Alsayed Nahed S, Sereika Susan M, Albrecht Susan A, Terry Martha A, Erlen Judith A
School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.
Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
Qual Life Res. 2017 Mar;26(3):655-663. doi: 10.1007/s11136-016-1482-4. Epub 2016 Dec 21.
The purpose of this secondary analysis was to test Ferrans et al.'s (J Nurs Scholarsh 37(4):336-342, 2005) revised model of health-related quality of life (HRQoL) (2005) modified from the Wilson and Cleary (J Am Med Assoc 273(1):59-65, 1995) model on women living with HIV. The primary aim was to test this model, examining the relations among the five central components (biological function, symptoms, functional status, general health perceptions, and HRQoL). The secondary aim was to explore the individual (age, children, race, marital status, education) and environmental (HIV-related stigma, social support) characteristics that may impact the main components of the model.
This study employed a cross-sectional correlational design using baseline data from 178 women living with HIV/AIDS who participated in one of the two independent randomized controlled trials designed to enhance HIV medication adherence. Path analysis using structural equation modeling was used to examine the hypothesized multivariate relations proposed in the revised Wilson and Cleary (J Am Med Assoc 273(1):59-65, 1995) model of HRQoL.
While the revised model did not fit, exploratory post hoc modified models with a path from depressive symptoms to overall general health had an adequate model fit. Women with lower depressive symptoms (r = -.457, p < .01), lower HIV-related stigma (r = -.462, p < .01), higher social support (r = .413, p < .01), higher physical functioning (r = .350, p < .01), and higher general health perceptions (r = .537, p < .01) had higher overall HRQoL.
The results of this study have the potential to assist healthcare professionals in improving HRQoL for women living with HIV/AIDS.
本二次分析的目的是检验费兰斯等人(《护理学术期刊》37(4):336 - 342, 2005年)修订后的健康相关生活质量(HRQoL)模型(2005年),该模型是在威尔逊和克利里(《美国医学会杂志》273(1):59 - 65, 1995年)模型基础上针对感染HIV的女性进行修改的。主要目的是检验该模型,研究五个核心组成部分(生理功能、症状、功能状态、总体健康认知和健康相关生活质量)之间的关系。次要目的是探索可能影响该模型主要组成部分的个体特征(年龄、子女情况、种族、婚姻状况、教育程度)和环境特征(与HIV相关的耻辱感、社会支持)。
本研究采用横断面相关设计,使用了178名感染HIV/艾滋病女性的基线数据,这些女性参与了两项旨在提高HIV药物依从性的独立随机对照试验之一。采用结构方程模型进行路径分析,以检验修订后的威尔逊和克利里(《美国医学会杂志》273(1):59 - 65, 1995年)健康相关生活质量模型中提出的假设多变量关系。
虽然修订后的模型拟合不佳,但探索性的事后修改模型,即从抑郁症状到总体健康有一条路径的模型,具有足够的模型拟合度。抑郁症状较轻(r = -0.457,p < 0.01)、与HIV相关的耻辱感较低(r = -0.462,p < 0.01)、社会支持较高(r = 0.413,p < 0.01)、身体功能较好(r = 0.350,p < 0.01)以及总体健康认知较高(r = 0.537,p < 0.01)的女性,其总体健康相关生活质量较高。
本研究结果有可能帮助医疗保健专业人员提高感染HIV/艾滋病女性的健康相关生活质量。