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感染艾滋病毒的老年人健康相关生活质量的风险和保护因素。

Risk and protective factors for health-related quality of life among persons aging with HIV.

作者信息

Nguyen Annie L, McNeil Candice J, Han S Duke, Rhodes Scott D

机构信息

a Department of Family Medicine, Keck School of Medicine , University of Southern California , Alhambra , CA , USA.

b Department of Internal Medicine, Section on Infectious Diseases , Wake Forest University Health Sciences , Winston-Salem , NC , USA.

出版信息

AIDS Care. 2018 Apr;30(4):518-522. doi: 10.1080/09540121.2017.1381333. Epub 2017 Sep 25.

Abstract

For persons living with HIV, health-related quality of life (HRQOL) may be threatened by physical and mental conditions but may be protected by positive psychological traits. We performed an exploratory look at the risk and protective factors for HRQOL in older adults living with HIV. Cross-sectional analyses of baseline data from the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA), a community-based cohort of persons ages ≥50 living with HIV (n = 176) were performed. Analyses examined the relationship between risk/protective factors and two outcomes (i.e., self-reported health status [SRHS] and the healthy days index [HDI]). Having good/excellent health was associated with being a non-smoker (p = 0.002), greater purpose in life (p = 0.006), higher education (p = 0.007), fewer depressive symptoms (p = 0.004), fewer disabilities (p = 0.000), and less loneliness (p = 0.002) in bivariate analyses. Males (p = 0.03) and African Americans/Blacks (p = 0.03) reported higher HDI. Fewer depressive symptoms (p = 0.000), disabilities (p = 0.002), adverse life events (p = 0.0103), and loneliness (p = 0.000) were associated with higher HDI in bivariate analyses. In a logistic regression model, greater purpose in life, fewer disabilities, and being a non-smoker were associated with better SRHS after adjusting for covariates. For African Americans/Blacks, having fewer depressive symptoms and disabilities were associated with higher HDI after adjusting for covariates. Disabilities, depression, smoking status, race/ethnicity, and purpose in life were significantly associated with HRQOL. Findings support the need for research to examine the influence of cultural interpretations of life quality and focus on promoting physical function, smoking cessation, and psychological wellness in persons aging with HIV.

摘要

对于感染艾滋病毒的人来说,与健康相关的生活质量(HRQOL)可能会受到身体和精神状况的威胁,但积极的心理特质可能会起到保护作用。我们对老年艾滋病毒感染者HRQOL的风险和保护因素进行了探索性研究。对拉什艾滋病毒与衰老差异卓越中心(CEDHA)的基线数据进行了横断面分析,该中心是一个以社区为基础的队列,研究对象为年龄≥50岁的艾滋病毒感染者(n = 176)。分析考察了风险/保护因素与两个结果(即自我报告的健康状况[SRHS]和健康天数指数[HDI])之间的关系。在双变量分析中,健康状况良好/极佳与不吸烟(p = 0.002)、生活目标更明确(p = 0.006)、受教育程度更高(p = 0.007)、抑郁症状更少(p = 0.004)、残疾更少(p = 0.000)以及孤独感更少(p = 0.002)相关。男性(p = 0.03)和非裔美国人/黑人(p = 0.03)报告的HDI更高。在双变量分析中,抑郁症状更少(p = 0.000)、残疾更少(p = 0.002)、不良生活事件更少(p = 0.0103)以及孤独感更少(p = 0.000)与更高的HDI相关。在逻辑回归模型中,在调整协变量后,生活目标更明确、残疾更少以及不吸烟与更好的SRHS相关。对于非裔美国人/黑人,在调整协变量后,抑郁症状更少和残疾更少与更高的HDI相关。残疾、抑郁、吸烟状况、种族/族裔以及生活目标与HRQOL显著相关。研究结果支持有必要进行研究,以考察生活质量的文化解读的影响,并专注于促进艾滋病毒感染老年人的身体功能、戒烟和心理健康。

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