Patient-clinician relationships and treatment system effects on HIV medication adherence
Patient-clinician relationships and treatment system effects on HIV medication adherence
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DOI：
10.1007/s10461-005-1684-1
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发表时间：
2005-03-01
影响因子：
4.4
通讯作者：
Heckman, CJ
中科院分区：
文献类型：
--
作者：
Ingersoll, KS;Heckman, CJ
研究的目的是确定患者-临床医生关系对患者依从性的影响，以确定患者-临床医生关系和治疗系统的哪些方面影响依从性，并确定这些变量中的哪些变量在考虑精神困扰和药物滥用的影响时仍然重要。该设计是一项横断面研究，使用120例HIV+门诊患者的样本。初级保健评估调查（PCAS）评估了临床医生-患者关系和治疗系统。综合国际诊断量表-简表（CIDI-SF）筛查精神障碍，简要物质滥用史表测量最近和遥远的物质使用。使用5个标记评估患者依从性，包括3个访谈引发的自我报告，1个病历审查和1个汇总评分。Logistic回归分析确定了每种坚持行为的独立预测因素。PCAS分数有助于所有五个模型，当考虑精神痛苦和药物滥用时，它们的影响仍然存在。依从性行为可以由多种因素解释，应该使用多种方法进行评估。进一步研究阐明临床医生-患者关系对艾滋病毒药物依从性的作用机制是必要的。
The study objectives were to determine the impact of the patient - clinician relationship on patient adherence to HIV medication, to identify which aspects of the patient - clinician relationship and the treatment system influenced adherence, and to determine which of these variables remained important when the impact of mental distress and substance abuse were considered. The design was a cross-sectional study using a sample of 120 HIV+ clinic patients. The Primary Care Assessment Survey (PCAS) assessed the clinician - patient relationship and the treatment system. The Composite International Diagnostic Inventory - Short Form (CIDI-SF) screened for mental disorders, and the Brief Substance Abuse History Form measured recent and remote substance use. Patient adherence was assessed using five markers including 3 interview-elicited self-reports, 1 medical chart review, and 1 summary score. Logistic regression analyses identified independent predictors of each adherence behavior. PCAS scores contributed to all five models, and their effects persisted when mental distress and substance abuse were considered. Adherence behaviors are explained by a variety of factors and should be assessed using multiple methods. Further study to illuminate the mechanisms of action of the clinician - patient relationship on adherence to HIV medication is warranted.