Department of Applied Psychology, Government College University Faisalabad, Main Campus, Faisalabad, Punjab, Pakistan.
Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
BMC Psychiatry. 2023 Jul 25;23(1):539. doi: 10.1186/s12888-023-05013-2.
OBJECTIVE: Individuals living with HIV/AIDs are at a high risk of many problems like depression, stigma, quality of life, decreased adherence to treatment, and lack of social support. The present study aimed to investigate the impact of brief-cognitive behavior therapy (B-CBT) on reducing depression and stigma and improving treatment adherence, quality of life, and social support among patients with HIV/AIDS attending antiretroviral therapy (ART). MATERIALS AND METHODS: This randomized clinical trial was conducted at ART Clinic in the Tehsil Headquarters Hospital Shahkot Nankana Sahib from July 2021 to October 2021. After baseline screening, 126 patients met the eligibility criteria and 63 were allocated to the experimental group (EXPg = 63) and 63 to waitlist-control group (WLCg = 63). Participants' age range was from 20 to 55 years. Participants who were taking ART treatment were enrolled for the CBT treatment. Before this, all the participants completed a baseline assessment to ensure a level of severity and diagnosis. A total of eight CBT based therapeutic sessions were conducted individually with EXPg. To assess the outcomes among patients receiving ART, we used Demographic form, Patient health questionnaire, HIV stigma scale, General medication adherence scale, Multidimensional scale of perceived social support, and WHOQOL BREF scale. RESULTS: Findings suggest that B-CBT significantly reduced the level of depression (i.e. F (1, 78) = 101.38, p < .000, η2 = .599), and social stigma (i.e. F (1, 78) = 208.47, p < .000, η2 = .787) among patients with HIV/AIDS. Furthermore, CBT substantially improved the level of adherence to treatment (i.e. F(1,78) = 24.75, p < .000, η2 = .503), social support (i.e. F (1, 78) = 128.33, p < .000, η2 = .606), and quality of life (i.e. F (1, 78) = 373.39, p < .000, η2 = .837) among patients with HIV/AIDS. Significant mean difference M(SD) on PHQ at post-analysis in the EXPg vs. WLCg was seen 1.22(0.47) vs. 2.30(0.68) and similarly, on MPSS at a post-analysis in the EXPg vs. WLCg 2.85(0.36) vs. 1.70(0.51) which indicates sound therapeutic outcomes. CONCLUSIONS: Cognitive behavioral therapy effectively decreases the level of depression and stigma and enhances the level of social support, quality of life, and adherence to treatment among HIV/AIDS patients. It is concluded that cognitive behavior therapy is an effective treatment approach for patients with HIV/AIDS. TRIAL REGISTRATION: Thai clinical trial registry (i.e. TCTR = TCTR20210702002 ).
目的：感染艾滋病毒/艾滋病的个体面临许多问题的高风险，如抑郁、耻辱感、生活质量、治疗依从性降低以及社会支持不足。本研究旨在调查简短认知行为疗法（B-CBT）对降低艾滋病毒/艾滋病患者的抑郁和耻辱感以及提高治疗依从性、生活质量和社会支持的影响，这些患者正在接受抗逆转录病毒治疗（ART）。
材料和方法：这是一项随机临床试验，于 2021 年 7 月至 2021 年 10 月在沙赫科特纳纳萨赫布的泰西尔总部医院的 ART 诊所进行。基线筛查后，符合条件的 126 名患者中有 63 名被分配到实验组（EXPg=63）和 63 名等待名单对照组（WLCg=63）。参与者的年龄范围为 20 至 55 岁。正在接受 ART 治疗的参与者被纳入 CBT 治疗。在此之前，所有参与者都完成了基线评估，以确保有一定的严重程度和诊断。共进行了 8 次基于 CBT 的个别治疗会议。为了评估接受 ART 治疗的患者的结果，我们使用了人口统计学表格、患者健康问卷、艾滋病毒耻辱量表、一般药物依从量表、多维感知社会支持量表和世界卫生组织生活质量简表。
结果：研究结果表明，B-CBT 显著降低了艾滋病毒/艾滋病患者的抑郁水平（即 F（1，78）=101.38，p<0.000，η2=0.599）和社会耻辱感（即 F（1，78）=208.47，p<0.000，η2=0.787）。此外，CBT 显著提高了治疗依从性（即 F（1，78）=24.75，p<0.000，η2=0.503）、社会支持（即 F（1，78）=128.33，p<0.000，η2=0.606）和艾滋病毒/艾滋病患者的生活质量（即 F（1，78）=373.39，p<0.000，η2=0.837）。在 EXPg 与 WLCg 的 post-analysis 中，PHQ 的平均差异 M（SD）分别为 1.22（0.47）与 2.30（0.68），类似地，在 EXPg 与 WLCg 的 post-analysis 中，MPSS 的平均差异 M（SD）分别为 2.85（0.36）与 1.70（0.51），这表明治疗效果良好。
结论：认知行为疗法可有效降低艾滋病毒/艾滋病患者的抑郁和耻辱感水平，提高社会支持、生活质量和治疗依从性。结论是认知行为疗法是艾滋病毒/艾滋病患者的有效治疗方法。
试验注册：泰国临床试验注册处（即 TCTR= TCTR20210702002）。
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