Solomon Patricia, O'Brien Kelly, Wilkins Seanne, Gervais Nicole
a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada.
AIDS Care. 2014 Feb;26(2):240-5. doi: 10.1080/09540121.2013.811209. Epub 2013 Jun 26.
Due to advances in treatment, people with HIV are living longer and developing disabilities related to the virus, adverse side effects of medications, and aging. Illness-related uncertainty has been shown to contribute to disablement; however, there is little understanding of the uncertainties related to aging with HIV. The purpose of this research was to describe the contribution of uncertainty to the disability experienced by older adults living with HIV. Forty-nine men and women living with HIV and 50 years or older participated in in-depth qualitative interviews exploring various aspects of social participation and disability. Transcriptions of the interviews were analyzed using a grounded theory approach. Age-related uncertainties were described in the following themes: source of health challenge; health providers' age-related knowledge and skills; financial uncertainty; transition to retirement; appropriate long-term housing, and uncertainty over who would care for them. While not directly attributable to aging, the episodic nature of HIV left many with uncertainties related to when their next episode of illness would occur and often resulted in an inability to plan in advance. Results highlight the need to focus on the notion of successful and positive aging with the view to identifying effective interventions that reduce disability and enhance the overall health of older adults with HIV. This work builds on previous studies highlighting the role of uncertainty in the disability experience by identifying age-related components specific to older adults aging with HIV.
由于治疗方面的进展，感染艾滋病毒的人寿命延长，并且出现了与该病毒、药物的不良副作用以及衰老相关的残疾。疾病相关的不确定性已被证明会导致残疾；然而，对于与感染艾滋病毒后的衰老相关的不确定性却知之甚少。本研究的目的是描述不确定性对感染艾滋病毒的老年人所经历的残疾的影响。49名年龄在50岁及以上的感染艾滋病毒的男性和女性参与了深入的定性访谈，探讨社会参与和残疾的各个方面。访谈记录采用扎根理论方法进行分析。与年龄相关的不确定性在以下主题中有所描述：健康挑战的来源；医疗服务提供者与年龄相关的知识和技能；经济不确定性；向退休的过渡；合适的长期住房，以及对谁会照顾他们的不确定性。虽然并非直接归因于衰老，但艾滋病毒的发作性使许多人对下一次发病时间存在不确定性，并且常常导致无法提前规划。研究结果强调，有必要关注成功和积极老龄化的概念，以便确定有效的干预措施，减少残疾并提高感染艾滋病毒的老年人的整体健康水平。这项工作建立在以往研究的基础上，通过确定感染艾滋病毒的老年人特有的与年龄相关的因素，突出了不确定性在残疾经历中的作用。
