Social support, stigma, and the mediating roles of depression on self-reported medication adherence of HAART recipients in China
Social support, stigma, and the mediating roles of depression on self-reported medication adherence of HAART recipients in China
复制标题
社会支持、耻辱以及抑郁症对中国HAART接受者自我报告药物依从性的中介作用
DOI：
10.1080/09540121.2019.1587360
复制
发表时间：
2019-03-06
影响因子：
1.7
通讯作者：
Wang, Ying
中科院分区：
文献类型：
--
作者：
Jiang, Man;Yang, Jiezhe;Wang, Ying
摘要 对艾滋病病毒感染者/艾滋病患者（PLWHA）的歧视是中国长期存在的问题，影响着他们的心理健康。然而，心理因素与高效抗逆转录病毒治疗（HAART）依从性之间的关联此前尚未得到系统研究。因此，本研究基于 Cha 等人的模型，探讨了社会支持、抑郁和服药自我效能对 PLWHA 中 ART 依从性的影响，并在原始模型中加入了“耻辱”来解释其心理机制。在接受HAART的504名参与者中，37.8%患有轻度至重度抑郁症。根据结构方程模型，社会支持与抑郁、耻辱和依从性直接相关。抑郁部分介导了社会支持和依从自我效能之间的正相关以及耻辱和自我效能之间的负相关。修改和扩展的 Cha 等人的模型具有令人满意的拟合效果。需要通过心理健康服务、社会支持和增强坚持自我效能信念来改善心理健康。
ABSTRACT Discrimination of people living with HIV/AIDS (PLWHA) is a persistent issue in China, which affects their psychological health. However, the association between psychological factors and adherence to highly active antiretroviral therapy (HAART) has not been systematically investigated before. Therefore, this study examined the impact of social support, depression, and medication-taking self-efficacy on ART adherence among PLWHA based on Cha et al.’s model, and included “stigma” to the original model to explain the psychological mechanism. Of the 504 participants receiving HAART, 37.8% had mild-to-severe depression. According to structural equation modeling, social support was directly associated with depression, stigma, and adherence; depression partially mediated the positive relationship between social support and adherence self-efficacy and the negative association between stigma and self-efficacy. The modified and extended Cha et al.’s model had a satisfactory fit. Interventions to improve mental health through mental health services, social support, and enhancement of adherence self-efficacy beliefs are required.