Cook Paul F, Schmiege Sarah J, Bradley-Springer Lucy, Starr Whitney, Carrington Jane M
J Assoc Nurses AIDS Care. 2018 May-Jun;29(3):383-393. doi: 10.1016/j.jana.2017.09.003. Epub 2017 Sep 9.
Medication adherence is a challenge for people living with HIV (PLWH), who may experience a gap between their intentions and everyday behaviors. We measured PLWH's (n = 87) daily experiences and tested a model to explain the intention-behavior gap. Participants completed baseline questionnaires, then used a smartphone-based survey and an electronic pill bottle to provide daily data for the next 10 weeks. These PLWH, with generally well-controlled HIV, were nevertheless adherent on only 73% of study days. Multilevel analyses were used to test predicted relationships between variables (n = 58). Four of five theory-based daily measures predicted motivation for antiretroviral therapy (betas = 0.06-0.10), and motivation, in turn, predicted adherence. Consistent with our theory, control beliefs, mood, and social support had indirect effects on adherence. However, stress and coping did not. Daily experiences affect adherence, even in PLWH with well-controlled HIV. Providers should ask about everyday changes in motivation.
药物依从性对于艾滋病毒感染者（PLWH）来说是一项挑战，他们可能会在服药意愿和日常行为之间存在差距。我们测量了87名艾滋病毒感染者的日常经历，并测试了一个模型来解释意愿 - 行为差距。参与者完成了基线调查问卷，然后使用基于智能手机的调查和电子药瓶在接下来的10周内提供每日数据。这些艾滋病毒总体得到良好控制的感染者在研究日的服药依从率仅为73%。我们使用多层次分析来测试变量之间的预测关系（n = 58）。五项基于理论的每日测量指标中有四项预测了抗逆转录病毒治疗的动机（β系数 = 0.06 - 0.10），而动机又反过来预测了依从性。与我们的理论一致，控制信念、情绪和社会支持对依从性有间接影响。然而，压力和应对方式则没有。即使是艾滋病毒得到良好控制的感染者，日常经历也会影响依从性。医疗服务提供者应该询问患者动机方面的日常变化。
