Gifford A L, Laurent D D, Gonzales V M, Chesney M A, Lorig K R
U.S. Veterans Administration San Diego Healthcare System, Department of Medicine, the University of California San Diego School of Medicine, La Jolla 92161, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Jun 1;18(2):136-44. doi: 10.1097/00042560-199806010-00005.
To evaluate the acceptability, practicality, and short-term efficacy of a health education program to improve disease self-management in patients with symptomatic HIV/AIDS.
Randomized controlled trial, baseline and 3-month follow-up questionnaire assessments.
San Francisco Bay communities.
Seventy-one men with symptomatic HIV or AIDS were randomly assigned to a seven-session group educational intervention (N=34) or a usual-care control group (N=37).
Interactive health education groups were used to teach wide-ranging disease self-management skills and information: symptom assessment and management, medication use, physical exercise, relaxation, doctor-patient communication, and nutrition. Each group was led by two trained peer-leaders (one of whom was HIV-positive) recruited from the community.
The primary outcome of interest was symptom status. Secondary outcomes were self-efficacy and health behaviors. Analysis of covariance was used to compare experimental and control group mean outcomes, adjusting for baseline value differences.
The symptom severity index (number of symptoms moderate or greater severity) decreased in the experimental, and increased in the control group (-0.9 versus +0.5; p < .03). Pain, fatigue, and psychological symptoms were not significantly different between groups. Self-efficacy for controlling symptoms improved in the experimental, and decreased in the control group (+4 versus -7; p < .02). Changes in stress/relaxation exercises and HIV/AIDS knowledge were not different between groups. A trend was shown toward more frequent physical exercise in the experimental group compared with less in the control group (+1.3 versus -0.5 times/week; p=.06).
Health education emphasizing self-management skills for HIV/AIDS patients can be implemented and evaluated and was accepted by patients, peer-leaders, and health care providers. Whether this educational program can lead to prolonged improvement in HIV symptoms and behaviors can be adequately addressed only by a larger trial of longer duration.
评估一项健康教育计划在改善有症状的艾滋病毒/艾滋病患者疾病自我管理方面的可接受性、实用性和短期疗效。
随机对照试验，采用基线和3个月随访问卷调查评估。
旧金山湾社区。
71名有症状的艾滋病毒或艾滋病男性被随机分为接受七节小组教育干预的组（N = 34）或常规护理对照组（N = 37）。
互动式健康教育小组用于教授广泛的疾病自我管理技能和信息：症状评估与管理、药物使用、体育锻炼、放松、医患沟通和营养。每个小组由两名从社区招募的经过培训的同伴领导者（其中一名是艾滋病毒阳性）带领。
主要关注的结果是症状状况。次要结果是自我效能感和健康行为。采用协方差分析比较实验组和对照组的平均结果，并对基线值差异进行调整。
实验组的症状严重程度指数（中度或更严重症状的数量）下降，而对照组增加（-0.9对+0.5；p <.03）。两组之间的疼痛、疲劳和心理症状无显著差异。实验组控制症状的自我效能感提高，而对照组下降（+4对-7；p <.02）。两组之间压力/放松练习和艾滋病毒/艾滋病知识的变化无差异。与对照组较少的体育锻炼相比，实验组显示出体育锻炼更频繁的趋势（+1.3对-0.5次/周；p = 0.06）。
强调艾滋病毒/艾滋病患者自我管理技能的健康教育可以实施和评估，并为患者、同伴领导者和医疗保健提供者所接受。只有通过更大规模、更长时间的试验才能充分解决该教育计划是否能导致艾滋病毒症状和行为的长期改善。
