Family experiences with pediatric antiretroviral therapy: Responsibilities, barriers, and strategies for remembering medications
Family experiences with pediatric antiretroviral therapy: Responsibilities, barriers, and strategies for remembering medications
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DOI：
10.1089/apc.2007.0110
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发表时间：
2008-08-01
影响因子：
4.9
通讯作者：
Abrams, Elaine J.
中科院分区：
文献类型：
--
作者：
Marhefka, Stephanie L.;Koenig, Linda J.;Abrams, Elaine J.
本研究探讨了儿童艾滋病毒治疗方案的依从性与三个家庭经历因素之间的关系：(1) 治疗方案责任； (2) 遵守障碍； (3) 记住服药的策略。 PACTS-HOPE 多中心研究中采访了 127 名 2-15 岁儿童的看护者。 76% 的护理人员报告说，他们的孩子遵守规定（在过去 6 个月内服用了≥90% 的处方剂量）。大多数护理人员表示对药物相关活动承担主要责任（所有活动中 72%-95%）；主要负责打电话获取补充品的看护者 (95%) 更有可能有听从的孩子。超过一半的护理人员表示遇到一种或多种依从性障碍（59%）。那些表示存在更多障碍的看护者也更有可能表示自己的孩子不听话。与不遵守规定相关的个人障碍包括遗忘、日常生活改变、太忙和孩子拒绝。大多数人报告使用一种或多种记忆策略（86%）。策略的使用与依从性无关。使用更多的策略与报告遗忘是障碍的可能性更大相关。对于一些存在与依从性相关的组织或动机困难的家庭，使用多种记忆策略可能不足以掌握依从性。可能需要更强化的干预措施，例如家庭护士给药。
This study examines the relationship between adherence to pediatric HIV regimens and three family experience factors: (1) regimen responsibility; (2) barriers to adherence; and (3) strategies for remembering to give medications. Caregivers of 127 children ages 2-15 years in the PACTS-HOPE multisite study were interviewed. Seventy-six percent of caregivers reported that their children were adherent (taking >= 90% of prescribed doses within the prior 6 months). Most caregivers reported taking primary responsibility for medication-related activities (72%-95% across activities); caregivers with primary responsibility for calling to obtain refills (95%) were more likely to have adherent children. More than half of caregivers reported experiencing one or more adherence barriers (59%). Caregivers who reported more barriers were also more likely to report having non-adherent children. Individual barriers associated with nonadherence included forgetting, changes in routine, being too busy, and child refusal. Most reported using one or more memory strategies (86%). Strategy use was not associated with adherence. Using more strategies was associated with a greater likelihood of reporting that forgetting was a barrier. For some families with adherence-related organizational or motivational difficulties, using numerous memory strategies may be insufficient for mastering adherence. More intensive interventions, such as home-based nurse-administered dosing, may be necessary.