University of KwaZulu Natal, Durban, South Africa.
Appl Nurs Res. 2011 Feb;24(1):1-9. doi: 10.1016/j.apnr.2009.01.001. Epub 2009 Jul 9.
Symptom management in HIV/AIDS is a critical issue that influences the quality of life of those living with the disease. Although the goals of treating the numbers living with HIV/AIDS have not yet been achieved, availability of antiretroviral therapies (ARVs) has been expanded to many clinical settings in KwaZulu-Natal, the epicenter of HIV infection in South Africa. The South African Department of Health (2007) estimates indicate that 5.54 million South Africans are living with HIV/AIDS, whereas UNAIDS (2007) estimates suggest that 18.8% of the population in South Africa is affected. Because the symptom experience may influence adherence to ARVs and quality of life, this study focused on the prevalence of symptoms reported by patients (N = 149) diagnosed with HIV/AIDS and adherence to medications and appointments. Self-report data were obtained from this community-based sample of HIV-infected patients who received care in outpatient clinics in Durban, KwaZulu-Natal, South Africa. With an average of three side effects, the most frequently reported by the study participants were fatigue/tiredness (41%), rashes (40%), headaches (32%), insomnia (31%), sadness (24%), disturbing dreams (23%), numbness (22%), pain (22%), and self-appearance (20%). On a scale of 1 to 10 (10 being worst possible), those with symptoms reported an average intensity of 4.2 (SD = 2.0), and the degree to which symptoms affected activity levels was 3.2 (SD = 2.2). Although intensity of symptoms and effects on activity levels were strongly correlated (r = .78, p < .001), there were no significant relationships between adherence and the intensity of symptoms or the relationship of symptoms with activity levels. Logistic regression analyses indicate that the presence of a greater number of symptoms was not associated with greater adherence (odds ratio = 2.27, 95% confidence interval = 0.60-8.70, ns). However, those who reported higher adherence were 1.5 times more likely to report greater physical health than low adherers (p = .04). High adherers were also 1.6 times more likely to report greater psychological health than low adherers (p = .03). This suggests that further study is needed to investigate adherence motivations for those living with HIV/AIDS in South Africa because adherence seems not to be linked to the frequency of symptoms or limitations on activity related to symptoms.
艾滋病毒/艾滋病的症状管理是一个关键问题，它影响着患者的生活质量。尽管治疗艾滋病毒感染者的目标尚未实现，但在南非艾滋病毒感染中心夸祖鲁-纳塔尔省，抗逆转录病毒疗法（ARV）的可及性已扩大到许多临床环境。南非卫生部（2007 年）的估计表明，有 550 万南非人患有艾滋病毒/艾滋病，而艾滋病规划署（2007 年）的估计表明，南非有 18.8%的人口受到影响。由于症状体验可能会影响对 ARV 的依从性和生活质量，因此本研究侧重于报告的症状（N = 149）的患病率艾滋病毒/艾滋病患者以及对药物和预约的遵守情况。该研究从在南非夸祖鲁-纳塔尔省德班的门诊诊所接受护理的艾滋病毒感染患者的社区样本中获得了自我报告数据。研究参与者报告的最常见副作用平均有三种，分别是疲劳/疲倦（41%）、皮疹（40%）、头痛（32%）、失眠（31%）、悲伤（24%）、噩梦（23%）、麻木（22%）、疼痛（22%）和自我形象（20%）。在 1 到 10 分的量表中（10 分表示最差），那些有症状的人报告的平均强度为 4.2（标准差 = 2.0），症状对活动水平的影响程度为 3.2（标准差 = 2.2）。尽管症状的强度和对活动水平的影响呈强相关（r =.78，p <.001），但在症状的强度与活动水平之间没有显著关系。逻辑回归分析表明，出现更多症状与更高的依从性无关（优势比 = 2.27，95%置信区间 = 0.60-8.70，ns）。然而，报告更高依从性的人报告身体更健康的可能性是低依从者的 1.5 倍（p =.04）。高依从者报告心理健康状况更好的可能性是低依从者的 1.6 倍（p =.03）。这表明，需要进一步研究南非艾滋病毒感染者的依从性动机，因为依从性似乎与症状的频率或与症状相关的活动限制无关。
