Research On Improving Self-Management Ability Of HIV/AIDS Patients Based On Case Management Model

Objective:1)Understand the level of self-management,psychological resilience,and self-efficacy of HIV/AIDS patients in Xinjiang;2)Explore the impact of case management models on self-management ability,psychological resilience,and self-efficacy of HIV/AIDS patients;3)Analysis the effect of case management model on the follow-up of HIV/AIDS patients,medication compliance,body mass index?BMI?,and immunodetection index?CD₄⁺T lymphocyte count?.Methods:From July 2016 to July2017,160 HIV/AIDS patients receiving anti-virus therapy in the Care Center of the Sixth People's Hospital of Xinjiang Uygur Autonomous Region for the first time were selected.According to the random number table,the subjects were divided into control group and intervention group,each group 80 cases.All HIV/AIDS patients participating in the study were divided into groups according to different intervention methods.The remaining treatment methods were maintained for 6 months.The control group was given routine management in the hospital,and the intervention group was given case management.The self-management ability,mental resilience,self-efficacy,treatment compliance and BMI,CD₄⁺T lymphocyte count changes in two groups were evaluated before and after intervention to analyze the impact of the two management modes on patients'self-management ability.Results:1)Results of baseline data survey:There was no significant difference in demographic data,disease status,self-management ability,level of resilience,self-efficacy between the two groups?P>0.05?.Self-management ability at a low level.Repeated measures analysis of variance:patients with self-management scores and all dimensions of the difference between the two groups were statistically significant?P<0.05?.The scores of self-management and all dimensions in both groups increased with time,but scores of intervention group were higher than those of control group?P<0.05?.There were significant differences in the interaction between time and grouping factors?P<0.05?.The scores of self-management score,daily life management,treatment compliance management,emotion cognition management,social support and help in four dimensions were statistically significant;3)Before the intervention,the psychological resilience of the two groups of patients was lower.Repeated measures of analysis of variance:the total score of the patient's mental flexibility and the total score of each factor between the two groups was statistically significant?P<0.05?.The total score of psychological resilience and the total score of each factor increased with time,but the score of intervention group was higher than that of control group?P<0.05?.The total score of psychological resilience and the total score of each factor after intervention were statistically significant?P<0.05?in the interaction of time and grouping factors;4)The self-efficacy of HIV/AIDS patients in the two groups before intervention was low.Repeated measures of analysis of variance:two groups of patients with total self-efficacy and scores of each dimension difference between the two groups was statistically significant?P<0.05?.The scores of self-efficacy and scores of all dimensions increased with time,but scores of intervention group were higher than those of control group?P<0.05?.5)After 0.5 and 1 months of intervention,there was no significant difference in the follow-up between the two groups?P>0.05?.At 3 and 6 months after intervention,the follow-up of the two groups was statistically significant?P<0.05?,and the follow-up rate of the intervention group was higher than that of the control group.6)After 0.5 and 1month There was no significant difference in medication adherence between the two groups?P>0.05?.At 3 months and 6 months after intervention,the medication compliance of the two groups was statistically significant?P<0.05?,and the medication compliance of the intervention group was better than that of the control group.7)After intervention at each time point,the difference was statistically significant?P<0.05?.8)At 6 months after intervention,CD₄⁺T cell counts in both groups were significantly different?P<0.05?.Conclusion:The self-management ability,mental resilience and self-efficacy of HIV/AIDS patients are generally at a low level.The case management model can effectively improve the patient's self-management ability,psychological flexibility level,self-efficacy and treatment compliance,and can promote patients.The BMI value and CD₄⁺T cell count increase within the normal range.All these factors will help to cultivate and enhance the patient's self-management ability.This research can provide a theoretical basis for constructing and perfecting the nursing management mode applicable to native HIV/AIDS patients.