老年人对 HIV 感染者照护模式的偏好：一项横断面研究。
Preference for care models among older people living with HIV: cross-sectional study.
机构信息
Department of Gynecology, The First Branch of The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
出版信息
BMC Public Health. 2023 Oct 18;23(1):2033. doi: 10.1186/s12889-023-16941-9.
BACKGROUND
The number of people living with HIV (PWH) aged 50 and above is increasing. The question of care among older PWH (aged ≥ 50 years) is an increasing concern. Understanding the care preference of older people can better provide care services for them. The purpose of this study was to investigate the care preference (home-based care, self-care, institutional care, community-based care, and mutual-aid care) among older PWH and identify the factors affecting their care preference.
METHODS
A cross-sectional survey was conducted among older PWH (aged ≥ 50 years) about care preference from May to November 2021. We enrolled 319 participants using convenience sampling. We designed a questionnaire to assess the care preference of older PWH. The Chi-square test and Fisher's exact test were used to conduct univariate analysis of care preference. Multinomial logistic regression was used to identify factors influencing care preference.
RESULTS
Most older PWH (72.7%) preferred home-based care, and few (15.7%) preferred self-care. Fewer older PWH preferred community-based care (5.3%), institutional care (5.0%) and mutual-aid care (1.3%). Multivariate analysis showed that older PWH with a house, spouse and more children were more inclined to choose home-based care (p < .05). Older PWH living alone, having higher monthly income and higher HIV stigma preferred to choose self-care (p < .05).
CONCLUSION
Home-based care was the most preferred model of older PWH, and self-care ranked second. The number of those who preferred institutional care, community-based care and mutual-aid care were few. Nation and government should take measures to allocate care resources for older adults reasonably to better meet the care needs of older PWH. It is important to strengthen social security, reduce internalized HIV stigma, improve social support, and explore diversified care models for improving the quality of life of older PWH.
背景
感染艾滋病毒（HIV）的人数不断增加，年龄在 50 岁及以上的人数也在增加。对年龄较大的 HIV 感染者（年龄≥50 岁）的关怀问题越来越受到关注。了解老年人的关怀偏好可以更好地为他们提供关怀服务。本研究旨在调查年龄较大的 HIV 感染者的关怀偏好（居家护理、自我护理、机构护理、社区护理和互助护理），并确定影响其关怀偏好的因素。
方法
2021 年 5 月至 11 月，采用便利抽样法对年龄较大的 HIV 感染者（年龄≥50 岁）进行了关怀偏好的横断面调查。共纳入 319 名参与者。我们设计了一份问卷来评估年龄较大的 HIV 感染者的关怀偏好。采用卡方检验和 Fisher 确切检验对关怀偏好进行单因素分析。采用多变量逻辑回归分析确定影响关怀偏好的因素。
结果
大多数年龄较大的 HIV 感染者（72.7%）更喜欢居家护理，少数（15.7%）更喜欢自我护理。较少的年龄较大的 HIV 感染者更喜欢社区护理（5.3%）、机构护理（5.0%）和互助护理（1.3%）。多变量分析显示，有房、有配偶和子女较多的年龄较大的 HIV 感染者更倾向于选择居家护理（p<0.05）。独居、月收入较高和 HIV 耻辱感较高的年龄较大的 HIV 感染者更倾向于选择自我护理（p<0.05）。
结论
居家护理是年龄较大的 HIV 感染者最偏好的模式，其次是自我护理。选择机构护理、社区护理和互助护理的人数较少。国家和政府应采取措施合理分配老年人的护理资源，更好地满足年龄较大的 HIV 感染者的护理需求。加强社会保障，减少内化的 HIV 耻辱感，提高社会支持，探索多元化的护理模式，提高年龄较大的 HIV 感染者的生活质量非常重要。
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