| Objective:To understand the status of HIV/AIDS patients’quality of life who received antiretroviral therapy,and analyze the influencing factors of the quality of life,then to provide a reference for the formulation of relevant policies and measures,after that,further improve their quality of life.Methods:Using a multi-stage stratified cluster sampling method to sample,and conducted a cross-sectional survey among HIV/AIDS patients receiving ART in designated hospitals in Yunnan Province.The MOS-HIV scale was used to evaluate the quality of life of the research subjects.Rank test,Quantile regression,and ordinal Logistic regression were used to analyze the influencing factors of the subjects’quality of life.Wilcoxon rank sum test was used to compare the scores of two groups,and H test was used for comparison between multiple groups.The multivariate influencing factors were analyzed by Quantile regression and ordinal Logistic regression.Results:1.This survey distributed a total of 643 questionnaires and collected 632,resulting in a response rate of 98.3%.The number of valid questionnaires was 610,with an effective questionnaire rate of 96.5%.The subjects of the study ranged from a minimum age of 16 to a maximum age of 79,with an average age of 45.62±12.03years.Males accounted for a higher percentage(59.2%)than females(40.8%).The majority of the ethnic groups were Han Chinese(71.8%).52.6%of the respondents lived in urban areas and 47.4%lived in rural areas.Most of the respondents lived with others(76.9%),while 20.1%lived alone.56.4%of respondents were married,22.6%were unmarried,14.6%were divorced,and 6.3%were widowed.The education level of respondents was mainly at the primary school(25.6%)and junior high school level(35.9%),with high school/vocational school level accounting for 15.9%,and college degree or above accounting for 13.9%.8.7%of the respondents were illiterate.The unemployment rate was 30.2%,with workers and farmers accounting for 20.7%and20.2%respectively.Business personnel accounted for 14.4%,and other occupations accounted for 14.6%.93.8%of the respondents had medical insurance.2.43.4%of the participants had no symptoms when they first sought medical service,29.7%were diagnosed during pregnancy check-ups or hospitalization for other illnesses,13.9%experienced unexplained weight loss,11.1%experienced fever of unknown origin for at least a month,8.9%experienced unexplained diarrhea,6.2%experienced night sweats or persistent cough for over a month,and 1.6%experienced other symptoms.During antiviral treatment,51.0%of respondents had no symptoms or physical signs,24.4%experienced dizziness or vivid dreams,21.0%experienced memory loss,15.4%experienced extreme fatigue,11.8%experienced unexplained weight loss,6.6%experienced chest tightness or shortness of breath,4.8%experienced night sweats or persistent cough for over a month,4.6%had diarrhea five or more times a day,3.0%experienced recurring or persistent fever for at least a month,and 2.5%experienced other symptoms.At the initial diagnosis,51.4%of respondents had a CD4~+T lymphocyte count of 200-500/μL,39.4%had a count below200/μL,and 9.1%had a count above 500/μL.The primary route of transmission was heterosexual contact(63.1%).73.0%of respondents indicated that their family members were not infected with the HIV.3.The physical health summary score for the participants was 53.20(45.61,57.55),and the mental health summary score was 51.77(43.90,58.05).The scores for each dimension,from highest to lowest,were:social function 100.00(80.00,100.00)points,pain 100.00(77.78,100.00)points,role function 100.00(50.00,100.00)points,physical function 91.67(83.33,100.00)points,health distress 80.00(65.00,100.00)points,cognitive function 80.00(65.00,95.00)points,mental health 72.00(56.00,84.00)points,quality of life 75.00(50.00,75.00)points,energy/fatigue 65.00(50.00,80.00)points,general health perception 62.50(50.00,75.00)points,and health transition 50.00(50.00,75.00)points.4.There is a positive correlation between social support and physical/mental health summary score,as well as health transition score for HIV/AIDS patients receiving antiviral treatment.The higher the social support score,the better the quality of life.Conversely,there is a negative correlation between the HIV stigma scale and physical/mental health scores,as well as health transition scores.The higher the HIV stigma scale,the worse the quality of life.5.The influencing factors of the physical health summary score:Single-factor analysis results showed that the participants with higher physical health summary scores were those living in urban areas[52.54(44.08,56.90)],not living alone,married[54.05(47.52,57.94)],working as business personnel[54.15(48.00,58.52)],infected through other transmission routes[54.23(49.51,57.88)],asymptomatic at initial visit[54.05(47.90,57.85)],asymptomatic during treatment[55.44(50.82,58.3)],had higher social support scores,and lower HIV stigma scores(P<0.05).Quantile regression analysis results showed that the participants with fewer symptoms during treatment and higher social support scores had higher physical health summary scores at all percentile points(P<0.05).The participants working as laborers had higher physical health summary scores than those unemployed at the 25%and 50%percentile points(P<0.05).The intravenous drug users had lower scores at the 25%and 75%percentile points compared with those infected through other routes(P<0.05).The business personnel had higher scores at the 25%percentile point than those unemployed(P<0.05).Unmarried,divorced,and widowed participants had lower scores at the 75%percentile point compared with those whose spouse died;the participants infected through same-sex contact had higher scores compared with those infected through other routes(P<0.05).The influence of occupation,symptom severity during treatment,and social support decreased as the percentile point increased(P<0.05).6.The influencing factors of the mental health summary score:Single-factor analysis results showed that the participants with higher mental health summary scores were those aged 50-59[54.25(45.98,59.57)],not living alone[52.22(44.86,58.58)],married[53.02(45.92,59.10)],working as business personnel[53.66(46.34,59.65)],asymptomatic at initial visit[52.38(45.76,58.29)],asymptomatic during treatment[53.95(47.68,59.69)],had higher social support scores,and lower HIV stigma scores(P<0.05).Quantile regression analysis results showed that the participants with fewer symptoms during treatment,higher social support scores,and lower HIV stigma scores had higher mental health summary scores at all percentile points(P<0.05).The participants with one symptom during treatment had higher scores than those with three or more symptoms at the 50%and 75%percentile points(P<0.05).At the 50%percentile point,the participants aged 40-49 had higher scores than those aged 60 or above;the business personnel and other professionals had higher scores compared with those unemployed;the participants with two symptoms during treatment had higher scores than those with three or more symptoms(P<0.05).At the 75%percentile point,the participants aged 50-59 had higher scores than those aged 60 or above;the participants with one symptom at initial visit had higher scores than those with two or more symptoms(P<0.05).The influence of age,initial visit symptoms,and symptoms during treatment increased as the percentile point increased(P<0.05).The influence of social support and HIV stigma decreased as the percentile point increased(P<0.05).7.The influencing factors of the health transformation:Single-factor analysis results showed that younger participants(<30 years old)[50.00(50.00,100.00)],ethnic minorities[50.00(50.00,75.00)],asymptomatic during treatment[50.00(50.00,75.00)],higher social support scores,and lower HIV stigma scores had higher health transformation(P<0.05).Ordinal logistic regression analysis results showed that age,ethnicity,social support,and HIV stigma were factors that influenced different levels of health transformation(P<0.05).Younger age,belonging to an ethnic minority,higher social support scores,and lower HIV stigma scores were all reasons for better health transformation among HIV/AIDS patients receiving antiretroviral therapy.Conclusion(s):1.The physical health summary score and mental health summary score in HIV/AIDS patients receiving antiretroviral therapy were higher than those in previous studies,indicating improved quality of life in this population.2.Social support had a significant impact on quality of life,affecting the physical health summary score,mental health summary score,and health transition.Increasing social support could improve the quality of life.3.HIV stigma had an impact on the mental health summary score and health transformation.Strengthening promotion and education on antiretroviral therapy and psychological well-being lowered perceived discrimination and improved quality of life.4.HIV/AIDS patients who were unemployed and had symptoms during treatment had lower physical health summary scores and mental health summary scores.Physicians should focus on providing more encouragement and assistance to this group of patients during treatment,motivating them to continue receiving effective therapy,undergoing regular examinations of viral load and immune indicators,addressing related symptoms promptly,and ultimately improving their quality of life.5.Widowed and Intravenous injectors had lower the physical health summary score;HIV/AIDS patients who were younger and have more symptoms at the first visit to the doctor had lower mental health summary scores.Older,Han people had poor health transition.We should pay attention to these influencing factors and take effective intervention measures to improve the quality of life of HIV/AIDS patients receiving ART. |
PDF Full Text Request