Shen Yu-Ming, Lin Sheue-Rong, Chen Chia-Ling, Huang Tsuei-Mi, Huang Yi-Hua, See Lai-Chu, Deng Fong-Ling
Department of Public Health, Medical College, Chang Gung University, Taoyuan, Taiwan.
AIDS Care. 2013;25(3):309-16. doi: 10.1080/09540121.2012.701725. Epub 2012 Jul 12.
The professional attitude of health care workers (HCWs) who serve HIV/AIDS patients and drug users is important in implementation of the harm reduction program (HRP). This study was to explore the causal relationships between education and training, AIDS-related knowledge, attitude of supporting methadone maintenance treatment (MMT), risk perception, and professional attitude of HCWs toward serving HIV/AIDS patients and drug users. We distributed a self-administered questionnaire to HCWs who have served HIV/AIDS patients and drug users due to work in Taoyuan, northern Taiwan. Structural equation modeling (SEM) was used to test various pathways regarding the professional attitudes of HIV/AIDS patients and drug users among HCWs. A total of 218 HCWs were eligible for this study. The dual pathway model was emerged: (1) have attended education and training courses regarding to HRP positively and significantly affects professional attitude via the attitude of supporting MMT. The correlation (r) was 0.27 between education and training and the attitude of SMMT, and was 0.42 between the attitude of SMMT and professional attitude. (2) AIDS-related knowledge negatively and significantly affects professional attitude via risk perception of contracting HIV. The correlation was -0.22 between AIDS-related knowledge and risk perception, and was -0.25 between risk perception and professional attitude. Various fit indices confirmed a reasonable and acceptable fit of the model. Balance theory and approach-avoidance conflict may partially explain the dual pathways of professional attitude of HCWs toward serving HIV/AIDS patients and drug users. Our result suggests that, among HCWs, education and training courses regarding to HRP are important in increasing the attitude SMMT and AIDS-related knowledge directly, thus, professional attitude serving HIV/AIDS patients and drug users can be enhanced indirectly.
为艾滋病毒/艾滋病患者和吸毒者提供服务的医护人员的专业态度，对实施减少伤害计划（HRP）至关重要。本研究旨在探讨教育培训、艾滋病相关知识、支持美沙酮维持治疗（MMT）的态度、风险认知以及医护人员对为艾滋病毒/艾滋病患者和吸毒者提供服务的专业态度之间的因果关系。我们向因在台湾北部桃园工作而服务过艾滋病毒/艾滋病患者和吸毒者的医护人员发放了一份自填式问卷。采用结构方程模型（SEM）来检验医护人员对艾滋病毒/艾滋病患者和吸毒者专业态度的各种路径。共有218名医护人员符合本研究的条件。出现了双重路径模型：（1）积极参加与HRP相关的教育培训课程，通过支持MMT的态度对专业态度产生积极且显著的影响。教育培训与支持MMT的态度之间的相关性（r）为0.27，支持MMT的态度与专业态度之间的相关性为0.42。（2）艾滋病相关知识通过感染艾滋病毒的风险认知对专业态度产生消极且显著的影响。艾滋病相关知识与风险认知之间的相关性为-0.22，风险认知与专业态度之间的相关性为-0.25。各种拟合指数证实该模型具有合理且可接受的拟合度。平衡理论和趋避冲突可能部分解释了医护人员对为艾滋病毒/艾滋病患者和吸毒者提供服务的专业态度的双重路径。我们的结果表明，在医护人员中，与HRP相关的教育培训课程对于直接提高支持MMT的态度和艾滋病相关知识很重要，因此，可以间接增强为艾滋病毒/艾滋病患者和吸毒者提供服务的专业态度。
