Roberts K J, Volberding P
Department of Sociology, University of California, Los Angeles 90095-1551, USA.
AIDS. 1999 Sep 10;13(13):1771-8. doi: 10.1097/00002030-199909100-00022.
To explore how HIV/AIDS care physicians communicate with HIV-positive patients about the need for adherence to antiretroviral treatment regimens.
Semi-structured, face-to-face interviews, a qualitative research method.
A comprehensive, multidisciplinary, HIV/AIDS practice at San Francisco General Hospital.
Fifteen physicians, most of whom (73%) were board certified in internal medicine and/or infectious diseases; all were involved in HIV continuity care.
Most physicians engaged in both pre- and post-prescription phases of adherence communication with their patients. During the pre-prescription phase, physicians made decisions about offering prescriptions to patients, often based on their beliefs about the patient's likelihood of adhering to therapy. During the post-prescription phase, physicians asked patients questions about if/how they were adhering to the regimens. Physicians' practices, such as the length of time spent in the pre-prescription phase, the timing of the 'check-ins' in the post-prescription phase, and the overall content of both phases, varied significantly.
Physicians have diverse ways of communicating with patients regarding adherence to antiretroviral medications. The effect of such communication on treatment outcomes needs to be assessed; however, the potential benefit suggests that training programs should be developed to improve physicians' skills in this area. Further studies should be done to assess how generally applicable these findings are to other groups of physicians.
探讨艾滋病护理医生如何就坚持抗逆转录病毒治疗方案的必要性与艾滋病毒呈阳性的患者进行沟通。
半结构化面对面访谈，一种定性研究方法。
旧金山综合医院的一个综合性、多学科的艾滋病毒/艾滋病诊疗机构。
15名医生，其中大多数（73%）获得内科和/或传染病专业委员会认证；均参与艾滋病毒连续性护理工作。
大多数医生在与患者沟通坚持治疗方面既涉及开处方前阶段也涉及开处方后阶段。在开处方前阶段，医生决定是否给患者开处方，这通常基于他们对患者坚持治疗可能性的判断。在开处方后阶段，医生询问患者关于他们是否/如何坚持治疗方案的问题。医生的做法，如在开处方前阶段花费的时间长度、开处方后阶段“跟进”的时间安排以及两个阶段的总体内容，差异很大。
医生在与患者沟通坚持抗逆转录病毒药物治疗方面有多种方式。这种沟通对治疗结果的影响需要评估；然而，其潜在益处表明应制定培训计划以提高医生在该领域的技能。应进一步开展研究以评估这些发现对其他医生群体的普遍适用性。
