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对加拿大安大略省感染艾滋病毒的老年妇女发作性残疾经历的定性纵向研究。

Qualitative longitudinal study of episodic disability experiences of older women living with HIV in Ontario, Canada.

作者信息

Solomon Patricia, O'Brien Kelly K, Nixon Stephanie, Letts Lori, Baxter Larry, Gervais Nicole

机构信息

School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2018 Apr 20;8(4):e021507. doi: 10.1136/bmjopen-2018-021507.

Abstract

OBJECTIVES

To examine the episodic disability experiences of older women living with HIV over time.

DESIGN

Qualitative longitudinal study, conducting semistructured in-depth interviews on four occasions over a 20-month time frame. Inductive thematic analyses were conducted cross-sectionally and longitudinally.

SETTING

Participants were recruited from HIV community organisations in Canada.

PARTICIPANTS

10 women aged 50 years or older living with HIV for more than 6 years.

RESULTS

Two major themes related to the episodic nature of the women's disability. Women were living with multiple and complex sources of uncertainty over time including: unpredictable health challenges, worrying about cognition, unreliable weather, fearing stigma and the effects of disclosure, maintaining housing and adequate finances, and fulfilling gendered and family roles. Women describe strategies to deal with uncertainty over time including withdrawing and limiting activities and participation and engaging in meaningful activities.

CONCLUSIONS

This longitudinal study highlighted the disabling effects of HIV over time in which unpredictable fluctuations in illness and health resulted in uncertainty and worrying about the future. Environmental factors, such as stigma and weather, may put older women living with HIV at a greater risk for social isolation. Strategies to promote dealing with uncertainty and building resilience are warranted.

摘要

目的

考察感染艾滋病毒的老年女性随时间推移的发作性残疾经历。

设计

定性纵向研究,在20个月的时间内分四次进行半结构化深度访谈。进行了横断面和纵向的归纳主题分析。

背景

参与者从加拿大的艾滋病毒社区组织招募。

参与者

10名年龄在50岁及以上、感染艾滋病毒超过6年的女性。

结果

两个主要主题与女性残疾的发作性本质相关。随着时间的推移,女性面临多种复杂的不确定性来源,包括:不可预测的健康挑战、对认知的担忧、不可靠的天气、害怕耻辱感和披露的影响、维持住房和充足的资金,以及履行性别和家庭角色。女性描述了随着时间推移应对不确定性的策略,包括减少和限制活动及参与,以及参与有意义的活动。

结论

这项纵向研究强调了艾滋病毒随时间推移造成的致残影响,其中疾病和健康的不可预测波动导致了不确定性和对未来的担忧。耻辱感和天气等环境因素可能使感染艾滋病毒的老年女性面临更大的社会孤立风险。有必要制定促进应对不确定性和增强复原力的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7719/5914902/dd763f7a6394/bmjopen-2018-021507f01.jpg

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