Department of Pediatrics, University Federico II, Naples, Italy.
J Dev Behav Pediatr. 2011 Jan;32(1):52-5. doi: 10.1097/DBP.0b013e3181f51907.
After active antiretroviral therapy, children with HIV are clinically well, whereas psychosocial issues continue to influence their quality of life. The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization evaluates health status and environmental and social factors associated with health. We investigated the efficacy of the ICF to describe the health status and needs of a cohort of children and adolescents with HIV seen at a reference center for pediatric AIDS in Europe.
A quantitative analysis of structured interviews was performed. Caregivers of children and adolescents with HIV infection in follow-up at 2 reference centers for pediatric AIDS were enrolled. Four major areas included in the ICF instrument were investigated: impairments of body structures; impairments of body functions; environmental factors; and activity limitations and restrictions to social life.
Forty-one families of children with HIV were enrolled. Body structures and functions were marginally impaired, whereas environmental factors and psychosocial issues had a relevant impact on quality of life. Most families considered environmental factors to be "barriers"; these were poverty, unemployment, and single-parent family structure. Activity limitations and social restrictions were also reported in a few cases. Almost all parents reported problems in disclosing their child's HIV status because of the fear of social stigma.
Psychosocial issues are part of the well-being of children with HIV. The ICF is a standard tool to evaluate the clinical and psychosocial status of children and adolescents with HIV infection and to measure the impact of therapeutic interventions and strategies on psychosocial functioning.
接受积极的抗逆转录病毒治疗后，HIV 儿童的临床状况良好，但心理社会问题仍会影响其生活质量。世界卫生组织的《国际功能、残疾和健康分类》（ICF）评估健康状况以及与健康相关的环境和社会因素。我们调查了 ICF 描述欧洲一家儿科艾滋病参考中心就诊的 HIV 儿童和青少年健康状况和需求的效果。
对结构访谈进行了定量分析。我们招募了在 2 家儿科艾滋病参考中心接受随访的 HIV 感染儿童和青少年的照顾者。研究了 ICF 工具中包含的四个主要领域：身体结构损伤；身体功能损伤；环境因素；以及活动受限和社会生活受限。
共纳入 41 个 HIV 儿童家庭。身体结构和功能有轻微损伤，而环境因素和心理社会问题对生活质量有重大影响。大多数家庭认为环境因素是“障碍”，包括贫困、失业和单亲家庭结构。在少数情况下，也报告了活动受限和社会限制。几乎所有父母都报告说，由于害怕社会耻辱，他们在透露孩子的 HIV 状况时存在问题。
心理社会问题是 HIV 儿童福祉的一部分。ICF 是评估 HIV 感染儿童和青少年临床和心理社会状况的标准工具，并可衡量治疗干预和策略对心理社会功能的影响。
