Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
PLoS One. 2019 Nov 8;14(11):e0223723. doi: 10.1371/journal.pone.0223723. eCollection 2019.
This study assessed the satisfaction of patients receiving antiretroviral treatment (ART) in Vietnam and its multilevel predictors. Cross-sectional data were collected from January to September 2013 in eight outpatient clinics in Hanoi and Nam Dinh provinces. Patient satisfaction was evaluated using the Satisfaction with HIV/AIDS Treatment Interview Scale. Multivariable Tobit regression was utilized to measure the associations between these factors and satisfaction with treatment services. Generalized Mixed-effect Regression model was used to estimate the effect of satisfaction with the quality of service on the change between the initial and the latest CD4 cell count. Among 1133 patients, most of them were completely satisfied with the 10 domains measured (65.5% to 82.5%). "Service quality and convenience" domain which was attributed by the waiting time and administrative procedure had the lowest score of complete satisfaction. Compared to central clinics, provincial clinics were negatively associated with the overall satisfaction (Coef = -0.58; 95%CI = -0.95; -0.21). Patients rating higher score in "Consultation, explanation, and guidance of health care workers", "Responsiveness of health care workers to patients' questions and requests" and "Perceived overall satisfaction with the quality of service" were related to improvement in immunological treatment outcomes. Our results revealed the high level of satisfaction among ART patients towards HIV care and treatment services, and this had a high correlation to treatment outcomes. Interventions should focus on reducing administrative procedures, providing sufficient guidance and comprehensive services which integrate physical with psychological care for improving the health outcome of the ART program.
本研究评估了越南接受抗逆转录病毒治疗（ART）的患者的满意度及其多层次预测因素。2013 年 1 月至 9 月，在河内省和南定省的 8 个门诊诊所收集了横断面数据。使用艾滋病治疗满意度访谈量表评估患者满意度。多变量 Tobit 回归用于测量这些因素与对治疗服务满意度之间的关联。广义混合效应回归模型用于估计对服务质量的满意度对初始和最新 CD4 细胞计数之间变化的影响。在 1133 名患者中，大多数对所测量的 10 个领域完全满意（65.5%至 82.5%）。“服务质量和便利性”这一领域的满意度最低，其归因于等待时间和行政程序。与中央诊所相比，省级诊所与总体满意度呈负相关（系数=-0.58；95%CI=-0.95；-0.21）。在“医护人员的咨询、解释和指导”、“医护人员对患者问题和请求的响应”以及“对服务质量的整体满意度”方面评分较高的患者，其免疫治疗结果得到改善。我们的研究结果表明，接受抗逆转录病毒治疗的患者对艾滋病毒护理和治疗服务的满意度很高，这与治疗结果密切相关。干预措施应重点减少行政程序，提供充分的指导和全面的服务，将身体和心理护理相结合，以改善抗逆转录病毒治疗方案的健康结果。
