Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda.
Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda.
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DOI：
10.1371/journal.pone.0147896
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Seeley J
中科院分区：
文献类型：
--
作者：
Russell S;Martin F;Zalwango F;Namukwaya S;Nalugya R;Muhumuza R;Katongole J;Seeley J
艾滋病毒感染者的健康和抗逆转录病毒治疗方案的持续成功取决于艾滋病毒感染者长期自我管理病情的动机和能力，包括每天坚持服药。艾滋病毒感染者的自我管理和他们的福祉可能是相互关联的。成功的自我管理可以维持幸福感，而幸福感很可能会激发持续的自我管理。在资源有限的情况下，缺乏对艾滋病病毒携带者在抗逆转录病毒治疗方面的自我管理过程的详细研究。本文介绍了一项研究的结果，PLWH的自我管理和福祉在Wakiso区，乌干达。在恩德培及其周边地区由政府和艾滋病支助组织经营的抗逆转录病毒治疗设施中，有目的地挑选了38名艾滋病毒感染者（20名妇女，18名男子）。在三到四次访问中，对每个参与者进行了两次深入访谈。许多人在经济上苦苦挣扎，然而，健康的恢复和对抗逆转录病毒疗法的希望增强了福祉，并激励了自我管理。大多数人在自我管理的三个广泛领域都能很好地管理自己的病情。首先，他们调动了资源，特别是通过与卫生工作者的良好关系。咨询和辅导帮助他们更积极地重新认识自己的状况和处境，看到未来的希望，激励他们自我管理。许多人还通过他们在ART诊所建立的联系人建立了新的支持网络。第二，他们获得了管理其健康的知识和技能，这是管理其状况和生活的有用框架。第三，参与者在心理上适应了自己的状况和新的“自我”：他们将艾滋病毒视为一种正常的疾病，正在应对耻辱，重新获得自尊，并找到了生活的意义。我们的研究表明，社会关系和其他非医疗方面的自我管理，ART计划可能会进一步探索和鼓励的福祉的中心。
The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH’s motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH’s self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH’s self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH’s self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new ‘self’: they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management which ART programmes might explore further and encourage.