云南省某地艾滋病抗病毒治疗病人脱失原因分析

发布时间：2018-05-21 13:10

本文选题：艾滋病 + 抗病毒治疗　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]通过对云南省某地抗病毒治疗脱失患者进行梳理和脱失因素进行详细调查,了解云南省艾滋病国家免费抗病毒治疗患者脱失的主要原因,为全省下一步在减少患者脱失方面制定政策和采取措施提供理论依据。[方法]选取云南省艾滋病国家免费抗病毒治疗机构中的五个治疗点:包括(红河州一院、个旧、建水、开远、蒙自)五个医院作为研究现场。采取定量研究和定性研究相结合的研究方法。定量研究:根据云南省艾滋病数据信息系统中患者基本情况数据库信息,初步确定好的研究对象名单,对艾滋病患者一对一发放问卷进行调查。运用描述性分析方法,描述在治疗和脱失治疗的原因,采用单因素和多因素Logistic回归分析方法探讨影响艾滋病患者接受治疗和脱失治疗的相关因素。定性研究:采用个人深入访谈,访谈对象为艾滋病抗病毒治疗管理者、一线医务工作者、艾滋病患者(在治疗患者、脱失患者)、同伴教育者。主要了解艾滋病患者脱失治疗的原因,对访谈结果归纳整理,进行分析。[结果]本研究共收到有效问卷376份(在治疗患者问卷253份,脱失患者问卷123份)。访谈负责艾滋病抗病毒治疗医务工作者9名,同伴教育者5名,艾滋病患者20名。1脱失的主要原因:药物副作用太大58人(47.1%);打工服药不方便22人(17.9%);距离远不方便领药12人(9.8%);羁押9人(7.3%);吃药身体变差7人(5.7%);担心服药暴露感染者身份6人(4.9%);身体还好不想服药4人(3.3%);经济困难3人(2.4%)。2脱失治疗相关因素分析:饮酒(OR=12.87,95%CI:1.97～84.20)、使用毒品(OR=1.65,95%CI:10.32～17.86)、感染途径(OR=2.63,95%CI:1.13～8.83)、吃药困难(OR=4.80,95%CI:1.05～4.92)、药物不良反应(OR=1.91,95%CI:1.20～6.33)是维持治疗的危险因素;出现不良反应后坚持服药/去找医生(OR=0.00,95%CI:0.00～0.01)、高中/中专学历(OR=0.00,95%CI:0.00～0.11)是维持治疗的保护因素。3通过访谈了解到当地艾滋病抗病毒治疗脱失的影响因素:药物不良反应、外出打工不方便、路途遥远、对艾滋病抗病毒治疗认识不足、羁押。[结论]影响当地艾滋病患者维持治疗的因素主要有:1).社会人口学特征:有吸毒、饮酒特殊习惯人群更容易脱失。2).对药物副作用处理办法不当(不坚持服药、不主动联系医生)人群更容易脱失。3).社会环境:外出打工、戒毒、羁押患者更容易脱失。4).文化程度较低患者更容易脱失。
[Abstract]:[objective] to find out the main causes of free antiviral therapy for AIDS patients in Yunnan province through a detailed investigation of the causes of antiviral therapy in Yunnan province. To provide the theoretical basis for the next step in reducing the loss of patients to formulate policies and take measures. [methods] five treatment points of free antiviral treatment institutions in Yunnan province were selected, including five hospitals (Honghe first Hospital, Gejiu Hospital, Jianshui Hospital, Kaiyuan Hospital, Mengzi Hospital). The method of combining quantitative and qualitative studies is adopted. Quantitative study: according to the basic information database information of patients in Yunnan AIDS data information system, a list of good research objects was preliminarily determined, and a one-to-one questionnaire for AIDS patients was investigated. Descriptive analysis was used to describe the causes of treatment and loss of treatment. Univariate and multivariate Logistic regression analysis was used to explore the related factors affecting the treatment and loss of AIDS patients. Qualitative study: we used personal in-depth interviews to interview AIDS antiviral treatment managers, frontline medical workers, AIDS patients (in the treatment of patients, lost patients, peer educators). To understand the causes of AIDS patients without treatment, the results of the interview summarized and analyzed. [results] A total of 376 valid questionnaires were received in this study. Interviews were conducted with 9 medical workers responsible for HIV / AIDS treatment and 5 peer educators. The main reasons for the loss of 20 AIDS patients are: 58 patients have too many side effects, 22 people are not convenient to take medicine, 12 people are not convenient to get medicine, 9 people are detained, 7 people are ill with medicine, 7 people are worried about exposure to drugs. Status 6: 4. 9; body is fine; 4 are not willing to take medicine; 3 are in financial difficulties. 2. 2. 2. Analysis of the factors related to the treatment of loss: drinking OR12.87 / 95CI1.97: 84.20, using the drug OR1.6595: CI10.3217.866.The route of infection is OR2.6395CIW 1.138.83, the difficulty of taking medicine OR4.80 / 95. The CI1.054.92and the adverse drug reaction OR1.9195CI1.206.33) are the risk factors for the maintenance of treatment. Sticking to medication after adverse reactions / going to the doctor to take medicine / go to the doctor / doctor Long way, AIDS anti-viral treatment insufficient understanding, custody. [conclusion] the main factors affecting the maintenance of local AIDS patients are: 1: 1. Social demographic characteristics: drug use, drinking special habits of people are more likely to lose. 2. People who mismanage side effects (don't stick to medication, don't actively contact doctors) are more likely to lose. Social environment: going out to work, detoxification, detaining patients are more likely to lose. People with a lower level of education are more likely to lose their education.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91

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