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目的分析艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)接受抗病毒治疗(ART)中出现脱失的原因,探讨降低脱失率的对策。方法对2006-2014年伊宁市国家艾滋病疫情报告系统抗病毒治疗数据库中,脱失的HIV/AIDS病人进行面对面或电话访谈,采用描述性分析方法进行分析。结果在861例脱失者中,失联231例,死亡65例,转外县市治疗65例,重复39例,坚决拒绝调查4例,最后457例脱失者参与问卷调查。被调查的457例中,40.0%的病例接受ART到脱失的时间≤3个月,76.8%的人出现了不同程度的药物不良反应。药物不良反应是144例(31.5%)首要的脱失原因,其余是工作原因64例(14.0%),害怕被人知道感染HIV44例(9.6%),觉得药物无效43例(9.4%),抗拒吃药40例(8.8%)。对抗病毒治疗看法,188例(41.1%)受访者认为能促进健康,延长生命,提升生活质量;160例(35.0%)受访者认为药物有很多不良反应,不愿治疗。参加抗病毒治疗的原因,222例(48.6%)认为工作人员多次劝导,不好意思拒绝;174例(38.1%)受访者认为促进健康,延长生命。服药依从性较差,近一半的受访者未按医嘱服药。结论建立药物不良反应的监测和告知机制,加强宣传教育,完善家庭与社会支持,优化用药方案,能提高病人的服药依从性,降低脱失率。
Objective To analyze the causes of the loss of ART in patients with HIV / AIDS (AIDS / AIDS) and to explore ways to reduce the rate of loss. Methods Face-to-face or telephone interviews with HIV / AIDS patients who lost HIV / AIDS in Yining National AIDS Epidemic System from 2006 to 2014 were conducted and analyzed by descriptive analysis. Results Of the 861 withdrawers, 231 were lost, 65 died, and 65 were transferred to other counties. 39 were repeated, and 4 were rejected. 457 withdrawers were involved in the questionnaire survey. Among the 457 cases investigated, 40.0% of the patients accepted ART until the time of their withdrawal was ≤3 months, and 76.8% of them experienced various degrees of adverse drug reactions. Adverse drug reactions were the primary cause of extubation in 144 patients (31.5%). The remaining 64 cases (14.0%) were working for fear of being infected with HIV, and 44 (9.4%) felt drug ineffective, 40 cases of medication (8.8%). 188 cases (41.1%) of respondents think it can promote health, prolong life and improve the quality of life. 160 (35.0%) respondents think the drug has a lot of adverse reactions and is unwilling to treat. 222 (48.6%) of the respondents believed that they had been persuaded by the staff for many times, and were embarrassed to refuse them. 174 (38.1%) said they believed that they could promote health and prolong life. Poor compliance with medication, nearly half of the respondents did not take the medication prescribed. Conclusions The establishment of a monitoring and notification mechanism of adverse drug reactions, strengthening publicity and education, improving family and social support, and optimizing medication regimens can improve patient compliance and reduce the rate of loss.