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加拿大安大略省感染艾滋病毒的老年男性应对残疾的生活策略:一项纵向定性研究

Living strategies for disability in men ageing with HIV in Ontario, Canada: a longitudinal qualitative study.

作者信息

Solomon Patricia, O'Brien Kelly K, McGuff Rebecca, Sankey Michelle

机构信息

School of Rehabilitation Science, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada

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

出版信息

BMJ Open. 2019 Sep 3;9(8):e031262. doi: 10.1136/bmjopen-2019-031262.

Abstract

OBJECTIVES

To examine the living strategies used by older men living with HIV to deal with the episodic nature of disability and associated uncertainty, over time.

DESIGN

Qualitative longitudinal study in which men living with HIV were interviewed on four occasions over 20 months.

SETTING

Men were recruited from HIV community organisations in Canada.

PARTICIPANTS

14 men with a median age of 57.5 years and median time since diagnosis of 21.5 years.

RESULTS

Five themes depict the living strategies used to deal with the episodic nature of disability and uncertainty over time. Actively engaging in problem-solving by prioritising and modifying activities and avoiding stress, advocating for support, being positive and future oriented, engaging in healthy pursuits and providing social support to others helped men to mitigate their disability. By following participants over time, we were able to gather insights into triggers of episodes of disability, and perceptions of the success of implementing their living strategies and avoiding uncertainty.

CONCLUSIONS

Participants used living strategies to deal with uncertainty and mitigate episodes of disability over time. This study supports the importance of programmes that promote self-management for older men living with HIV through helping them identify triggers of disability, set realistic goals and problem-solve. These may help build self-efficacy, increase sense of control, and decrease feelings of uncertainty and episodes of disability.

摘要

目的

探讨感染艾滋病毒的老年男性随着时间推移应对残疾的间歇性及相关不确定性所采用的生活策略。

设计

定性纵向研究,对感染艾滋病毒的男性在20个月内进行了4次访谈。

背景

从加拿大的艾滋病毒社区组织招募男性。

参与者

14名男性,中位年龄57.5岁,自确诊以来的中位时间为21.5年。

结果

五个主题描述了随着时间推移用于应对残疾的间歇性和不确定性的生活策略。通过对活动进行优先排序和调整以及避免压力来积极解决问题、争取支持、保持积极和面向未来、进行健康的追求以及为他人提供社会支持,有助于男性减轻残疾。通过长期跟踪参与者,我们能够深入了解残疾发作的触发因素,以及对实施其生活策略和避免不确定性的成功看法。

结论

参与者采用生活策略来应对不确定性并随着时间推移减轻残疾发作。本研究支持通过帮助感染艾滋病毒的老年男性识别残疾触发因素、设定现实目标并解决问题来促进自我管理的项目的重要性。这些可能有助于建立自我效能感、增强控制感,并减少不确定性和残疾发作的感觉。

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