Weller P D, Hambleton I R, Chambers C, Bain S, Christie C D C, Bain B
Health Centre Counselling Unit, The University of the West Indies, Kingston 7, Jamaica.
West Indian Med J. 2008 Jun;57(3):274-81.
We hypothesized that voluntary counselling and testing during pregnancy are necessary but not sufficient to provide the holistic psychosocial support needed by Jamaican women living with HIV and/or AIDS. Based on this hypothesis, we investigated a range of coping methods and support systems used by HIV-infected women and a group of their HIV-negative counterparts before, during and immediately after their pregnancies.
Women attending obstetric clinics in urban Jamaica completed a quantitative survey aimed at discovering coping behaviours, social and spiritual support systems. Pre-survey focus group studies and key informant interviews contributed to the design of the questionnaire while post-survey focus groups were used to probe the validity of the data gleaned from the questionnaire survey Survey data were analyzed using non-parametric tests for trend with independent univariate tests.
Fifty-five HIV-infected women and 51 HIV-negative women completed the survey Compared with HIV-negative women, more HIV-infected women reported both feeling depressed (p = 0.07) and having difficulty concentrating (p = 0.05) during the month immediately prior to the study. Other statistically significant differences included: HIV-infected women were more likely to pray, to sleep and to change eating habits in response to worry and stress (p = 0.001 in each instance). Although several women declared religious faith, significantly fewer HIV-infected women were willing to talk to a religious leader about their problems compared to their HIV-negative counterparts (p < 0.001).
Participation of HIV-infected women in post-survey focus groups augmented the survey findings. Many of the women reported negative emotions and some indicated serious challenges in accessing social support. The results point to the need for systematic documentation of psychosocial profiles as part of the approach to caring for these women. In addition, in the Jamaican sociocultural context, we recommend improved training of religious leaders and healthcare providers in psychosocial issues.
我们推测孕期的自愿咨询与检测对于为感染艾滋病毒和/或患艾滋病的牙买加女性提供所需的全面心理社会支持而言是必要的，但并不充分。基于这一推测，我们调查了感染艾滋病毒的女性及其一部分未感染艾滋病毒的同龄女性在怀孕前、孕期及产后立即采用的一系列应对方法和支持系统。
在牙买加城市的产科诊所就诊的女性完成了一项定量调查，旨在发现应对行为、社会及精神支持系统。调查前的焦点小组研究和关键信息人访谈为调查问卷的设计提供了帮助，而调查后的焦点小组则用于探究从问卷调查中收集的数据的有效性。调查数据采用非参数趋势检验和独立单变量检验进行分析。
55名感染艾滋病毒的女性和51名未感染艾滋病毒的女性完成了调查。与未感染艾滋病毒的女性相比，更多感染艾滋病毒的女性报告在研究前一个月感到抑郁（p = 0.07）和难以集中注意力（p = 0.05）。其他具有统计学意义的差异包括：感染艾滋病毒的女性更有可能通过祈祷、睡觉和改变饮食习惯来应对担忧和压力（每种情况的p值均为0.001）。尽管有几名女性宣称有宗教信仰，但与未感染艾滋病毒的女性相比，愿意与宗教领袖谈论自身问题的感染艾滋病毒的女性明显更少（p < 0.001）。
感染艾滋病毒的女性参与调查后的焦点小组扩大了调查结果。许多女性报告了负面情绪，一些女性表示在获得社会支持方面面临严峻挑战。结果表明，有必要系统记录心理社会状况，作为关爱这些女性方法的一部分。此外，在牙买加的社会文化背景下，我们建议加强宗教领袖和医疗服务提供者在心理社会问题方面的培训。
