A randomized trial of a nursing intervention for HIV disease management among persons with serious mental illness.
A randomized trial of a nursing intervention for HIV disease management among persons with serious mental illness.
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DOI：
10.1176/ps.62.11.pss6211_1318
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发表时间：
2011-11
期刊：
影响因子：
--
通讯作者：
Aiken LH
中科院分区：
文献类型：
--
作者：
Blank MB;Hanrahan NP;Fishbein M;Wu ES;Tennille JA;Ten Have TR;Kutney-Lee AM;Gross R;Hines JM;Coyne JC;Aiken LH
患有严重精神疾病的人感染和传播艾滋病毒的风险增加，被认为是一个公共卫生问题。艾滋病毒感染者和精神疾病患者可能面临治疗依从性差、产生耐药病毒和更差结果的风险。本研究的目的是测试的有效性，以社区为基础的高级实践护士（APN）的干预（PATH，通过健康预防艾滋病），以促进坚持艾滋病毒和精神病治疗方案。从2004年至2008年从社区艾滋病提供机构招募了社区居住的艾滋病毒阳性参与者，共发生严重精神疾病（N=238），参加随机对照试验。干预组（N=128）的参与者被分配给APN，APN每周至少提供一次社区护理管理，并协调客户的医疗和心理健康护理一年。在基线和12个月时评价病毒载量和CD 4细胞计数。连续对数病毒载量的纵向模型显示，与对照组相比，干预组在12个月时表现出明显更大的对数病毒载量下降（d=-0.361 log 10拷贝/毫升，p<0.001）。CD 4计数从基线至12个月的差异无统计学显著性。该项目证明了基于社区的APN在提供量身定制的干预措施以改善艾滋病毒感染者和并发严重精神疾病的个人的结果方面的有效性。患有这些并发症的人可以成功治疗;通过适当的支持服务，可以降低他们的病毒载量。
The heightened risk of persons with serious mental illness to contract and transmit HIV is recognized as a public health problem. Persons with HIV and mental illness may be at risk for poor treatment adherence, development of treatment-resistant virus, and worse outcomes. The objective of this study was to test the effectiveness of a community-based advanced practice nurse (APN) intervention (PATH, Preventing AIDS Through Health) to promote adherence to HIV and psychiatric treatment regimens. Community-dwelling HIV-positive participants with co-occurring serious mental illnesses (N=238) were recruited from community HIV provider agencies from 2004 to 2008 to participate in the randomized controlled trial. Participants in the intervention group (N=128) were assigned an APN who provided community-based care management at a minimum of one visit per week and coordinated clients’ medical and mental health care for one year. Viral load and CD4 cell count were evaluated at baseline and 12 months. Longitudinal models for continuous log viral load showed that compared with the control group, the intervention group exhibited a significantly greater reduction in log viral load at 12 months (d=−.361 log 10 copies per milliliter, p<.001). Differences in CD4 counts from baseline to 12 months were not statistically significant. This project demonstrated the effectiveness of community-based APNs in delivering a tailored intervention to improve outcomes of individuals with HIV and co-occurring serious mental illnesses. Persons with these co-occurring conditions can be successfully treated; with appropriate supportive services, their viral loads can be reduced.
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DOI：
10.1097/qai.0b013e3181605b26
发表时间：
2008-03-01
影响因子：
3.6
作者：
Walkup, James;Blank, Michael B.;Schumacher, Joseph E.
通讯作者：
Schumacher, Joseph E.
DOI：
10.1080/09540120050123783
发表时间：
2000-08-01
影响因子：
1.7
作者：
Gao, X;Nau, DP;Woodward, C
通讯作者：
Woodward, C
影响因子：
5.7
作者：
Brady, KA;Berry, S;Turner, BJ
通讯作者：
Turner, BJ
DOI：
10.1016/s1055-3290(06)60420-2
发表时间：
2000-01-01
期刊：
The Journal of the Association of Nurses in AIDS Care : JANAC
影响因子：
--
作者：
Holzemer, W L;Henry, S B;Miramontes, H
通讯作者：
Miramontes, H
影响因子：
3.8
作者：
Rothbard, Aileen B.;Blank, Michael B.;Eachus, Susan
通讯作者：
Eachus, Susan