巴生谷地区感染艾滋病毒的年轻人（PLHIV）应对机制与药物依从性的关联

Association of coping mechanisms with medication adherence among young People living with HIV (PLHIV) in Klang Valley.

作者信息

Zainal-Abidin A N I, Miptah H N, Ariffin F, Razali S, Badlishah-Sham S F

机构信息

Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia.

Hospital Al-Sultan Abdullah (HASA), UiTM Puncak Alam, Selangor, Malaysia.

出版信息

Heliyon. 2024 Feb 8;10(4):e25740. doi: 10.1016/j.heliyon.2024.e25740. eCollection 2024 Feb 29.

DOI:10.1016/j.heliyon.2024.e25740

PMID:38380003

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10877255/

Abstract

BACKGROUND

As young People Living with HIV (PLHIV) will need to take antiretroviral therapy (ART) for life, there is a need to understand their coping mechanisms in living with the disease. Lack of coping mechanisms leads to poor medication adherence and hospital follow-up, poor health outcomes and shortened life expectancy.

OBJECTIVES

This study aimed to determine the pattern of coping mechanisms in young PLHIV and its association with medication adherence.

METHODS

This study was a cross-sectional study amongst young PLHIV patients (aged 20-39 years old) attending two HIV clinics in Klang Valley. Data was collected between February to August 2022. The pattern of coping strategies was assessed using the 28-item Brief Coping Orientation to Problems Experienced (COPE) questionnaire in English and Malay language, which was validated and found to have good internal consistency. Self-reported medication adherence was measured using the one-item Medical Outcomes Study (MOS) Specific Adherence Scale. Statistical analysis included descriptive statistics, single and multiple logistic regression.

RESULTS

A total of 395 respondents were recruited for the study. The mean scores for each coping mechanism were: 1) problem-focused coping 2.98 (SD 0.62), 2) emotion-focused coping 2.40 (SD 0.48), 3) dysfunctional coping 1.84 (SD 0.44) and 4) religion/spirituality coping 3.07 (SD 0.97). The majority of the respondents (66.8%) were adherent to their ART. Respondents who had a longer duration of medication [OR:1.014 (95% CI: 1.002,1.026)] and those who adopted less religion/spirituality coping mechanisms [OR: 0.495 (95% CI:0.246, 0.997)] were found to be significantly associated with medication adherence.

CONCLUSION

This study revealed an overall medication adherence rate of 66.8%. Patients with longer ART duration and who adopted less religion or spirituality coping had better medication adherence. These study findings provide input into the design of intervention by clinicians and healthcare policy makers for young PLHIV in clinical practice.

摘要

背景

由于感染艾滋病毒的年轻人（PLHIV）需要终身接受抗逆转录病毒治疗（ART），因此有必要了解他们应对该疾病的机制。缺乏应对机制会导致药物依从性差、医院随访不佳、健康结果不佳以及预期寿命缩短。

目的

本研究旨在确定年轻PLHIV的应对机制模式及其与药物依从性的关联。

方法

本研究是一项横断面研究，研究对象为在巴生谷两家艾滋病毒诊所就诊的年轻PLHIV患者（年龄在20 - 39岁之间）。数据收集于2022年2月至8月期间。使用28项问题体验应对取向简表（COPE）问卷以英语和马来语评估应对策略模式，该问卷经过验证，具有良好的内部一致性。使用单项医疗结果研究（MOS）特定依从性量表测量自我报告的药物依从性。统计分析包括描述性统计、单因素和多因素逻辑回归。

结果

本研究共招募了395名受访者。每种应对机制的平均得分分别为：1）以问题为中心的应对2.98（标准差0.62），2）以情绪为中心的应对2.40（标准差0.48），3）功能失调性应对1.84（标准差0.44），4）宗教/精神应对3.07（标准差0.97）。大多数受访者（66.8%）坚持服用抗逆转录病毒药物。研究发现，用药时间较长的受访者[比值比（OR）：(1.014)（95%置信区间：(1.002)，(1.026)）]和采用较少宗教/精神应对机制的受访者[比值比（OR）：(0.495)（95%置信区间：(0.246)，(0.997)）]与药物依从性显著相关。