Dowse R, Barford K, Browne S H
a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa.
AIDS Care. 2014;26(11):1400-6. doi: 10.1080/09540121.2014.931559. Epub 2014 Jun 30.
Few studies have investigated antiretroviral (ARV) knowledge and self-efficacy in limited literacy patients. Using a randomized controlled study design, we investigated the influence of a simple pre-tested patient information leaflet (PIL) containing both text and illustrations on HIV- and ARV-related knowledge and on self-efficacy over six months in a limited literacy African population. The recruited patients were randomly allocated to either control (standard care) or intervention group (standard care plus illustrated PIL). HIV and medicines-related knowledge was evaluated with a 22-question test at baseline, one, three, and six months. Self-efficacy was assessed using a modified version of the HIV Treatment Adherence Self-Efficacy Scale. Two-thirds of the patients were female, mean age was 39.0 ± 9.6 years and mean education was 7.3 ± 2.8 years. Patients who received the PIL showed a significant knowledge increase over the six-month period (62.0-94.4%), with improvement at each subsequent interview whereas the control group showed no improvement. At baseline, side effect knowledge was the lowest (50-56%) but increased in the intervention group to 92%. Similarly, other medicine-related knowledge at baseline (57-67%) improved significantly (93%) and was sustained over six months. Cohen's d values post-baseline ranged between 1.36 and 2.18, indicating a large intervention effect. Self-efficacy improved significantly over six months in intervention but not control patients. At baseline, patients with ≤ 3 years of education had lower knowledge and self-efficacy but this was not observed post-intervention, which we attribute to the PIL mitigating the effect of limited education. Knowledge and self-efficacy were significantly correlated in the intervention group. In conclusion, a low-cost intervention of a well-designed, pre-tested, simple, illustrated PIL significantly increased both ARV knowledge and self-efficacy in HIV patients with limited education.
很少有研究调查识字能力有限的患者的抗逆转录病毒（ARV）知识和自我效能。我们采用随机对照研究设计，调查了一份经过预测试的、包含文字和插图的简单患者信息手册（PIL）对非洲识字能力有限人群在六个月内的HIV和ARV相关知识以及自我效能的影响。招募的患者被随机分配到对照组（标准护理）或干预组（标准护理加带插图的PIL）。在基线、1个月、3个月和6个月时，通过一项包含22个问题的测试评估HIV和药物相关知识。使用HIV治疗依从性自我效能量表的修改版评估自我效能。三分之二的患者为女性，平均年龄为39.0±9.6岁，平均受教育年限为7.3±2.8年。接受PIL的患者在六个月内知识有显著增加（62.0 - 94.4%），在每次后续访谈中都有改善，而对照组没有改善。在基线时，副作用知识最低（50 - 56%），但在干预组中增加到92%。同样，基线时的其他药物相关知识（57 - 67%）显著改善（93%），并在六个月内保持。基线后Cohen's d值在1.36至2.18之间，表明干预效果显著。干预组患者的自我效能在六个月内显著改善，而对照组患者没有。在基线时，受教育年限≤3年的患者知识和自我效能较低，但干预后未观察到这种情况，我们将其归因于PIL减轻了教育程度有限的影响。干预组中知识和自我效能显著相关。总之，一项设计良好、经过预测试、简单且带插图的PIL的低成本干预措施显著提高了受教育程度有限的HIV患者的ARV知识和自我效能。
