Patients' Adherence to Anti-Retroviral Therapy in Botswana
Patients' Adherence to Anti-Retroviral Therapy in Botswana
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DOI：
10.1111/j.1547-5069.2009.01266.x
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发表时间：
2009-01-01
影响因子：
3.4
通讯作者：
van der Wal, Dirk M.
中科院分区：
文献类型：
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作者：
Kip, Esther;Ehlers, Valerie J.;van der Wal, Dirk M.
目的：确定影响博茨瓦纳四家诊所患者抗逆转录病毒治疗 (ART) 依从性的因素。设计：定量描述。对 2007 年 4 月和 5 月期间在博茨瓦纳随机选择的 4 家 ART 诊所就诊的所有患者中随机抽取 400 名患者进行结构化访谈。方法：使用 SPSS 13 版对数据进行分析。卡方和 p 值计算用于测试类别或变量之间关系的显着性。结果：以患者为中心的 ART 依从性障碍包括对 ART、人类免疫缺陷病毒 (HIV) 的了解不足、获得的知识不足。免疫缺陷综合症 (AIDS)、CD4 细胞和病毒载量结果、耻辱、旅行费用、诊所等待时间、ART 的副作用、传统（本土或民间）药物的使用以及酗酒。以服务为中心的障碍包括护士的态度和知识、卫生工作者无法进行家访和联系违约者、有限的门诊时间、延迟获得 CD4 和病毒载量结果。结论：坚持 ART 需要的不仅仅是免费 ART。如果以患者为中心和以服务为中心的障碍都得到解决，依从性水平将会提高。临床相关性：护士在教育患者关于 ART 依从性和副作用方面发挥着关键作用，但他们也应该教育患者有关 CD4 和病毒载量测试结果以及在 ART 中使用传统药物和酒精的危险。缩短诊所的等待时间可以使 ART 患者的生活变得更容易管理。
Purpose: To identify factors influencing patients' anti-retroviral therapy (ART) adherence at four clinics in Botswana.Design: Quantitative descriptive. Structured interviews were conducted with a random sample of 400 patients out of the population of all patients attending the four randomly selected ART clinics in Botswana during April and May 2007.Methods: Data were analysed using SPSS version 13. Chi-square and p-value calculations were done to test significance of the relationships between categories or variables.Findings: Patient-centred barriers to ART adherence included inadequate knowledge about ART, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), CD4 cell and viral-load results, stigma, travelling costs, waiting times at clinics, side effects of ART, use of traditional (indigenous or folk) medicines, and abuse of alcohol. Service-centred barriers included nurses' attitudes and knowledge, health workers' inability to conduct home visits and to contact defaulters, limited clinic hours, delays in getting CD4 and viral-load results.Conclusions: ART adherence requires more than free ART. Adherence levels will improve if both patient-centred and service-centred barriers are addressed.Clinical Relevance: Nurses play key roles in educating patients about ART adherence and side effects, but they should also educate patients about CD4 and viral-load test results and about the dangers of using traditional medicines and alcohol with ART. Shorter waiting times at clinics could make ART patients' lives more manageable.