在南非自由邦省,医疗保健基础设施和情感支持是接受抗逆转录病毒治疗患者的CD4细胞计数和生活质量指数的预测因素。

Healthcare infrastructure and emotional support are predictors of CD4 cell counts and quality of life indices of patients on antiretroviral treatment in Free State Province, South Africa.

作者信息

Bhargava Alok, Booysen Frikkie le R

机构信息

Department of Economics, University of Houston, TX 77204-5019, USA.

出版信息

AIDS Care. 2010 Jan;22(1):1-9. doi: 10.1080/09540120903012585.

Abstract

While many AIDS patients in sub-Saharan Africa are receiving antiretroviral treatment (ART) via public clinics, improvements in health status also depend on socioeconomic and psychological factors and quality of healthcare services. Inter-dependence between patients' clinical markers and quality of life indicators should be analyzed using comprehensive models. This longitudinal study compiled socioeconomic and clinical variables at six monthly intervals on patients receiving ART in South Africa; patients' ratings of quality of services and staff in "Assessment" and "Treatment" sites were assessed. Dynamic random effects models were estimated by maximum likelihood for CD4 cell counts and for quality of life indices (EQ-5D and Visual Analogue Scale), incorporating the inter-dependence between plasma HIV RNA levels and CD4 cell counts. The results showed that emotional support received by patients was a significant predictor (P<0.05) of CD4 cell counts and quality of life indices. Ratings of services and staff in Assessment and Treatment sites were significantly associated with CD4 cell counts and quality of life indices; CD4 cell count was a significant predictor of quality of life indices. The results indicated that it is important to compile socioeconomic and psychological variables for AIDS patients and monitor healthcare services for improving their health status and quality of life.

摘要

虽然撒哈拉以南非洲的许多艾滋病患者正在通过公共诊所接受抗逆转录病毒治疗(ART),但健康状况的改善还取决于社会经济和心理因素以及医疗服务质量。应使用综合模型分析患者临床指标与生活质量指标之间的相互依存关系。这项纵向研究每隔六个月收集一次南非接受抗逆转录病毒治疗患者的社会经济和临床变量;评估了患者在“评估”和“治疗”地点对服务质量和工作人员的评分。通过最大似然法估计了CD4细胞计数和生活质量指数(EQ-5D和视觉模拟量表)的动态随机效应模型,纳入了血浆HIV RNA水平与CD4细胞计数之间的相互依存关系。结果表明,患者获得的情感支持是CD4细胞计数和生活质量指数的显著预测因素(P<0.05)。“评估”和“治疗”地点的服务和工作人员评分与CD4细胞计数和生活质量指数显著相关;CD4细胞计数是生活质量指数的显著预测因素。结果表明,为艾滋病患者收集社会经济和心理变量并监测医疗服务对于改善他们的健康状况和生活质量很重要。

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