Taking antiretroviral therapy for HIV infection - Learning from patients' stories
Taking antiretroviral therapy for HIV infection - Learning from patients' stories
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DOI：
10.1046/j.1525-1497.2000.90732.x
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发表时间：
2000-12-01
影响因子：
5.7
通讯作者：
Kerr, SM
中科院分区：
文献类型：
--
作者：
Laws, MB;Wilson, IB;Kerr, SM
目的：描述艾滋病毒感染者如何理解和体验坚持抗逆转录病毒药物治疗方案的问题。设计：我们进行了一项定性研究，基于对艾滋病毒感染患者的访谈，包括46名艾滋病服务机构的客户，根据年龄、种族和注射药物使用史进行抽样，以及15名患者的方便抽样。采访以英语或西班牙语进行，并有录音和文字记录。参与者：在52名接受抗逆转录病毒治疗的受访者中，随机选择25名进行深度分析。其中5人报告被诊断患有艾滋病，15人报告了他们认为是艾滋病毒引起的症状，5人报告没有艾滋病毒疾病的症状。测量和主要结果：研究者准备了结构化的访谈摘要，以提取与依从性相关的数据。一名研究者将摘要与原始文本进行比较，以确认解释，并使用摘要对发现进行组织和分类。大多数受试者（84%）报告了最近的不依从行为，包括停止治疗，药物“假期”，在给药期间睡觉，忘记给药，因副作用而跳过给药，以及遵循高度不对称的时间表。最初，大多数人报告说他们没有明显的不坚持，许多人并不认为他们的行为是不坚持的。只有少数人清楚地知道缺少剂量可能造成的后果。大多数人说，他们没有和医生讨论过自己的不遵医嘱。结论：许多人认为自己容易达到的坚持治疗标准是合适的，从而为自己难以坚持艾滋病毒治疗找借口。医生应详细询问与依从性相关的行为，并确保患者了解不符合适当标准的后果。
OBJECTIVE: To describe how people with HIV understand and experience the problem of adhering to antiretroviral medication regimens.DESIGN: We performed a qualitative study based on interviews with HIV-infected patients, including 46 clients of AIDS service organizations, who were sampled according to age, ethnicity, and injection drug use history, and a convenience sample of 15 patients. Interviews were conducted in English or Spanish and were audiotaped and transcribed.PARTICIPANTS: Of 52 respondents who had prescriptions for antiretroviral therapy, 25 were randomly selected for indepth analysis. Of these, 5 reported having an AIDS diagnosis, 15 reported symptoms they attributed to HIV, and 5 reported having no symptoms of HIV disease.MEASUREMENTS AND MAIN RESULTS: Investigators prepared structured abstracts of interviews to extract adherence-related data. One investigator compared the abstracts with the original transcripts to confirm the interpretations, and used the abstracts to organize and classify the findings. Most subjects (84%) reported recent nonadherent behavior, including ceasing treatment, medication "holidays." sleeping through doses, forgetting doses, skipping doses due to side effects, and following highly asymmetric schedules. Initially, most reported that they were not significantly nonadherent, and many did not consider their behavior nonadherent. Only a minority clearly understood the possible consequences of missing doses. Most said they had not discussed their nonadherence with their physicians.CONCLUSIONS: Many people rationalize their difficulty in adhering to HIV treatment by deciding that the standard of adherence they can readily achieve is appropriate. Physicians should inquire about adherence-related behavior hn specific detail, and ensure that patients understand the consequences of not meeting an appropriate standard.