Nightingale A, Ratcliffe D, Leonidou L, Margetts A, Asboe D, Gazzard B, Catalan J, Barber T J
a St. Stephen's AIDS Trust , Chelsea and Westminster Hospital , London , UK.
AIDS Care. 2014;26(8):1036-41. doi: 10.1080/09540121.2014.894619. Epub 2014 Mar 13.
Despite ever improving advances in antiretroviral therapy, neurocognitive impairments such as asymptomatic and mild neurocognitive impairment remain a significant problem for the HIV-positive population. We distributed a post-neurocognitive impairment screening service evaluation questionnaire to assess satisfaction and anxiety. Subjects were HIV positive and aged 18-50. They were screened using the Brief Neurocognitive Score and International HIV Dementia Score as well as undergoing screening for anxiety (Generalised Anxiety Disorder Assessment [GAD-7]), depression (Participant Health Questionnaire Mood Scale [PHQ-9]) and memory (Everyday Memory Questionnaire [EMQ-R]). On completion, they were either reassured that the tests were normal or were referred for further investigation. Following assessment, subjects were asked to complete an anonymous satisfaction survey; 101 surveys were analysed. Forty-nine per cent of participants stated that they "felt better" following screening, 43% said it "made no difference", 6% stated it "worried me" and 1% "did not understand". On a scale of 0-10 of helpfulness, the mean score was 7.53. Forty-seven subjects indicated that they were referred for further investigation and 46 subjects that nothing else was needed; 8 reported they did not know. Those referred on rated satisfaction at a mean of 7.54/10 and those with normal screen as 7.09/10 (p = 0.46). Of the groups that were referred for further investigation, 6% said the test "worried them" compared to 4% in the non-referred group. Forty-nine per cent said they "felt better" despite an abnormal result compared to 50% in a normal screening result (p = 0.76). The results of this survey show that screening for neurocognitive impairment by this method is acceptable and helpful to participants. It did not lead to an increase in anxiety and there was no correlation between referred for further investigations and anxiety suggesting concerns about creating undue anxiety by screening and referral are unfounded.
尽管抗逆转录病毒疗法不断取得进步，但诸如无症状和轻度神经认知障碍等神经认知损害仍是艾滋病毒阳性人群面临的重大问题。我们发放了一份神经认知损害筛查服务评估后调查问卷，以评估满意度和焦虑情况。受试者为18至50岁的艾滋病毒阳性者。他们使用简易神经认知评分和国际艾滋病毒痴呆评分进行筛查，并接受焦虑症（广泛性焦虑症评估量表[GAD - 7]）、抑郁症（患者健康问卷情绪量表[PHQ - 9]）和记忆力（日常记忆问卷[EMQ - R]）的筛查。完成后，他们要么被告知检测结果正常，要么被转介进行进一步检查。评估后，要求受试者完成一份匿名满意度调查；对101份调查问卷进行了分析。49%的参与者表示筛查后“感觉好多了”，43%的人说“没什么区别”，6%的人表示“让我担心”，1%的人“不明白”。在0至10分的帮助程度评分中，平均分为7.53分。47名受试者表示他们被转介进行进一步检查，46名受试者表示无需其他检查；8人表示不知道。被转介者的满意度平均评分为7.54/10，筛查结果正常者为7.09/10（p = 0.46）。在被转介进行进一步检查的人群中，6%的人表示检测“让他们担心”，而非转介组为4%。49%的人表示尽管结果异常但他们“感觉好多了”，而正常筛查结果组为50%（p = 0.76）。这项调查结果表明，通过这种方法进行神经认知损害筛查对参与者来说是可以接受且有帮助的。它并未导致焦虑增加，被转介进行进一步检查与焦虑之间也没有相关性，这表明担心筛查和转介会造成过度焦虑是没有根据的。
