Mutabazi-Mwesigire Doris, Seeley Janet, Martin Faith, Katamba Achilles
Makerere College of Health Sciences, Makerere University, P,O, Box 7062, Kampala, Uganda.
BMC Public Health. 2014 Apr 10;14:343. doi: 10.1186/1471-2458-14-343.
Ugandans have endured the HIV epidemic for three decades. Now, with the availability of antiretroviral therapy (ART) and early diagnosis, those living with HIV can live longer and can enjoy the same life expectancy as the rest of the Ugandan population. This emerging trend necessitates the assessment of quality of life, alongside other patient outcomes, of those undergoing therapy, alongside other patient outcomes. While major strides have been made in developing measures of quality of life in the developed world, there remains a paucity of evidence from resource-limited settings. This challenge is further complicated by the contentious definition of quality of life, which is highly subjective and varies between individuals. In this paper, we aim to identify the determinants of quality of life for people living with HIV in a Ugandan context to contribute to the chronic care model for persons living with HIV/AIDS.
Twenty HIV-positive participants took part in in-depth interviews at an urban clinic, with follow-ups at three and six months. Ten patients were on ART and ten not on ART. All interviews were transcribed and translated for analysis. Data were analysed manually using the framework approach to content analysis.
Individuals reported on four aspects of quality of life: liveability of the environment, utility of life, life ability of a person and appreciation of life. Respondents described multiple expectations and expressed hope for their future. However, many still suffered from stigma, fears of disclosure and poverty, which negatively affected their quality of life.
Individuals living with HIV receiving treatment or in care experienced an improved quality of life in this setting, although the situation for many remains precarious.
乌干达人已历经三十年的艾滋病疫情。如今,随着抗逆转录病毒疗法(ART)的普及和早期诊断技术的应用,艾滋病毒感染者能够活得更长久,预期寿命与乌干达其他人群相同。这一新兴趋势使得评估接受治疗者的生活质量以及其他患者治疗结果成为必要。尽管在发达国家,生活质量评估方法已取得重大进展,但资源有限地区的相关证据仍然匮乏。生活质量的定义颇具争议,主观性很强且因人而异,这使得这一挑战更加复杂。在本文中,我们旨在确定乌干达艾滋病毒感染者生活质量的决定因素,为艾滋病毒/艾滋病患者的慢性病护理模式做出贡献。
20名艾滋病毒呈阳性的参与者在一家城市诊所接受了深入访谈,并在三个月和六个月后进行了随访。其中10名患者正在接受抗逆转录病毒治疗,10名未接受治疗。所有访谈内容均被转录并翻译以供分析。采用框架式内容分析法对数据进行人工分析。
参与者报告了生活质量的四个方面:环境宜居性、生活效用、个人生活能力和对生活的满意度。受访者描述了多种期望,并对未来表达了希望。然而,许多人仍然遭受着耻辱感、对暴露病情的恐惧和贫困的困扰,这些都对他们的生活质量产生了负面影响。
在这种情况下,接受治疗或护理的艾滋病毒感染者的生活质量有所改善,尽管许多人的情况仍然岌岌可危。