背景:由于HIV的慢性特性,心理健康已成为艾滋病毒感染者(PLWHIV)的一个重要问题。然而,中国PLWHIV患者对进展恐惧(FoP)与医学应对方式(MCMs)之间的关系知之甚少。
方法:连续纳入303例PLWHIV队列,收集临床和心理信息。对进展的恐惧问卷简表(FoP-Q-SF),社会支持评定量表(SSRS),使用内化HIV污名量表(IHSS)和MCMs问卷。
结果:在参与者中,215PLWHIV被归类为低水平FoP组,88人根据他们的FoP-Q-SF得分分为高水平FoP组,根据癌症患者功能失调的FoP分类标准。高水平组获得性免疫缺陷综合征(AIDS)阶段的比例更高(P=0.005),较低的教育水平(P=0.027)和较低的收入水平(P=0.031)。此外,高水平组的社会支持及其三个维度得分较低(P<0.001),SSRS总分与FoP-Q-SF两个维度呈负相关,即身体健康(r2=0.0409,P<0.001)和社会家庭(r2=0.0422,P<0.001)。Further,高水平组在内化HIV污名的四个维度上得分较高,发现IHSS评分与身体健康(r2=0.0960,P<0.001)和社会家庭(r2=0.0719,P<0.001)的FoP-Q-SF评分之间存在正相关关系。社会支持(OR=0.929,P=0.001),处于AIDS期(OR=3.795,P=0.001),内在化HIV污名(OR=1.028,P<0.001)是FoP的独立影响因素。此外,对预期的MCM进行了评估。FoP与回避得分呈正相关(r2=0.0886,P<0.001),在多因素分析中被验证为对抗方式(OR=0.944,P=0.001)和回避方式(OR=1.059,P=0.001)的唯一因素。
结论:我们研究人群中功能失调的FoP发生率相对较高。高水平的FoP与不良的社会支持有关,高水平内在化的HIV污名和PLWHIV中的MCM阴性。
BACKGROUND: Due to the chronic nature of HIV, mental health has become a critical concern in people living with HIV (PLWHIV). However, little knowledge exists about the association between fear of progression (FoP) and medical coping modes (MCMs) in PLWHIV in
China.
METHODS: A cohort of 303 PLWHIV were consecutively enrolled and their demographic, clinical and psychological information was collected. The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS), Internalized HIV Stigma Scale (IHSS) and MCMs Questionnaire were utilized.
RESULTS: Of the participants, 215 PLWHIV were classified into the low-level FoP group, and 88 were grouped into the high-level FoP group based on their FoP-Q-SF scores, according to the criteria for the classification of dysfunctional FoP in cancer patients. The high-level group had a higher proportion of acquired immunodeficiency syndrome (AIDS) stage (P = 0.005), lower education levels (P = 0.027) and lower income levels (P = 0.031). Additionally, the high-level group had lower scores in social support (P < 0.001) and its three dimensions, with total SSRS scores showing a negative correlation with two dimensions of FoP-Q-SF, namely physical health (r2 = 0.0409, P < 0.001) and social family (r2 = 0.0422, P < 0.001). Further, the high-level group had higher scores in four dimensions of internalized HIV stigma, and a positive relationship was found to exist between IHSS scores and FoP-Q-SF scores for physical health (r2 = 0.0960, P < 0.001) and social family (r2 = 0.0719, P < 0.001). Social support (OR = 0.929, P = 0.001), being at the AIDS stage (OR = 3.795, P = 0.001), and internalized HIV stigma (OR = 1.028, P < 0.001) were independent factors for FoP. Furthermore, intended MCMs were evaluated. FoP were positively correlated with avoidance scores (r2 = 0.0886, P < 0.001) and was validated as the only factor for the mode of confrontation (OR = 0.944, P = 0.001) and avoidance (OR = 1.059, P = 0.001) in multivariate analysis.
CONCLUSIONS: The incidence of dysfunctional FoP in our study population was relatively high. High-level FoP was associated with poor social support, high-level internalized HIV stigma and a negative MCM among PLWHIV.