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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south.
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How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south.

机译：创伤，近期的压力事件和PTSD如何影响南部艾滋病毒感染患者的功能健康状况和健康利用。

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OBJECTIVE: In addition to biological markers of human immunodeficiency virus (HIV) disease progression, physical functioning, and utilization of health care may also be important indicators of health status in HIV-infected patients. There is insufficient understanding of the psychosocial predictors of health-related physical functioning and use of health services among those with this chronic disease. Therefore, the current study examines how trauma, severe stressful events, posttraumatic stress disorder (PTSD), and depressive symptoms are related to physical functioning and health utilization in HIV-infected men and women living in rural areas of the South. METHODS: We consecutively sampled patients from 8 rural HIV clinics in 5 southern states, obtaining 611 completed interviews. RESULTS: We found that patients with more lifetime trauma, stressful events, and PTSD symptoms reported more bodily pain, and poorer physical, role, and cognitive functioning. Trauma, recent stressful events, and PTSD explained from 12% to 27% of the variance in health-related functioning, over and above that explained by demographic variables. In addition, patients with more trauma, including sexual and physical abuse, and PTSD symptoms were at greater risk for having bed disability, an overnight hospitalization, an emergency room visit, and four or more HIV outpatient clinic visits in the previous 9 months. Patients with a history of abuse had about twice the risk of spending 5 or more days in bed, having an overnight hospital stay, and visiting the emergency room, compared with those without abuse. The effects of trauma and stress were not explained by CD4 lymphocyte count or HIV viral load; however, these effects appear to be largely accounted for by increases in current PTSD symptoms. CONCLUSION: These findings highlight the importance of addressing past trauma, stress, and current PTSD within clinical HIV care.
机译：目的：除了人类免疫缺陷病毒（HIV）疾病进展的生物学标记外，身体功能和医疗保健的利用也可能是感染HIV的患者健康状况的重要指标。在患有这种慢性疾病的人群中，人们对与健康有关的身体功能的心理社会预测因素以及使用卫生服务的了解不足。因此，本研究检查了南部农村地区感染艾滋病毒的男女的创伤，严重压力事件，创伤后应激障碍（PTSD）和抑郁症状与身体机能和健康利用的关系。方法：我们从南部5个州的8个农村HIV诊所连续采样了患者，获得611个完整的访谈。结果：我们发现患有一生中更多创伤，压力事件和PTSD症状的患者报告了更多的身体疼痛，以及较差的身体，作用和认知功能。创伤，近期压力事​​件和PTSD解释了与健康相关的机能差异的12％至27％，超过了人口统计学变量所解释的差异。此外，在过去的9个月中，遭受更多创伤（包括性虐待和身体虐待以及PTSD症状）的患者患床残障，过夜住院，急诊就诊以及四次或更多HIV门诊的风险更大。与未受虐待的患者相比，有受虐待历史的患者在床上卧床休息5天或更长时间，住院过夜以及前往急诊室的风险大约是其两倍。 CD4淋巴细胞计数或HIV病毒载量不能解释创伤和压力的影响。然而，这些影响似乎在很大程度上是由于当前PTSD症状增加所致。结论：这些发现强调了在临床HIV护理中解决过去的创伤，压力和当前PTSD的重要性。

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