使用因果贝叶斯网络来评估以患者为中心的护理和心理社会因素对持久性HIV病毒抑制的作用
Mary Jo Trepka1,2, Zhenghua Gong3, Melissa K Ward4,5
1Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, University Park, AHC 5, 11200 SW 8th Street, Miami, FL, 33199, USA. trepkam@fiu.edu.
AIDS and behavior
|April 4, 2024
概括
以患者为中心的护理和强大的提供者关系改善了艾滋病毒患者的持久性病毒抑制. 然而,解决心理社会需求对于全面的艾滋病毒治疗成功至关重要.
科学领域:
- 公共卫生 公共卫生
- 艾滋病毒/艾滋病研究研究
- 医疗保健服务研究 医疗服务研究
背景情况:
- 持久的病毒抑制是艾滋病毒管理的关键目标.
- 以患者为中心的护理 (PCC) 可能会影响治疗的坚持和结果.
- 了解与病毒抑制相关的因素对于优化护理至关重要.
研究的目的:
- 评估以患者为中心的护理对迈阿密-戴德县瑞安·怀特计划 (RWP) 客户的持久病毒抑制的影响.
- 探索心理社会因素,以患者为中心的护理和病毒抑制之间的复杂相互作用.
- 确定与实现和维持病毒抑制相关的关键患者和提供者特征.
主要方法:
- 5037名艾滋病毒患者的回顾性队列研究,由RWP管理的医疗病例.
- 通过对1352名客户的调查评估以患者为中心的护理实践.
- 贝叶斯网络模型用于分析心理社会因素,PCC和病毒抑制之间的关系.
主要成果:
- 82.1%的患者实现了持久的病毒抑制 (病毒载量<200副本/毫升).
- 家庭收入是持久性病毒抑制的最强预测因素.
- 较高的医疗保健关系得分和"提供者了解患者作为一个人"得分与病毒抑制有关.
- 医疗保健关系得分调节了低收入对病毒抑制的影响.
结论:
- 以患者为中心的护理与艾滋病毒阳性个体中改善的持久性病毒抑制有关.
- 虽然PCC是有益的,但通过全面的支持来解决未得到满足的心理社会需求对于全面的艾滋病毒治疗至关重要.
- 收入等社会经济因素显著影响病毒抑制,突显了综合支持服务的需要.
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