Sorting Through the Lost and Found: Are Patient Perceptions of Engagement in Care Consistent With Standard Continuum of Care Measures?
Sorting Through the Lost and Found: Are Patient Perceptions of Engagement in Care Consistent With Standard Continuum of Care Measures?
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DOI：
10.1097/qai.0000000000000575
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发表时间：
2015-05-01
影响因子：
3.6
通讯作者：
Greenberg, Alan
中科院分区：
文献类型：
--
作者：
Castel, Amanda D.;Tang, Wenze;Greenberg, Alan
背景资料：用于确定一个人在艾滋病毒护理连续体中的地位的指标往往是使用临床和监测数据来衡量的，但通常不评估病人的观点。我们评估了病人报告的护理状态沿着的护理连续性，以及它是否不同于医疗记录和监测data.Methods：2013年6月至2014年10月，方便的样本，临床就诊的艾滋病毒感染者进行了调查，关于寻求护理的行为和自我感知的状态沿着的护理连续性。参与者的反应与DC卫生部的监测数据和诊所记录相匹配。使用卫生资源服务管理局定义的护理状态对参与者的护理模式进行分类：护理（IC），零星护理（SC）或护理（OOC）。半结构化的定性访谈进行了分析，使用一个开放的编码过程，以阐明有关主题参与者的看法，在护理。结果：169名参与者中，大多数是男性参与者（64%）和黑人（72%），平均年龄为50.7岁。使用自我报告的访视模式，115名参与者（68%）符合IC，33名（20%）SC和21名（12%）OOC。在OOC参与者中，52%的人认为自己完全参与了艾滋病毒护理。去年，在OOC参与者中，71%的人报告有非艾滋病毒相关的医疗访问，90%的人报告目前使用抗逆转录病毒药物。定性，大多数SC和OOC的人没有看到他们的艾滋病毒提供者定期，因为他们觉得health.Conclusions：参与者的艾滋病毒护理参与的看法不同，从实际的护理接收监测和临床记录。护理参与措施可能需要重新考虑，因为没有定期接受艾滋病毒护理的人可能在其他地方获得其他保健和艾滋病毒药物。
Background: Indicators for determining one's status on the HIV care continuum are often measured using clinical and surveillance data but do not typically assess patient perspectives. We assessed patient-reported care status along the care continuum and whether it differed from medical records and surveillance data.Methods: Between June 2013 and October 2014, a convenience sample of clinic-attending HIV-infected persons was surveyed regarding care-seeking behaviors and self-perceived status along the care continuum. Participant responses were matched to DC Department of Health surveillance data and clinic records. Participants' care patterns were classified using Health Resources Services Administration-defined care status: in care (IC), sporadic care (SC), or out of care (OOC). Semistructured qualitative interviews were analyzed using an open coding process to elucidate relevant themes regarding participants' perceptions of engagement in care.Results: Of 169 participants, most were male participants (64%) and black (72%), with a mean age of 50.7 years. Using self-reported visit patterns, 115 participants (68%) were consistent with being IC, 33 (20%) SC, and 21 (12%) OOC. Among OOC participants, 52% perceived themselves to be fully engaged in HIV care. In the previous year, among OOC participants, 71% reported having a non-HIV-related medical visit and 90% reported current antiretroviral use. Qualitatively, most SC and OOC persons did not see their HIV providers regularly because they felt healthy.Conclusions: Participants' perceptions of HIV care engagement differed from actual care receipt as measured by surveillance and clinical records. Measures of care engagement may need to be reconsidered as persons not receiving regular HIV care maybe accessing other health care and HIV medications elsewhere.