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在约翰内斯堡的克里斯·哈尼·巴拉干纳特医院,使用《国际功能、残疾和健康分类》(ICF)对艾滋病毒呈阳性的住院患者进行评估。

Assessment of HIV-positive in-patients using the International Classification of Functioning, Disability and Health (ICF) at Chris Hani Baragwanath Hospital, Johannesburg.

作者信息

Myezwa Hellen, Stewart Aimee, Musenge Eustasius, Nesara Paul

出版信息

Afr J AIDS Res. 2009 Mar;8(1):93-105. doi: 10.2989/AJAR.2009.8.1.10.723.

Abstract

The International Classification of Functioning, Disability and Health (ICF) short-version checklist was used to assess the impairments, activity limitations and participation restrictions experienced by a sample of HIV-positive in-patients admitted to Chris Hani Baragwanath Hospital in Johannesburg, South Africa. Laboratory tests, observation and review of patients' medical records were used to complete the ICF Checklist. Eighty patients were assessed (23 males and 57 females). Common impairments related to the following functions: digestive, metabolic and endocrine systems (83.9%); sensory (83.5%); haematological, immunological and respiratory systems (82.5%); neuromusculoskeletal movement (73.8%); mental (72.6%); energy and drive (75%); sleep (71%); emotional (62%); and muscle power (75%). Activity limitations were present in the area of mobility (56.4%), major life areas (55.1%), and community, social and civic life (50%). Associations found among impairments, activity limitations and participation restrictions were that patients with sensory problems were five-times more likely to have problems in self-care than people without sensory problems. Patients with impairments in the digestive, genitourinary and neuromusculoskeletal systems experienced problems with general tasks (confidence interval [CI]: 4.05-103.03; p < 0.01). Patients with cardiovascular, haematological, immunological and respiratory system problems were 14-times more likely to have problems with execution of general tasks (odds ratio [OR] 14.06, CI: 2.75-71.94; p = 0.002). Activities of participation restriction, difficulties with general tasks and demands (OR 9.68, CI: 1.20-77.92), interpersonal relationships (OR 3.62, CI: 1.09-12.00), domestic life (OR 3.97, CI: 1.12-14.16), and community, social and civic life (OR 4.13, CI: 1.05-16.20) were closely associated with barriers in obtaining products for personal use and using technology. Understanding the prevalence and associations of disability and function in the course of HIV disease may serve as a baseline for developing appropriate and context-sensitive rehabilitation interventions and management strategies for people living with HIV or AIDS.

摘要

采用《国际功能、残疾和健康分类》(ICF)简版检查表,对南非约翰内斯堡克里斯·哈尼·巴拉格瓦纳特医院收治的一组HIV阳性住院患者所经历的损伤、活动受限和参与限制进行评估。通过实验室检查、观察以及查阅患者病历等方式来完成ICF检查表。共评估了80名患者(23名男性和57名女性)。常见损伤涉及以下功能系统:消化、代谢和内分泌系统(83.9%);感官(83.5%);血液、免疫和呼吸系统(82.5%);神经肌肉运动(73.8%);心理(72.6%);精力和动力(75%);睡眠(71%);情绪(62%);以及肌肉力量(75%)。活动受限出现在行动能力(56.4%)、主要生活领域(55.1%)以及社区、社会和公民生活(50%)方面。在损伤、活动受限和参与限制之间发现的关联有:存在感官问题的患者在自我护理方面出现问题的可能性是没有感官问题患者的五倍。消化、泌尿生殖和神经肌肉骨骼系统存在损伤的患者在一般任务方面存在问题(置信区间[CI]:4.05 - 103.03;p < 0.01)。心血管、血液、免疫和呼吸系统存在问题的患者在执行一般任务方面出现问题的可能性高出14倍(比值比[OR] 14.06,CI:2.75 - 71.94;p = 0.002)。参与限制活动、一般任务和需求方面的困难(OR 9.68,CI:1.20 - 77.92)、人际关系(OR 3.62,CI:1.09 - 12.00)、家庭生活(OR 3.97,CI:1.12 - 14.16)以及社区、社会和公民生活(OR 4.13,CI:1.05 - 16.20)与获取个人用品和使用技术方面的障碍密切相关。了解HIV疾病过程中残疾和功能的患病率及关联情况,可为制定适合且符合实际情况的针对HIV感染者或艾滋病患者的康复干预措施和管理策略提供基线依据。

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