Schönnesson Lena Nilsson, Ross Michael W, Williams Mark
Gay Men's Health Center, Söder Hospital/Karolinska Institute, Stockholm, Sweden.
AIDS Behav. 2004 Sep;8(3):293-301. doi: 10.1023/B:AIBE.0000044076.98833.64.
The purpose of this paper is to report on the construction of the HIV Medication Self-Reported Nonadherence Reasons (SNAR) index and its psychological correlates. Data were derived from a sample of 193 Swedish HIV-seropositive women and men receiving antiretroviral medications. Participants who reported dosing and/or scheduling and/or dietary instructions nonadherence in the past 7 days were presented with a modified AACTG list of 18 reasons for nonadherence. From these data, two conceptually and statistically independent factors were obtained, which accounted for 39% of the variance in the data. These factors were used as the basis for constructing two composite measures composing the SNAR index: the Medication concerns scale and the Routine disruption scale. The Medication concerns scale correlated significantly to suboptimal dose and scheduling adherence and Routine disruption scale with poorer dietary instructions adherence. Psychological distress was the best predictor of the SNAR index. The SNAR index has a clearly interpretable factor structure that allows the derived scales to be useful as multi-item measures of self-reported reasons for nonadherence to HIV antiretroviral medications. The psychological factors found to be associated with the index may imply a number of mental-health-related interventions to improve adherence, which deserve further exploration.
本文旨在报告HIV药物治疗自我报告的不依从原因（SNAR）指数的构建及其心理关联。数据来源于193名接受抗逆转录病毒药物治疗的瑞典HIV血清反应阳性的女性和男性样本。在过去7天内报告有服药剂量和/或服药时间安排和/或饮食指导不依从情况的参与者，会看到一份经过修改的由18个不依从原因组成的AACTG清单。从这些数据中，获得了两个在概念和统计上相互独立的因素，它们占数据方差的39%。这些因素被用作构建构成SNAR指数的两个综合指标的基础：药物治疗担忧量表和日常安排紊乱量表。药物治疗担忧量表与次优剂量和服药时间安排依从性显著相关，日常安排紊乱量表与较差的饮食指导依从性相关。心理困扰是SNAR指数的最佳预测因素。SNAR指数具有清晰可解释的因素结构，使得由此得出的量表能够作为自我报告的不依从HIV抗逆转录病毒药物治疗原因的多项目测量工具。发现与该指数相关的心理因素可能意味着一系列与心理健康相关的干预措施来提高依从性，这值得进一步探索。
