱得分较高。与那些混乱程度较低的人相比，混乱程度较高的人在研究入组前 6 个月内不太可能有两次或两次以上门诊就诊（调整后比值比 [OR] 0.48，95% 置信区间 [CI]：0.24-0.98），更有可能出现两次或两次以上错过就诊（调整后 OR 2.30，95%CI：1.20-4.41），并且在入组和随访时心理健康状况较低。生活混乱与急诊就诊或身体健康状况无关。结论：我们创建了一种新的生活混乱衡量标准，它与门诊就诊和心理健康状况相关。混乱可能是常规医疗护理的重要障碍。未来的研究需要在更多样化的人群和患有其他疾病的人群中测试这一指标。
Background: Whether having a stable and predictable lifestyle is associated with health care use and health status among HIV patients is unknown.Objective: To develop and test the reliability and validity of a measure of life chaos for adults with HIV and examine its association with health care use and health status.Design: Prospective cohort study.Participants: Two hundred twenty HIV-infected persons recruited from those who tested positive in a mobile testing van and from HIV clinics serving low-income populations.Measurements: Participants completed a survey every 6 months, assessing their health care use, SF-12 mental and physical health status and life chaos.Results: Cronbach's alpha for the six-item measure of chaos was .67. Those without a spouse or partner and those with one or more unmet social service needs, such as housing or transportation, had higher chaos scores. Compared to those with less chaos, those with more chaos were less likely to have two or more outpatient visits (adjusted odds ratio [OR] 0.48, 95% confidence interval [CI]: 0.24-0.98), more likely to have two or more missed visits (adjusted OR 2.30, 95%CI: 1.20-4.41) in the 6 months before study enrollment and had lower mental health status at enrollment and at follow-up. Life chaos was not associated with emergency department visits or physical health status.Conclusions: We created a new measure of life chaos, which was associated with outpatient visits and mental health status. Chaos may be an important barrier to regular medical care. Future studies need to test this measure in more diverse populations and those with other diseases.