From adolescence through young adulthood: Psychosocial adjustment associated with long-term survival of HIV
From adolescence through young adulthood: Psychosocial adjustment associated with long-term survival of HIV
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DOI：
10.1016/s1054-139x(01)00341-x
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发表时间：
2002-03-01
影响因子：
7.6
通讯作者：
Wiener, LS
中科院分区：
文献类型：
--
作者：
Battles, HB;Wiener, LS
目的：探讨影响儿童人类免疫缺陷病毒（HIV）感染长期生存的社会心理因素。方法：采用儿童行为量表、儿童社会支持量表、儿童青少年自我认知量表和研究者设计的结构化访谈，对在美国国家癌症研究所参加临床试验的艾滋病毒感染儿童及其照顾者进行3次访谈并完成自我报告测量，间隔约12个月。从患者病历中提取历史数据。参与者在时间1和时间2时的平均年龄分别为11.8岁和14岁；56.3%的原始样本为男性，种族构成为白人72.2%，非裔美国人13.9%，西班牙裔6.9%，其他6.9%；38.9%的参与者在围产期感染艾滋病毒，34.7%通过血友病相关输血，26.4%通过其他类型的输血。结果：皮尔逊积矩相关性显示，披露被发现与社会支持、自我能力和减少问题行为呈正相关，但在公开披露的情况下，独立样本学生t检验显示，它与整体自我能力呈负相关。社会支持与问题行为呈显著负相关。5年随访数据的卡方分析表明，18岁及以上的参与者完成学业的可能性低于健康同龄人（国家标准）。失去父母的青少年更有可能在一生中患上抑郁症。结论：社会支持和关于诊断的公开交流是必不可少的，特别是在青少年发展和个性化的重点是决定关系、性活动、药物使用和未来计划的年龄。随着医疗的进步，感染艾滋病毒的儿童更有可能活到青春期甚至更久。因此，他们的社会心理需求正在发生变化，更接近于慢性病患者的需求，而不是绝症患者的需求。感染艾滋病毒儿童的家庭应认真考虑为独立生活做准备。
Purpose: To examine the psychosocial factors associated with long-term survival of pediatric human immunodeficiency virus (HIV) infection.Methods: Children infected with HIV enrolled in clinical trials at the National Cancer Institute and their caregivers were interviewed and completed self-report measures 3 times, approximately 12 months apart, using the Child Behavior Checklist, Social Support Scale for Children, Self-Perception Profile for Children and Adolescents, and a structured interview designed by the investigators. Historical data were also extracted from patient medical charts. Average age of participants was 11.8 years at time 1 and 14 years at time 2; 56.3% of the original sample were male, racial composition was 72.2% white, 13.9% African-American, 6.9% Hispanic, and 6.9% "other"; 38.9% of participants contracted HIV perinatally, 34.7% through a hemophilia-related transfusion, and 26.4% through another type of transfusion.Results: Pearson product-moment correlations revealed that disclosure was found to be positively related to social support, self-competence, and decreased problem behavior, except in the case of public disclosure, in which an independent-sample Student's t-test revealed that it was negatively associated with global self-competence. Social support was significantly negatively correlated with problem behavior. Chi-square analyses of the 5-year follow-up data indicated that participants aged 18 years and older were less likely to complete their academic education than their healthy peers (national norms). Adolescents who lost a parent were more likely to have suffered from depression during their lifetime.Conclusions: Social support and open communication about the diagnosis are essential, particularly at an age at which decisions about relationships, sexual activity, drug use, and plans for the future are the focus of adolescent development and individuation. With advances in medical treatment, HIV-infected children are more likely to survive into adolescence and beyond. Accordingly, their psychosocial needs are changing to more closely resemble the needs of the chronically ill individual, rather than the terminally ill. Families of HIV-infected children should seriously consider preparation for independent living.