HIV诊断后宗教信仰/精神性增强,且这预示着HIV感染者在4年里疾病进展较慢。

An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV.

作者信息

Ironson Gail, Stuetzle Rick, Fletcher Mary Ann

机构信息

Department of Psychology, University of Miami, Miami, FL, USA.

出版信息

J Gen Intern Med. 2006 Dec;21 Suppl 5(Suppl 5):S62-8. doi: 10.1111/j.1525-1497.2006.00648.x.

Abstract

BACKGROUND

Most studies on religion/spirituality predicting health outcomes have been limited to church attendance as a predictor and have focused on healthy people. However, confronting a major medical crisis may be a time when people turn to the sacred.

OBJECTIVE

The purpose of this study was to determine the extent to which changes in spirituality/religiousness occur after HIV diagnosis and whether changes predict disease progression.

DESIGN/PARTICIPANTS: This longitudinal study examined the relationship between changes in spirituality/religiousness from before with after the diagnosis of HIV, and disease progression (CD4 and viral load [VL] every 6 months) over 4 years in 100 people with HIV. Measures included change in religiousness/spirituality after diagnosis of HIV, religiousness/spirituality at various times in one's life, church attendance, depression, hopelessness, optimism, coping (avoidant, proactive), social support, CD4/VL, and health behaviors.

RESULTS

Forty-five percent of the sample showed an increase in religiousness/spirituality after the diagnosis of HIV, 42% remained the same, and 13% decreased. People reporting an increase in spirituality/religiousness after the diagnosis had significantly greater preservation of CD4 cells over the 4-year period, as well as significantly better control of VL. Results were independent of (i.e., held even after controlling for) church attendance and initial disease status (CD4/VL), medication at every time point, age, gender, race, education, health behaviors (adherence, risky sex, alcohol, cocaine), depression, hopelessness, optimism, coping (avoidant, proactive), and social support.

CONCLUSIONS

There is an increase in spirituality/religiousness after HIV diagnosis, and this increase predicts slower disease progression; medical personnel should be aware of its potential importance.

摘要

背景

大多数关于宗教信仰/精神信仰预测健康结果的研究都局限于将教堂礼拜作为预测因素,并且主要关注健康人群。然而,面对重大医疗危机时,人们可能会求助于宗教。

目的

本研究旨在确定感染艾滋病毒后精神信仰/宗教信仰的变化程度,以及这些变化是否能预测疾病进展。

设计/参与者:这项纵向研究考察了100名艾滋病毒感染者在感染艾滋病毒前后精神信仰/宗教信仰的变化与4年中疾病进展情况(每6个月检测一次CD4细胞计数和病毒载量[VL])之间的关系。测量指标包括感染艾滋病毒后的宗教信仰/精神信仰变化、一生中不同时期的宗教信仰/精神信仰、教堂礼拜出席情况、抑郁、绝望、乐观、应对方式(回避型、主动型)、社会支持、CD4细胞计数/VL以及健康行为。

结果

45%的研究对象在感染艾滋病毒后宗教信仰/精神信仰增强,42%保持不变,13%减弱。报告感染艾滋病毒后精神信仰/宗教信仰增强的人在4年期间CD4细胞的保存情况明显更好,病毒载量的控制也明显更佳。研究结果不受教堂礼拜出席情况和初始疾病状态(CD4细胞计数/VL)、每个时间点的用药情况、年龄、性别、种族、教育程度、健康行为(依从性、危险性行为、饮酒、使用可卡因)、抑郁、绝望、乐观、应对方式(回避型、主动型)以及社会支持的影响(即即使在控制这些因素后结果依然成立)。

结论

感染艾滋病毒后精神信仰/宗教信仰会增强,这种增强预示着疾病进展较慢;医务人员应意识到其潜在重要性。

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