Rousaud Araceli, Blanch Jordi, Hautzinger Martin, De Lazzari Elisa, Peri Josep Maria, Puig Olga, Martinez Esteban, Masana Guillem, De Pablo Joan, Gatell Josep Maria
Fundació Clínic per la Recerca Biomèdica-IDIBAPS, Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer, Hospital Clínic de Barcelona, Barcelona, Spain.
AIDS Patient Care STDS. 2007 Mar;21(3):212-22. doi: 10.1089/apc.2006.0077.
The present study evaluated the efficacy of a group therapy program in improving psychosocial adjustment to HIV infection, and tried to identify variables predictive of greater improvement. The outcome of 47 completing patients was analyzed, comparing the measures between T1 (1 month before therapy), and T2 (first session), and between T2 and T3 (last session) using the Wilcoxon matched-pairs signed-ranks test for each dimension of the Psychosocial Adjustment to Illness Scale (PAIS). The therapy consisted of 16 weekly 2-hour sessions following a structured time-limited cognitive-behavioral group psychotherapy program. During the intervention (between T2 and T3) a significant improvement was observed in health care orientation, vocational environment, domestic environment, sexual relation, extended family relationships, social environment, and total PAIS. There were no changes during baseline (between T1 and T2) in any of the PAIS subscales, or in the total PAIS score. Sexual route of transmission was independently associated with an improvement in health care orientation (beta = 2.525). Time since HIV diagnosis (beta = 0.022) and being employed (beta = 2.548) were independently associated with an improvement in adjustment to vocational environment. Men who have sex with men showed a poorer improvement in adjusting to family relations after the intervention (beta = -2.548). Finally, a lower CD4 count (beta = -0.005) and being employed (beta = 3.054) were independently associated with an improvement in adjustment to social environment. Our psychotherapy program improved psychosocial functioning in a heterogeneous sample of HIV-1-infected patients referred to a consultation-liaison psychiatry unit.
本研究评估了一项团体治疗方案在改善对HIV感染的心理社会适应方面的疗效，并试图确定能预测更大改善效果的变量。对47名完成治疗的患者的结果进行了分析，使用疾病心理社会适应量表（PAIS）各维度的Wilcoxon配对符号秩检验，比较了T1（治疗前1个月）和T2（第一次治疗）以及T2和T3（最后一次治疗）之间的测量结果。该治疗包括按照结构化限时认知行为团体心理治疗方案进行的16次每周2小时的治疗。在干预期间（T2和T3之间），观察到在医疗保健取向、职业环境、家庭环境、性关系、大家庭关系、社会环境和PAIS总分方面有显著改善。在基线期（T1和T2之间），PAIS任何子量表或PAIS总分均无变化。性传播途径与医疗保健取向的改善独立相关（β = 2.525）。自HIV诊断以来的时间（β = 0.022）和就业情况（β = 2.548）与职业环境适应的改善独立相关。男男性行为者在干预后家庭关系适应方面改善较差（β = -2.548）。最后，较低的CD4细胞计数（β = -0.005）和就业情况（β = 3.054）与社会环境适应的改善独立相关。我们的心理治疗方案改善了转诊至会诊联络精神科的HIV-1感染患者异质性样本的心理社会功能。
