在常规艾滋病毒护理中,行为质量改变咨询是否会根据主题和需求而有所不同?
Lauren E Claus1, Michael Barton Laws2, Ira B Wilson2
1Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21205, USA. LCLAUS@MGH.HARVARD.EDU.
AIDS and behavior
|October 4, 2023
概括
艾滋病毒临床医生在大多数访问中提供行为改变咨询,但随着主题数量的增加,质量会下降. 重组护理可能会改善对有复杂需求的患者的支持.
科学领域:
- 公共卫生 公共卫生
- 行为科学 行为科学
- 临床医学 临床医学
背景情况:
- 艾滋病毒临床医生在日常患者护理中面临着严重的时间限制.
- 改变行为咨询对于管理艾滋病毒和相关疾病至关重要.
- 了解咨询的质量和需求对于优化患者结果至关重要.
研究的目的:
- 确定艾滋病毒初级保健中的行为变化咨询的流行率和质量.
- 调查咨询质量是否随着咨询需求的增加而下降.
- 为了告知HIV门诊护理的潜在重组.
主要方法:
- 音频录制和转录的患者与临床医生的接触 (n=205名患者,12名临床医生).
- 编码辅导情节,以保持与激励面试 (MI) 的一致性.
- 利用多级回归来分析与行为主题数量相关的咨询质量.
主要成果:
- 行为改变咨询发生在92%的访问中,平均每次访问有2.5个主题.
- 咨询对药物和烟草使用最符合MI.
- 咨询质量 (MI一致性) 随着每一个额外的行为改变主题显著下降.
结论:
- 目前的艾滋病毒护理模式可能无法充分支持全面的行为改变咨询.
- 当临床医生面对多种患者需求时,提供不那么一致的MI咨询.
- 建议重组艾滋病毒门诊护理,为那些需要更多咨询的患者分配更多的时间.
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