Préau M, Bouhnik A-D, Spire B, Leport C, Saves M, Picard O, Reynes J, Salmon D, Dellamonica P, Raffi F, Morin M, Aproco-Copilote Etlegrouped'étude
Equipe Psychologie Sociale de la Santé, Laboratoire de Psychologie Sociale, Université de Provence, Aix-en-Provence.
Encephale. 2006 Oct;32(5 Pt 1):713-9. doi: 10.1016/s0013-7006(06)76223-6.
The aim of this work is to show to what extent a psychosocial evaluation can lead bring to comprehension of the subjectivity of Quality of Life (QoL) among HIV-infected patients. Evaluation of QoL makes it possible to understand the link between the therapeutic effectiveness and the subjective evaluation of the treatment, but also to estimate more precisely how people live and take their treatment in the context of HIV infection.
This work confronts the variation of QoL with the variation of several social and psychosocial parameters identified as of the components of the system, which is the subjective evaluation, and more precisely to a specific side effect of Highly Active AntiRetroviral Therapies (HAART): lipodystrophy syndrome that consists in body fat redistribution. This side effect could consist in an accumulation of body fat, or a loss of body fat or a combination of both symptoms. The analysis was made on the data from APROCO-COPILOTE cohort composed of HIV-infected patients initiating HAART.
Among a sample of 706 patients follow-up for three years and with available QoL data, we identified the variations of QoL according to the variation of this specific side effect and according to gender. Results show that lipodystrophy syndrome has a determinant impact on QoL different among male and female patients. Adjusted on clinical and socio-demographic characteristics, impaired women's QoL is associated with accumulation of body fat and impaired men's QoL is associated with loss of body fat.
These results underline the role of body image on subjective evaluation of QoL. The analysis of empirical data made it possible to highlight the social implication of the evaluation of QoL from the role of the social support, patient-provider relationship and the social context.
本研究旨在表明心理社会评估在多大程度上能够促进对艾滋病毒感染患者生活质量（QoL）主观性的理解。生活质量评估不仅有助于理解治疗效果与治疗主观评价之间的联系，还能更精确地估计人们在艾滋病毒感染背景下的生活及治疗方式。
本研究将生活质量的变化与若干被确定为系统组成部分的社会和心理社会参数的变化进行对比，具体而言，是与高效抗逆转录病毒疗法（HAART）的一种特定副作用——脂肪代谢障碍综合征（即身体脂肪重新分布）进行对比。这种副作用可能表现为身体脂肪堆积、身体脂肪流失或两者兼而有之。分析的数据来自由开始接受HAART治疗的艾滋病毒感染患者组成的APROCO-COPILOTE队列。
在706名接受了三年随访且有可用生活质量数据的患者样本中，我们根据这种特定副作用的变化以及性别确定了生活质量的变化情况。结果表明，脂肪代谢障碍综合征对男性和女性患者的生活质量有不同的决定性影响。在根据临床和社会人口学特征进行调整后，女性生活质量受损与身体脂肪堆积有关，而男性生活质量受损与身体脂肪流失有关。
这些结果强调了身体形象在生活质量主观评价中的作用。对实证数据的分析凸显了从社会支持、医患关系和社会背景的作用出发进行生活质量评估的社会意义。
