Préau M, Protopopescu C, Raffi F, Rey D, Chêne G, Marcellin F, Perronne C, Ragnaud J M, Leport C, Spire B
LABECD, Nantes University, France.
AIDS Care. 2012;24(4):434-43. doi: 10.1080/09540121.2011.613909. Epub 2011 Oct 14.
The aim of this study was to determine factors associated with complete satisfaction with the care provided (satisfaction with physicians and satisfaction with services and organization) among HIV-infected patients followed up in the French ANRS CO8 APROCO-COPILOTE cohort. Analyses focused on cross-sectional data collected during the ninth year of cohort follow-up. Satisfaction with care, sociodemographic characteristics, and behavioral data were collected using self-administered questionnaires, while clinical data were derived from medical records. Complete satisfaction with care was defined as being 100% satisfied. Two logistic regression models were used to identify predictors of (1) complete satisfaction with physicians (n=404) and (2) complete satisfaction with services and organization (n=396). Sixteen percent of patients were completely satisfied with physicians, while 15.9% were completely satisfied with services and organization. Being older and reporting fewer discomforting antiretroviral therapy (ART) side effects were factors independently associated with complete satisfaction with both physicians and services and organization. Strong support from friends and absence of hepatitis C (HCV) co-infection were independently associated with complete satisfaction with physicians, while strong support from one's family and comfortable housing conditions were independently associated with complete satisfaction with services and organization. Even after nine years of follow-up, social vulnerabilities still strongly influence HIV-infected patients' interactions with the health care system. Day-to-day experience with the disease, including perceived treatment side effects, appears to play a key role in the quality of these interactions. More attention should be given to patient satisfaction, especially for socially vulnerable patients, in order to avoid potentially detrimental consequences such as poor adherence to ART.
本研究的目的是确定在法国国家艾滋病研究机构（ANRS）CO8 APROCO-COPILOTE队列中接受随访的HIV感染患者对所提供护理完全满意（对医生的满意度以及对服务和机构的满意度）的相关因素。分析聚焦于队列随访第九年收集的横断面数据。使用自填问卷收集对护理的满意度、社会人口学特征和行为数据，而临床数据则来自医疗记录。对护理完全满意被定义为100%满意。使用两个逻辑回归模型来确定（1）对医生完全满意（n = 404）和（2）对服务和机构完全满意（n = 396）的预测因素。16%的患者对医生完全满意，而15.9%的患者对服务和机构完全满意。年龄较大以及报告的抗逆转录病毒疗法（ART）不适副作用较少是与对医生以及对服务和机构都完全满意独立相关的因素。来自朋友的大力支持以及无丙型肝炎（HCV）合并感染与对医生完全满意独立相关，而来自家人的大力支持和舒适的住房条件与对服务和机构完全满意独立相关。即使经过九年的随访，社会脆弱性仍然强烈影响HIV感染患者与医疗保健系统的互动。该疾病的日常体验，包括感知到的治疗副作用，似乎在这些互动的质量中起着关键作用。为避免诸如ART依从性差等潜在有害后果，应更加关注患者满意度，尤其是对社会脆弱患者。
