St Clair-Sullivan Natalie, Simmons Kiersten, Harding Richard, Levett Thomas, Maddocks Matthew, Roberts Jonathan, Trotman Daniel, Yi Deokhee, Vera Jaime H, Bristowe Katherine
Brighton and Sussex Medical School, Brighton, UK.
King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK.
HIV Med. 2023 Apr;24(4):480-490. doi: 10.1111/hiv.13419. Epub 2022 Oct 13.
People living with HIV are an ageing population with an increasing prevalence of frailty. Management of frailty requires assessment, communication and information sharing with patients. However, evidence regarding the meaning of frailty for this population, and the acceptability of frailty screening, is limited. This study aimed to explore the perceptions of older people living with HIV and HIV professionals towards frailty and routine screening for frailty.
Data collection consisted of in-depth individual qualitative interviews with older people living with HIV and focus groups with HIV professionals purposively sampled from outpatient HIV clinics in London and Brighton, UK. Verbatim pseudonymised transcripts were analysed using reflexive thematic analysis supported by NVivo.
A total of 45 people living with HIV were interviewed, and 12 HIV professionals participated in two focus groups. Frailty was described as a series of losses around mobility, social inclusion, independence and mental acuity, which could happen at any age. Regarding language, for people living with HIV, explicitly using the word frail was acceptable during screening when approached sensitively and alongside provision of information and support to slow the progression of frailty. However, HIV professionals described concerns about using the word frail for fear of causing distress or offence.
Professionals described frailty in terms of functional deficits, whereas people living with HIV described a loss of personhood. Although there is a clear desire among people living with HIV to be informed of their frailty status, approaching conversations about frailty with understanding and compassion is vital. To gain the most from the screening, it is essential that frailty status is shared alongside a clear plan of actionable steps in their care.
感染艾滋病毒的人群正逐渐老龄化，身体虚弱的患病率也在上升。对身体虚弱的管理需要对患者进行评估、沟通和信息共享。然而，关于身体虚弱对这一人群的意义以及身体虚弱筛查的可接受性的证据有限。本研究旨在探讨感染艾滋病毒的老年人和艾滋病毒专业人员对身体虚弱及常规身体虚弱筛查的看法。
数据收集包括对感染艾滋病毒的老年人进行深入的个人定性访谈，以及对从英国伦敦和布莱顿的门诊艾滋病毒诊所中有意抽取的艾滋病毒专业人员进行焦点小组访谈。使用NVivo支持的反思性主题分析对逐字化名的访谈记录进行分析。
共采访了45名感染艾滋病毒的人，12名艾滋病毒专业人员参加了两个焦点小组。身体虚弱被描述为在行动能力、社会融入、独立性和思维敏锐度方面的一系列丧失，这些情况可能在任何年龄发生。关于语言，对于感染艾滋病毒的人来说，在筛查时以敏感的方式提及并在提供信息和支持以减缓身体虚弱进展的同时明确使用“虚弱”一词是可以接受的。然而，艾滋病毒专业人员表示担心使用“虚弱”一词会引起困扰或冒犯。
专业人员从功能缺陷方面描述身体虚弱，而感染艾滋病毒的人则描述了人格的丧失。尽管感染艾滋病毒的人显然希望了解自己的身体虚弱状况，但以理解和同情的态度进行关于身体虚弱的谈话至关重要。为了从筛查中获得最大收益，在告知身体虚弱状况的同时，必须提供明确的可操作护理步骤计划。
