School of Psychology, University of Central Lancashire, Preston, UK.
Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
AIDS Care. 2021 Mar;33(3):337-346. doi: 10.1080/09540121.2020.1771263. Epub 2020 May 29.
Antiretroviral therapy (ART) has significantly improved immune health and survival rates in HIV, but these outcomes rely on near perfect adherence. While many psychosocial factors are related to sub-optimal adherence, effectiveness of associated interventions are modest or inconsistent. The Psychological Flexibility (PF) model underlying Acceptance and Commitment Therapy (ACT) identifies a core set of broadly applicable transdiagnostic processes that may be useful to explain and improve non-adherence. However, PF has not previously been examined in relation to ART adherence. Therefore, this cross-sectional study ( = 275) explored relationships between PF and intentional/unintentional ART non-adherence in people with HIV. Adults with HIV prescribed ART were recruited online. Participants completed online questionnaires assessing self-reported PF, adherence and emotional and general functioning. Logistic regressions examined whether PF processes were associated with intentional/unintentional non-adherence. Fifty-eight percent of participants were classified as nonadherent according to the Medication Adherence Rating Scale, of which 41.0% reported intentional and 94.0% unintentional non-adherence. Correlations between PF and adherence were small. PF did not significantly explain intentional/unintentional non-adherence after controlling for demographic and disease factors. Further clarification of the utility of PF in understanding ART non-adherence is warranted using prospective or experimental designs in conjunction with more objective adherence measures.
抗逆转录病毒疗法（ART）显著改善了 HIV 患者的免疫健康和生存率，但这些结果依赖于近乎完美的依从性。尽管许多心理社会因素与不依从有关，但相关干预措施的效果并不显著或不一致。接受和承诺疗法（ACT）背后的心理灵活性（PF）模型确定了一套广泛适用的核心跨诊断过程，这些过程可能有助于解释和改善不依从。然而，PF 以前尚未在与 ART 依从性的关系中进行过研究。因此，这项横断面研究（ = 275）探讨了 HIV 患者 PF 与有意/无意 ART 不依从之间的关系。在网上招募了接受 ART 治疗的 HIV 成人患者。参与者在线完成了评估自我报告的 PF、依从性以及情绪和一般功能的问卷。逻辑回归检验了 PF 过程是否与有意/无意的不依从有关。根据药物依从性评定量表，58%的参与者被归类为不依从者，其中 41.0%报告有意不依从，94.0%报告无意不依从。PF 与依从性之间的相关性很小。在控制人口统计学和疾病因素后，PF 并不能显著解释有意/无意的不依从。使用前瞻性或实验设计并结合更客观的依从性测量，进一步阐明 PF 在理解 ART 不依从方面的效用是必要的。
