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[抗逆转录病毒治疗开始时与患者治疗理解相关因素的评估]

[Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy].

作者信息

Braga Ceccato Maria das Graças, Acurcio Francisco de Assis, Vallano Antonio, Comini César Cibele, Crosland Guimarães Mark Drew

机构信息

Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

出版信息

Enferm Infecc Microbiol Clin. 2009 Jan;27(1):7-13. doi: 10.1016/j.eimc.2008.05.003. Epub 2009 Jan 9.

Abstract

OBJECTIVE

The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART).

METHOD

Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory.

RESULTS

A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed.

CONCLUSION

Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding.

摘要

目的

本研究旨在评估与患者对抗逆转录病毒疗法(ART)理解相关的因素。

方法

采用横断面分析,对巴西贝洛奥里藏特市两家艾滋病公共转诊中心开始接受抗逆转录病毒治疗后的患者进行访谈。记录与患者特征、所开处方治疗以及相关医护人员有关的变量信息。使用项目反应理论估计的潜在特质模型获得一个表明患者对所开药物理解程度的分数。

结果

共访谈了406名患者。平均(标准差)年龄为35(10)岁,男性227名(56%),非裔美国人302名(77%),213名接受教育年限<8年(53%)。回归模型确定,理解程度的52.25%的变异性可由个体特征解释。与对抗逆转录病毒疗法理解最差相关(P<0.05)的变量包括较低的教育水平(<8年)、对治疗持续时间和临床严重程度缺乏了解、医生提供的信息不足、无法理解药物信息、每日服药片数以及所开的抗逆转录病毒治疗方案。

结论

个体对所开抗逆转录病毒治疗方案信息的理解差异很大。尽管如此,发现几个因素与理解水平相关:患者特征(教育程度、临床严重程度)、治疗特征(每日服药片数、所开抗逆转录病毒治疗方案)以及医护人员的作用(医生和药剂师提供的信息)。对于理解水平较低的患者,加强抗逆转录病毒疗法信息的策略应成为优先事项。

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