Cho Hwayoung, Iribarren Sarah, Schnall Rebecca
Hwayoung Cho, MPhil, MSN, RN, Columbia University School of Nursing, 617 West 168th Street, New York, NY 10032, United States, Email:
Appl Clin Inform. 2017 Apr 12;8(2):348-368. doi: 10.4338/ACI-2016-10-R-0175.
As HIV/AIDS is considered a chronic disease; quality of life (QoL) has become an important focus for researchers and healthcare providers. Technology-mediated interventions have demonstrated improved clinical effectiveness in outcomes, such as viral suppression, for persons living with HIV/AIDS (PLWH). However, the evidence to support the impact of these interventions on QoL is lacking.
The aim of this paper was to assess the impact of technology-mediated interventions on QoL and to identify the instruments used to measure the QoL of PLWH.
For this review we followed the PRISMA guidelines. A literature search was conducted in PubMed, CINAHL, Cochrane, and EMBASE databases in April 2016. Inclusion criteria limited articles to those with technology-mediated interventions as compared to usual care; articles with the population defined as HIV-infected patients; and articles with QoL measured as a health outcome in randomized controlled trials. The Cochrane Collaboration Risk of Bias Tool was used to assess study quality.
Of the 1,554 peer-reviewed articles returned in the searches, 10 met the inclusion criteria. This systematic review identified four types of technology-mediated interventions and two types of QoL instruments used to examine the impact of technology-mediated interventions on PLWH. Four studies of technology-mediated interventions resulted in improvement in QoL. Four studies considered QoL as a secondary outcome and resulted in a negative or neutral impact on QoL. Overall, four studies had a low risk of bias, one study had a moderate risk of bias, and the other five studies had a high risk of bias.
The evidence to support the improvement of QoL using technology-mediated interventions is insufficient. This lack of research highlights the need for increased study of QoL as an outcome measure and the need for consistent measures to better understand the role of technology-mediated interventions in improving QoL for PLWH.
由于艾滋病毒/艾滋病被视为一种慢性病，生活质量（QoL）已成为研究人员和医疗服务提供者的重要关注点。技术介导的干预措施已证明对艾滋病毒/艾滋病感染者（PLWH）的临床效果有所改善，例如病毒抑制。然而，缺乏支持这些干预措施对生活质量影响的证据。
本文旨在评估技术介导的干预措施对生活质量的影响，并确定用于测量艾滋病毒/艾滋病感染者生活质量的工具。
对于本综述，我们遵循PRISMA指南。2016年4月在PubMed、CINAHL、Cochrane和EMBASE数据库中进行了文献检索。纳入标准将文章限制为与常规护理相比采用技术介导干预措施的文章；将人群定义为艾滋病毒感染患者的文章；以及在随机对照试验中将生活质量作为健康结果进行测量的文章。使用Cochrane协作偏倚风险工具评估研究质量。
在检索返回的1554篇同行评审文章中，10篇符合纳入标准。本系统综述确定了四种类型的技术介导干预措施和两种用于检查技术介导干预措施对艾滋病毒/艾滋病感染者影响的生活质量工具。四项技术介导干预措施的研究导致生活质量得到改善。四项研究将生活质量视为次要结果，对生活质量产生了负面或中性影响。总体而言，四项研究的偏倚风险较低，一项研究的偏倚风险中等，其他五项研究的偏倚风险较高。
支持使用技术介导干预措施改善生活质量的证据不足。这项研究的缺乏凸显了将生活质量作为结果指标进行更多研究的必要性，以及需要采用一致的测量方法来更好地理解技术介导干预措施在改善艾滋病毒/艾滋病感染者生活质量方面的作用。
