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The effects of markers for HIV disease progression, social network, barriers to care, depression, and substance abuse on medical appointment adherence of HIV-infected adults.

机译：HIV疾病进展，社交网络，护理障碍，抑郁和药物滥用的标志物对HIV感染成年人的就诊依从性的影响。

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摘要

The study was designed to test a causal model of theoretical relationships among markers for HIV disease progression, social network, barriers to care, depression, substance abuse, and medical appointment adherence among HIV-infected adults. The proposed causal model was derived and developed from Lazarus and Folkman's theory of stress, appraisal, and coping. The knowledge gained from this study may yield critical information with respect to determining how a health care provider or researcher can develop specific behavioral interventions for the improvement of medical appointment adherence among HIV-infected adults living in the Southeastern United States.;The correlational study was a secondary analysis of data from the UAB Center for AIDS Research 1917 HIV Clinic Cohort Database. Three hundred and thirty eight clients entering care during the period from 1 July 2009 through 30 June 2011 who met specific criteria were included in the secondary analysis. The analysis included data collected during an initial baseline measurement at entry into care and the pattern of adherence to medical appointments was observed over a 12-month period.;Structural equation modeling was conducted to test the proposed model using LISREL 8.4 software. The following proposed relationships among the causal model variable were found to be consistent with the data: (1) distance to treatment facility and depression were found to have direct positive effects on adherence to medical appointments; (2) substance abuse was found to have a direct negative effect on adherence; (3) social network had a direct positive effect on substance abuse; and (4) HIV disease progression had a direct negative effect on substance abuse.;The fully trimmed model provided a good fit to the observed data, with a χ2 (21, N = 338) = 22.31, p =.38; GFI = 0.99; RMSEA = 0.03, and CFI = 0.99. Thus the null hypothesis of no differences was supported for the trimmed model. However, the model only accounted for eight percent of the variance in adherence to medical appointments (R2 = 0.08). Longitudinal study of the relationships among causal model variable is recommended for deeper understanding of the pattern of HIV medical appointments adherence over time.
机译：该研究旨在测试HIV感染成年人中HIV疾病进展，社会网络，护理障碍，抑郁，药物滥用和就医依从性标志之间理论关系的因果关系模型。提出的因果模型是根据拉撒路和福克曼的压力，评估和应对理论而推导和发展的。从这项研究中获得的知识可能会在确定医疗保健提供者或研究人员如何开发特定的行为干预措施以改善居住在美国东南部的HIV感染成年人中改善医疗任命依从性方面提供重要信息。对来自UAB艾滋病研究中心（1917年HIV临床队列数据库）的数据进行了二次分析。次要分析包括2009年7月1日至2011年6月30日期间符合特定标准的138位接受护理的客户。分析包括在进入护理时的初始基线测量期间收集的数据，并观察了在12个月内遵守医疗任命的模式。;使用LISREL 8.4软件进行了结构方程模型测试，以测试所提出的模型。发现以下因果模型变量之间的建议关系与数据一致：（1）到治疗机构的距离和抑郁症对遵守医疗任命有直接的积极影响； （2）发现滥用药物会对依从性产生直接的负面影响； （3）社交网络对药物滥用有直接的积极影响； （4）HIV疾病的发展对药物滥用具有直接的负面影响。完全修剪的模型非常符合观察到的数据，χ2（21，N = 338）= 22.31，p = .38； GFI = 0.99； RMSEA = 0.03，CFI = 0.99。因此，修剪模型支持没有差异的零假设。但是，该模型仅占遵从医疗任命方差的8％（R2 = 0.08）。建议对因果模型变量之间的关系进行纵向研究，以更深入地了解随时间推移的艾滋病毒医疗预约依从性模式。

著录项

  • 作者

    Ng, Yeow Chye.;

  • 作者单位

    University of Colorado at Boulder.;

  • 授予单位 University of Colorado at Boulder.;
  • 学科 Health Sciences Medicine and Surgery.;Health Sciences Nursing.;Psychology General.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 203 p.
  • 总页数 203
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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