HIV 感染者和医护人员对 HIV 感染者认知障碍筛查的看法：一项定性研究。
People with HIV and healthcare workers views on screening for cognitive impairment in people with HIV: A qualitative study.
机构信息
Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
Florence Nightingale Faculty of Nursing Midwifery & Palliative Care, Cicely Saunders Institute, King's College London, London, UK.
出版信息
HIV Med. 2023 Dec;24(12):1244-1252. doi: 10.1111/hiv.13582. Epub 2023 Nov 21.
OBJECTIVES
People with HIV are an ageing population with an increased risk of cognitive impairment. Although cognitive impairment is dependent upon assessment, the acceptability of screening for cognitive impairment is unclear. This study aimed to explore the views of people with HIV and healthcare workers regarding routine screening for cognitive impairment.
METHODS
In-depth individual qualitative interviews were conducted with purposively sampled people with HIV and focus groups of healthcare workers from a UK HIV service. Verbatim pseudonymized transcripts were analysed using reflexive thematic analysis supported by NVivo.
RESULTS
Twenty people with HIV were interviewed and 12 healthcare workers participated in three focus groups. People with HIV were concerned about developing cognitive issues and were receptive to routine screening. Screening was seen as relevant and an important part of managing health in older age. Healthcare workers expressed concerns regarding the capacity of HIV services to implement routine screening and questioned the validity of screening measures used. People with HIV felt that screening and subsequent detection of cognitive impairment, if present, may help them to prepare for future issues and promote active management strategies and care pathways that would support cognitive health. People with HIV felt that screening should be brief and delivered by the HIV service and that they should be given a choice of administration method. Indications of cognitive impairment detected by a brief screening assessment should be discussed face to face and followed up with a comprehensive assessment.
CONCLUSIONS
People with HIV are concerned about cognitive impairment and would welcome regular screening for this as part of the holistic care provided by the HIV team. Both people with HIV and healthcare workers would like more information on cognitive impairment, its screening and ways to support cognitive health.
目的
HIV 感染者是一个老龄化人群，认知障碍的风险增加。尽管认知障碍依赖于评估，但对认知障碍筛查的可接受性尚不清楚。本研究旨在探讨 HIV 感染者和医护人员对认知障碍常规筛查的看法。
方法
采用目的性抽样，从英国 HIV 服务机构中选取 HIV 感染者和医护人员进行深入的个体定性访谈，并进行焦点小组讨论。使用 NVivo 支持的反思性主题分析对逐字记录的化名转录本进行分析。
结果
共对 20 名 HIV 感染者进行了访谈，12 名医护人员参加了 3 个焦点小组。HIV 感染者担心出现认知问题，愿意接受常规筛查。筛查被认为是相关的，是老年人群管理健康的重要组成部分。医护人员对 HIV 服务机构实施常规筛查的能力表示担忧，并对所使用的筛查措施的有效性提出质疑。HIV 感染者认为，如果存在认知障碍，筛查和随后的检测可能有助于他们为未来的问题做好准备，并促进积极的管理策略和护理途径，以支持认知健康。HIV 感染者认为，筛查应该简短，由 HIV 服务机构进行，并且应该给他们提供选择管理方法的机会。简短筛查评估中发现的认知障碍迹象应进行面对面讨论，并通过全面评估进行跟进。
结论
HIV 感染者担心认知障碍，并欢迎将其作为 HIV 团队提供的整体护理的一部分进行定期筛查。HIV 感染者和医护人员都希望了解更多关于认知障碍、其筛查以及支持认知健康的方法的信息。
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