Explanatory Models and Illness Experience of People Living with HIV.
Explanatory Models and Illness Experience of People Living with HIV.
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DOI：
10.1007/s10461-016-1358-1
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发表时间：
2016-09
影响因子：
4.4
通讯作者：
Laws, M. Barton
中科院分区：
文献类型：
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作者：
Laws, M. Barton
对疾病和疾病的解释模型的研究通常探索人们的概念理解，并强调患者和提供者模型之间的差异。然而，病因学、症状发作的时间和模式、病理生理学、病程和治疗的解释模型框架是建立在生物医学理解的类别特征之上的。目前还不清楚这些映射到人们的生活经验的疾病，以及他们做的程度，他们如何翻译。学者们以前曾通过污名和身份理论的视角研究过艾滋病毒感染者的经历。在这里，通过对美国东北部32名艾滋病毒感染者进行深入的定性访谈，我们使用解释性模型框架更广泛地探索了艾滋病毒感染者的经验和意义。我们发现，身份改造是一个重大的挑战，大多数人的艾滋病毒诊断后，可以理解为一个核心组成部分的概念，疾病的过程。突出的病因学解释不是生物学的，而是社会的，如背叛，或生活在一个特定的文化环境，往往自我评价。鉴于现在通过坚持治疗可以在很大程度上避免症状，因此最常见的描述是观察未坚持治疗的其他人，或治疗后症状的消退。病理生理学这一类别通常与患病经历关系不大，因为很少有受访者了解艾滋病毒的发病机制，对此也没有多大兴趣。治疗有各种个人意义，既有积极的，也有消极的，往往意义深远。要使人们成功地接受治疗并成功地与艾滋病毒一起生活，机械解释意义不大。相反，健康促进行为的积极心理整合至关重要。
Research into explanatory models of disease and illness typically explores people’s conceptual understanding, and emphasizes differences between patient and provider models. However, the explanatory models framework of etiology, time and mode of onset of symptoms, pathophysiology, course of sickness, and treatment is built on categories characteristic of biomedical understanding. It is unclear how well these map onto people’s lived experience of illness, and to the extent they do, how they translate. Scholars have previously studied the experience of people living with HIV through the lenses of stigma and identity theory. Here, through in-depth qualitative interviews with 32 people living with HIV in the northeast United States, we explored the experience and meanings of living with HIV more broadly using the explanatory models framework. We found that identity reformation is a major challenge for most people following the HIV diagnosis, and can be understood as a central component of the concept of course of illness. Salient etiological explanations are not biological, but rather social, such as betrayal, or living in a specific cultural milieu, and often self-evaluative. Given that symptoms can now largely be avoided through adherence to treatment, they are most frequently described in terms of observation of others who have not been adherent, or the resolution of symptoms following treatment. The category of pathophysiology is not ordinarily very relevant to the illness experience, as few respondents have any understanding of the mechanism of pathogenesis in HIV, nor much interest in it. Treatment has various personal meanings, both positive and negative, often profound. For people to engage successfully in treatment and live successfully with HIV, mechanistic explanation is of little significance. Rather, positive psychological integration of health promoting behaviors is of central importance.
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影响因子：
4.4
作者：
Laws MB;Danielewicz M;Rana A;Kogelman L;Wilson IB
通讯作者：
Wilson IB
影响因子：
3.2
作者：
Baumgartner, Lisa M.
通讯作者：
Baumgartner, Lisa M.
影响因子：
5.7
作者：
Laws, MB;Wilson, IB;Kerr, SM
通讯作者：
Kerr, SM
影响因子：
158.5
作者：
MECHANIC, D
通讯作者：
MECHANIC, D
影响因子：
39.2
作者：
通讯作者：
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