Côté José, Godin Gaston, Garcia Pilar Ramirez, Gagnon Marilou, Rouleau Genevieve
Research Chair in Innovative Nursing Practices, University of Montreal, CRCHUM, Montréal, Quebec, Canada.
AIDS Patient Care STDS. 2008 Dec;22(12):965-75. doi: 10.1089/apc.2008.0124.
In this paper the development of a self-management program to optimize long-term adherence to antiretroviral therapy for people living with HIV/AIDS is presented. The program is based on intervention mapping: that is, a framework that facilitates the use of theory and empirical evidence in intervention development. In the preparatory phase we conducted a needs-assessment. The results of this phase were then used in the operational phase in which the program was elaborated as follow: in Step 1 we established program objectives; in Step 2 we translated theoretical methods into practical strategies; and in Step 3 we integrated the strategies into a self-management program which were designed to help individuals mobilize their skills to cope with their antiretroviral therapies (ART). These particular abilities are: ability to integrate ART in daily routine, to cope with side effects, to handle situations in which ART is difficult to take, to interact with health professionals and to maintain relationships with social contacts. To address individuals' resources and skills in conjunction with the experience of taking the medication, we developed two different modalities to deliver the intervention: direct support and virtual support. Direct support consists of four 45-minute individualized, face-to-face sessions with a health professional. The Web application involved at least four interactive sessions with a computer. This application was developed with the intention to support individuals in managing their therapy, in a punctual, real-time mode. Treatment adherence behavior is an indicator or gauge that can reveal problems in being able to manage the therapy.
本文介绍了一项自我管理项目的开发情况，该项目旨在优化艾滋病毒/艾滋病感染者长期坚持抗逆转录病毒治疗的情况。该项目基于干预映射，即一个便于在干预开发中运用理论和实证依据的框架。在筹备阶段，我们进行了需求评估。然后，这一阶段的结果被用于实施阶段，在该阶段项目按以下方式详细制定：第一步，我们确定项目目标；第二步，我们将理论方法转化为实际策略；第三步，我们将这些策略整合到一个自我管理项目中，该项目旨在帮助个人调动自身技能以应对抗逆转录病毒治疗（ART）。这些特定能力包括：将抗逆转录病毒治疗融入日常生活的能力、应对副作用的能力、处理难以服用抗逆转录病毒治疗药物情况的能力、与医护人员互动的能力以及与社会联系人维持关系的能力。为结合服药经验处理个人的资源和技能，我们开发了两种不同的干预方式：直接支持和虚拟支持。直接支持包括与一名医护人员进行四次时长45分钟的个性化面对面辅导。网络应用程序包括与计算机进行至少四次互动环节。开发此应用程序的目的是及时、实时地支持个人管理其治疗。治疗依从行为是一个能够揭示治疗管理中存在问题的指标或衡量标准。
