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中国广西HIV与结核病合并感染患者的特征及自我感知健康状况

Patient characteristics and perceived health status of individuals with HIV and tuberculosis coinfection in Guangxi, China.

作者信息

Zhu Yujia, Wu Jizhou, Feng Xue, Chen Huanhuan, Lu Huaxiang, Chen Li, Luo Liuhong, Rui Chao

机构信息

Department of Infection, Eighth Affiliated Hospital of Guangxi Medical University, Guigang City People's Hospital, Guigang Department of Infection, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China School of Pharmacy, West Virginia University, Morgantown, WV, USA Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning Guangxi University of Chinese Medicine, Nanning, Guangxi, China.

出版信息

Medicine (Baltimore). 2017 Apr;96(14):e6475. doi: 10.1097/MD.0000000000006475.

Abstract

To explore demographics, clinical and medication profiles, patients' social support, and perceived health status in HIV/TB coinfected patients in Guangxi, China.We performed a cross-sectional study in the HIV clinic of the Guigang City People's Hospital (N = 150). Health professionals conducted face-to-face interviews and collected data from patients' electronic medical records regarding patients' demographic, clinical, and medication information, as well as their social support and perceived health status. We classified all HIV/AIDS patients into HIV monoinfected and TB coinfected, at a ratio of 2:1.Compared with the HIV monoinfected, patients with HIV/TB coinfection were more likely to be older, male, less educated, unemployed, carrying health insurance, having advanced stage of HIV infection, longer history with HIV, and other opportunistic infections. Patients coinfected with TB were also more likely to hold a negative belief that their HIV treatment could prevent exacerbations, and reported significantly worse emotional/informational support, social interaction, and perceived health status. Better social support and better self-efficacy to the HIV treatment adherence was significantly associated with better perceived health status among patients with HIV and TB coinfection.Having HIV/TB coinfection was associated with poorer perceived general well-being and mental health, particularly in those undergoing TB therapy. Our findings suggest the need for mental health referrals and medication management for coinfected individuals, as well as further efforts and policies to improve coordinated care.

摘要

为探究中国广西地区HIV/TB合并感染患者的人口统计学特征、临床和用药情况、患者的社会支持以及自我感知的健康状况,我们在贵港市人民医院的HIV门诊进行了一项横断面研究(N = 150)。卫生专业人员进行了面对面访谈,并从患者的电子病历中收集了有关患者人口统计学、临床和用药信息,以及他们的社会支持和自我感知健康状况的数据。我们将所有HIV/AIDS患者按照2:1的比例分为HIV单感染组和TB合并感染组。与HIV单感染患者相比,HIV/TB合并感染患者更可能年龄较大、为男性、受教育程度较低、失业、有医保、处于HIV感染晚期、感染HIV时间较长且患有其他机会性感染。合并感染TB的患者也更可能持有HIV治疗可预防病情加重的负面信念,并且报告称在情感/信息支持、社会交往和自我感知健康状况方面明显更差。更好的社会支持以及对HIV治疗依从性更高的自我效能感与HIV/TB合并感染患者更好的自我感知健康状况显著相关。HIV/TB合并感染与更差的总体幸福感和心理健康相关,尤其是在接受TB治疗的患者中。我们的研究结果表明,需要为合并感染个体提供心理健康转诊和用药管理,以及进一步努力并制定政策以改善协调护理。

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