积极自我管理理论在艾滋病管理中的运用状况分析被引量：3

A study on application of positive self management theory in HIV/AIDS prevention and control

导出

摘要目的评价艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)积极自我管理(PSM)互助活动的效果,为制定AIDS综合管理策略提供依据。方法借鉴"社区慢性病自我管理模式"、"群组看病模式",运用PSM理论开展互助活动。活动后6个月开展评估调查,采用SPSS软件对数据进行分析。结果 412名HIV/AIDS病人参与活动。活动前后相比,愿意"积极自我管理"的比例由74.3%(306/412)上升到84.7%(349/412)(χ2=13.76,P<0.05);负面心理,如恐惧死亡、害怕未来、有烦心事、感觉疲劳、感觉紧张等反应降低,差异有统计学意义(χ2值分别为22.31、24.56、24.31、10.85、8.30,P值均<0.05);行为,如开始锻炼、主动寻求建议和帮助、生活有目标、独立解决问题、控制情绪波动、表明感染情况、做行动计划、定期做CD+4T淋巴细胞检测、最近半年与配偶或固定性伴发生性行为时每次都使用安全套的比例均上升,差异有统计学意义(χ2值分别为28.91、39.54、54.91、35.22、29.45、18.75、16.08、41.82、12.89,P值均<0.05);接受抗病毒治疗的HIV/AIDS病人中,正常与医生交流、能评估常见症状、了解抗病毒药物的比例均上升,差异有统计学意义(χ2值分别为10.25、4.15、4.73,P值均<0.05);相关信息正确认知提升,差异有统计学意义。结论积极自我管理理论提升了HIV/AIDS病人的自我管理能力,符合HIV/AIDS病人需求,这一综合服务新模式可有效突破目前HIV/AIDS病人综合管理的瓶颈。 Objective To evaluate the effect of positive self management(PSM)and mutual aids among people living with HIV/AIDS(PLWHA),and provide the basis for AIDS prevention and control strategies.Methods Refered to the 'chronic disease self-management model' and 'group doctor mode',the theory of PSM was used to carry out mutual support activities for PLWHA.The assessments were carried out after half a year and the data were analyzed with SPSS.P-value<0.05 was considered significant.Results A total of 412 PLWHA participated in the activities.Comparing with before the activities,the proportion of PLWHA with PSM rised from 74.3%(306)to84.7%(349)(χ2=13.76,P<0.05).The proportion of PLWHA with negative psychological conditions such as fearing death,worrying about the future,feeling upset,feeling fatigue or feeling nervous were reduced significantly(χ2=22.31,24.56,24.31,10.85 and 8.30,respectively,P<0.05).The proportion of PLWHA with doing excises,actively seeking advice and aids,having life goals,independently solving problems, controlling mood swings,disclosing their HIV statuts,having action plans,taking CD+4T cell testing on time,using condoms with spouses or sexual partners in the last 6months were increased significantly(χ2= 28.91,39.54,54.91,35.22,29.45,18.75,16.08,41.82,and 12.89,P<0.05).Among antiretroviral patients,the proportion of good comunication with doctors,knowing how to evaluate the common symptoms,or recognizing antiviral drugs were increased significantly(χ2=10.25,4.15 and 4.73,P<0.05).The proportion of PLWHA who mastered the relevant knowledge was significantly higher than before.Conclusion PSM enhances self-management skills and meets the demands of HIV/AIDS patients.This comprehensive new service model could effectively break the bottleneck of current integrated management.