Psychometric assessment of health-related quality of life and symptom experience in HIV patients treated with antiretroviral therapy
Psychometric assessment of health-related quality of life and symptom experience in HIV patients treated with antiretroviral therapy
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DOI：
10.1007/s11136-014-0880-8
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发表时间：
2015-06-01
影响因子：
3.5
通讯作者：
Duracinsky, Martin
中科院分区：
文献类型：
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作者：
Lalanne, Christophe;Armstrong, Andrew R.;Duracinsky, Martin
被发现一致聚集的症状可以对患者的治疗结果产生协同效应，因此可以用于预测发病率或将疾病进展与共病分开。对不同抗逆转录病毒治疗方案下的 HIV 阳性患者的自我报告 HIV 特异性症状和 HRQL 测量进行联合分析。分析了来自四个国家的患者对 PROOQL-HIV 问卷的 9 项身体健康和症状维度以及 HIV 症状检查表的反应。使用项目反应模型和多维标度来推导与性别和目标语言相关的任何差异项目功能的 HRQL 分数，并总结蛋白酶抑制剂治疗（PI，45%）与其他药物（非 PI）患者的症状共表达。女性报告较差的 HRQL（），并且 HRQL 在法语、英语和泰语目标语言之间没有差异。疲劳、肌肉疼痛或入睡困难是最常报告的症状（> 35%）。 PI 与非 PI 患者表现出不同的症状模式，其中脂肪营养不良相关症状和胃肠道症状在 PI 组中形成良好分离的簇。较多的症状与较低的 HRQL () 相关，服用 PI 的患者报告较低的 HRQL ()。两组均报告有疲劳、性功能障碍或多种脂肪代谢障碍相关症状的患者生活质量较差。症状的共表达及其与 HRQL 的关系是监测 HIV 治疗的重要方面。
Symptoms which are found to cluster consistently can have synergistic effects on patient outcomes and therefore may serve to predict morbidity or disentangle disease progression from comorbid conditions. Self-report HIV-specific symptom and HRQL measures were jointly analyzed in HIV-positive patients under different antiretroviral treatment regimens.The responses of patients from four countries to the 9-item Physical Health and Symptom dimension of the PROOQL-HIV questionnaire and an HIV Symptom checklist were analyzed. Item response modeling and multidimensional scaling were used to derive HRQL scores free of any differential item functioning related to gender and target language and to summarize symptom co-expression in patients under protease inhibitor treatment (PI, , 45 %) versus other medication (Non-PI).Women reported poorer HRQL (), and HRQL did not differ between the target languages of French, English, and Thai. Fatigue, muscular pain, or difficulties falling asleep was the most frequently reported symptoms > 35 %). PI versus Non-PI patients exhibited different pattern of symptoms with lipodystrophy-related and gastrointestinal symptoms forming well-separated clusters in the PI group. A higher number of symptoms were associated with lower HRQL (), and patients taking PIs reported lower HRQL (). Patients in both groups who reported fatigue, sexual dysfunction, or several lipodystrophy-related symptoms had poorer quality of life.The co-expression of symptoms and their relation to HRQL are important aspects for the monitoring of HIV treatments.