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两家公共机构中接受治疗的HIV患者对医疗服务的满意度及抗逆转录病毒治疗的依从性

Satisfaction with Healthcare Services and Adherence to Antiretroviral Therapy among Patients with HIV Attending Two Public Institutions.

作者信息

Pérez-Salgado Diana, Compean-Dardón María Sandra, Staines-Orozco María Guadalupe, Ortiz-Hernández Luis

机构信息

Health Care Department, Universidad Autónoma Metropolitana Unidad Xochimilco, Coyoacán, México D.F., Mexico.

出版信息

Rev Invest Clin. 2015 Mar-Apr;67(2):80-8.

Abstract

BACKGROUND

Discontinuation of antiretroviral therapy has adverse consequences in HIV patients and is a major public health problem. We analyzed the relationship between satisfaction with healthcare services and adherence to antiretroviral therapy among patients with HIV in Mexico City.

MATERIAL AND METHODS

We conducted a cross-sectional study with patients with HIV (n = 557) who were treated in two public institutions. An ad hoc questionnaire was used to assess perceived satisfaction with healthcare services (i.e. physician/patient relationship, performance of services, and administrative aspects with focus on specific areas) and adherence to HIV treatment (i.e. failure to take antiretroviral therapy on previous day, week, and month).

RESULTS

The higher prevalence of non-adherence to antiretroviral therapy was during the previous month (23.5%). Dissatisfied patients with the relationship with their physician were more likely to have low adherence during the previous month (OR: 1.90; p < 0.05). Those who were dissatisfied with the care provided in specific clinical areas had low adherence (OR: 1.67; p = 0.051), but the difference disappeared (OR: 1.26; p = 0.443) after adjusting for satisfaction with physician/patient relationship.

CONCLUSIONS

The quality of the relationship between physician and patients is an aspect that impacts on adherence to antiretroviral therapy. It is necessary to promote effective communication between health personnel and patients with HIV.

摘要

背景

抗逆转录病毒疗法的中断对艾滋病毒患者有不良后果,是一个重大的公共卫生问题。我们分析了墨西哥城艾滋病毒患者对医疗服务的满意度与抗逆转录病毒疗法依从性之间的关系。

材料与方法

我们对在两家公共机构接受治疗的艾滋病毒患者(n = 557)进行了一项横断面研究。使用一份专门设计的问卷来评估对医疗服务的感知满意度(即医患关系、服务表现以及侧重于特定领域的管理方面)和对艾滋病毒治疗的依从性(即前一天、一周和一个月未服用抗逆转录病毒疗法)。

结果

在前一个月,抗逆转录病毒疗法不依从的患病率较高(23.5%)。对医患关系不满意的患者在前一个月更有可能依从性较低(比值比:1.90;p < 0.05)。对特定临床领域提供的护理不满意的患者依从性较低(比值比:1.67;p = 0.051),但在调整了对医患关系的满意度后,差异消失(比值比:1.26;p = 0.443)。

结论

医患关系的质量是影响抗逆转录病毒疗法依从性的一个方面。有必要促进卫生人员与艾滋病毒患者之间的有效沟通。

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