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转变艾滋病护理模式:调整全民健康模块以消除马来西亚基层医护人员中的耻辱感。

Transforming HIV Care: Adapting the Health4All Module to Combat the Stigma Among Malaysian Primary Healthcare Workers.

作者信息

Salaton Nor Fauziah, Ahmad Zaki Rafdzah, Lim Sin How, Che Ishak Natalia, Kamarulzaman Adeeba, Altice Frederick

机构信息

Social and Preventive Medicine, University Malaya, Kuala Lumpur, MYS.

Disease Control Division, Ministry of Health Malaysia, Putrajaya, MYS.

出版信息

Cureus. 2024 Sep 12;16(9):e69252. doi: 10.7759/cureus.69252. eCollection 2024 Sep.

Abstract

Globally, stigma and discrimination in healthcare settings have been identified as significant barriers to implementing HIV prevention and treatment strategies. However, research on interventions to reduce the stigma in healthcare facilities, particularly in Malaysia, is lacking. Hence, this study aims to bridge these gaps by implementing a globally accepted training module to reduce HIV stigma among healthcare workers (HCWs). This study aims to implement the Health4All module to reduce HIV stigma among HCWs in Malaysia. A randomized controlled trial (RCT) study with repeated measures over a period of six months was conducted to implement the Health4All module and evaluate the study outcomes. The implementation process involved a total of 300 randomly selected HCWs from 10 primary health clinics in the study area. A total of 263 respondents participated at the beginning, giving a response rate of 88%, but only 177 completed records were used for the final analysis. The mean score for perceived risk and fear was reduced by 1.07 between baseline and one month (p < 0.001) and reduced further by 0.81 between one month and three months (p < 0.05). The mean score for value-driven stigma was reduced by 2.31 between baseline and one month (p < 0.001) and reduced further by 0.86 between one month and three months (p = 0.25). The mean score for discriminatory attitude was reduced by 1.65 between baseline and one month (p = 0.002) and reduced further by 1.65 between one month and three months (p = 0.002). The Health4All module was effective in reducing the HIV stigma among HCWs over three months. This study suggests that the training program can be replicated across different healthcare settings worldwide for wider implementation.

摘要

在全球范围内,医疗机构中的耻辱感和歧视已被视为实施艾滋病毒预防和治疗策略的重大障碍。然而,关于减少医疗机构耻辱感的干预措施的研究,尤其是在马来西亚,却很缺乏。因此,本研究旨在通过实施一个全球公认的培训模块来弥合这些差距,以减少医护人员(HCW)中的艾滋病毒耻辱感。本研究旨在实施“全民健康”模块,以减少马来西亚医护人员中的艾滋病毒耻辱感。进行了一项为期六个月的重复测量随机对照试验(RCT)研究,以实施“全民健康”模块并评估研究结果。实施过程涉及从研究区域的10家初级保健诊所中随机挑选的300名医护人员。一开始共有263名受访者参与,回复率为88%,但最终分析仅使用了177份完整记录。在基线和一个月之间,感知风险和恐惧的平均得分降低了1.07(p<0.001),在一个月和三个月之间进一步降低了0.81(p<0.05)。在基线和一个月之间,价值驱动的耻辱感平均得分降低了2.31(p<0.001),在一个月和三个月之间进一步降低了0.86(p = 0.25)。在基线和一个月之间,歧视态度的平均得分降低了1.65(p = 0.002),在一个月和三个月之间进一步降低了1.65(p = 0.002)。“全民健康”模块在三个月内有效减少了医护人员中的艾滋病毒耻辱感。本研究表明,该培训项目可在全球不同医疗机构中复制,以进行更广泛的实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebfa/11470435/0fc162a64e45/cureus-0016-00000069252-i01.jpg

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