Department of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton, UK.
Psychol Health Med. 2013;18(3):343-54. doi: 10.1080/13548506.2012.722648. Epub 2012 Sep 17.
Adherence to antiretroviral (ARV) treatment during adolescence and young adulthood is a significant clinical issue for the current management of the HIV/AIDS epidemic in Romania. Understanding patients' own perceptions of their adherence behaviours and related psychological barriers is instrumental for developing robust interventions, and developing psychometrically sound instruments is essential for measuring adherence in this population. We adapted to Romanian an internationally validated questionnaire for the evaluation of ARV treatment adherence. We subsequently conducted a cross-sectional survey to examine its psychometric properties and investigate the relations between self-reported aspects of adherence and established indicators of adherence and health status: Pill count, doctor's assessment of patient's adherence and viral load. Results suggest that low self-reported adherence is particularly associated with experiencing side effects and emotional distress, as well as perceptions of high treatment difficulty and time demands, low self-efficacy, low treatment efficacy and low treatment satisfaction. Perceptions of improvements in health status were overall associated with increased adherence, but feeling good physically sometimes preceded non-adherence behaviours. The questionnaire proved psychometrically sound according to classical test theory criteria (e.g., Cronbach's α = 0.77, significant associations with adherence and health status indicators). Addressing adherence barriers in clinical practice with this population may help reduce their potential impact on behaviours.
青少年和青年时期坚持接受抗逆转录病毒 (ARV) 治疗，这对于罗马尼亚目前管理艾滋病毒/艾滋病疫情是一个重大的临床问题。了解患者对自身坚持治疗行为的看法以及相关的心理障碍，对于制定强有力的干预措施至关重要，而开发具有良好心理测量学特性的工具对于衡量该人群的治疗依从性也至关重要。我们对评估 ARV 治疗依从性的国际上经过验证的问卷进行了调整，以便适用于罗马尼亚。随后，我们进行了一项横断面调查，以检验其心理测量学特性，并研究自我报告的依从性与既定的依从性和健康状况指标之间的关系：用药计数、医生对患者依从性的评估和病毒载量。结果表明，低自我报告的依从性与体验副作用和情绪困扰、感知治疗难度和时间要求高、自我效能感低、治疗效果低以及治疗满意度低特别相关。对健康状况改善的认知与增加的依从性总体上相关，但有时身体感觉良好会先于不依从行为。根据经典测试理论标准（例如，克朗巴赫的 α = 0.77，与依从性和健康状况指标存在显著关联），该问卷在心理测量学上是可靠的。在临床实践中针对该人群的依从性障碍进行干预，可能有助于减少其对行为的潜在影响。
