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一项对美国开展的抗逆转录病毒依从性描述性研究和干预性研究进行比较的系统评价。

A systematic review comparing antiretroviral adherence descriptive and intervention studies conducted in the USA.

作者信息

Sandelowski Margarete, Voils Corrine I, Chang Yunkyung, Lee Eun-Jeong

机构信息

School of Nursing, University of North Carolina at Chapel Hill, NC, USA.

出版信息

AIDS Care. 2009 Aug;21(8):953-66. doi: 10.1080/09540120802626212.

Abstract

We examined the extent to which studies aimed at testing interventions to improve antiretroviral adherence have targeted the facilitators of and barriers known to affect adherence. Of the 88 reports reviewed, 41 were reports of descriptive studies conducted with US HIV-positive women and 47 were reports of intervention studies conducted with US HIV-positive persons. We extracted from the descriptive studies all findings addressing any factor linked to antiretroviral adherence and from the intervention studies, information on the nature of the intervention, the adherence problem targeted, the persons targeted for the intervention, and the intervention outcomes desired. We discerned congruence between the prominence of substance abuse as a factor identified in the descriptive studies as a barrier to adherence and its prominence as the problem most addressed in those reports of intervention studies that specified the problems targeted for intervention. We also discerned congruence between the prominence of family and provider support as factors identified in the descriptive studies as facilitators of adherence and the presence of social support as an intervention component and outcome variable. Less discernible in the reports of intervention studies was specific attention to other factors prominent in the descriptive studies, which may be due to the complex nature of the problem, individualistic and rationalist slant of interventions, or simply the ways interventions were presented. Our review raises issues about niche standardization and intervention tailoring, targeting, and fidelity.

摘要

我们研究了旨在测试改善抗逆转录病毒治疗依从性干预措施的研究在多大程度上针对了已知会影响依从性的促进因素和障碍。在审查的88份报告中,41份是对美国HIV阳性女性进行的描述性研究报告,47份是对美国HIV阳性人群进行的干预性研究报告。我们从描述性研究中提取了所有涉及与抗逆转录病毒治疗依从性相关任何因素的研究结果,并从干预性研究中提取了有关干预措施的性质、针对的依从性问题、干预措施的目标人群以及期望的干预结果等信息。我们发现,在描述性研究中被确定为依从性障碍因素的药物滥用的突出程度,与在那些明确指出干预目标问题的干预性研究报告中作为最常解决问题的突出程度之间存在一致性。我们还发现,在描述性研究中被确定为依从性促进因素的家庭和医疗服务提供者支持的突出程度,与作为干预组成部分和结果变量的社会支持的存在之间存在一致性。在干预性研究报告中,对描述性研究中其他突出因素的具体关注不太明显,这可能是由于问题的复杂性、干预措施的个人主义和理性主义倾向,或者仅仅是干预措施的呈现方式所致。我们的综述提出了关于小众标准化以及干预措施的定制、目标设定和保真度等问题。

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