Florence Nightingale Faculty of Nursing, Cicely Saunders Institute, Midwifery and Palliative Care, Kings College London, London, United Kingdom.
Infection & Population Health, Institute for Global Health, Faculty of Population Health Sciences, University College London, London, United Kingdom.
J Acquir Immune Defic Syndr. 2018 Oct 1;79(2):206-225. doi: 10.1097/QAI.0000000000001785.
Pain and symptoms still persist among people living with HIV/AIDS. Evidence-based self-management interventions have the potential to help people with HIV/AIDS to successfully manage pain and symptoms. We aimed to identify and appraise the evidence regarding the effectiveness of self-management interventions for pain and/or physical symptoms in people living with HIV/AIDS.
We searched for controlled intervention studies in Amed, Assian, CINAHL, Cochrane Library, Embase, Medline, PsycInfo, Scopus, and Web of Science data bases, from 1984 to February 2017. Two reviewers screened and extracted data, assessed risk of bias (using Joanna Briggs Institute Critical Appraisal checklist for randomized and nonrandomized trials), and rated the quality of evidence (GRADE tool).
We identified 22 original papers reporting 19 different studies. Of these, 17 used randomized controlled trial designs. Three studies reported data on pain severity, and 2 studies reported data on pain interference outcomes with one study reporting positive effect on both outcomes. Outcomes for physical symptoms were reported in 13 studies with 6 studies reporting positive effect. The quality of evidence was moderate for pain outcomes. For physical symptoms, one study was rated as moderate; the rest were rated as low n = 8 and very low n = 4 quality.
There is some evidence to suggest that self-management interventions delivered either online, face-to-face, or group-based consisting of booklet, leaflet, or manuals are effective in improving pain and physical symptoms. Findings suggest the need for theoretically plausible high-quality clinical trials of pain and physical symptom self-management among culturally diverse people with HIV.
艾滋病毒/艾滋病感染者仍存在疼痛和症状。循证自我管理干预措施有可能帮助艾滋病毒感染者成功管理疼痛和症状。我们旨在确定并评估针对艾滋病毒感染者的疼痛和/或身体症状的自我管理干预措施的有效性证据。
我们在 Amed、Assian、CINAHL、Cochrane 图书馆、Embase、Medline、PsycInfo、Scopus 和 Web of Science 数据库中搜索了从 1984 年到 2017 年 2 月的对照干预研究。两名审查员筛选和提取数据，评估偏倚风险（使用 Joanna Briggs Institute 对随机和非随机试验的批判性评价检查表），并评价证据质量（GRADE 工具）。
我们确定了 22 篇原始论文，报道了 19 项不同的研究。其中，17 项使用了随机对照试验设计。三项研究报告了疼痛严重程度的数据，两项研究报告了疼痛干扰结果的数据，其中一项研究对这两个结果均有积极影响。13 项研究报告了身体症状的结果，其中 6 项研究报告了积极的结果。疼痛结果的证据质量为中等。对于身体症状，有一项研究被评为中等质量；其余的研究被评为低质量 n = 8 和极低质量 n = 4。
有一些证据表明，无论是通过在线、面对面还是小组形式（包括小册子、传单或手册）提供的自我管理干预措施，都能有效改善疼痛和身体症状。研究结果表明，需要在文化多样化的艾滋病毒感染者中进行理论上合理的高质量疼痛和身体症状自我管理的临床试验。
