HIV感染者随访期间核心症状及严重程度的调查研究

doi:10.3761/j.issn.0254-1769.2021.05.014

摘要/Abstract

摘要：

目的调查HIV感染者随访期间症状的发生率和严重程度,构建HIV感染者症状网络,并分析网络中心化指标,探索症状网络中的核心症状。方法 2020年6月—10月选取昆明市某艾滋病定点诊疗机构感染科门诊的HIV感染者572例。采用艾滋病症状自评量表调查27个HIV相关症状的发生率和严重程度,并基于Spearman相关估计和Fruchterman-Reingold力引导布局探索症状网络的强度、紧密中心性和中介中心性。结果获得有效问卷572份。HIV感染者最常见的症状是疲乏（44.41%）、睡眠障碍（37.76%）、健忘（37.41%）;最严重的症状是疲乏,其次是睡眠障碍、健忘;症状网络中,疲乏（r_S=8.62,r_C=1.16,r_B=36）和反应变慢（r_S=8.54,r_C=1.07,r_B=14）是强度、紧密中心性和中介中心性最大的症状。结论疲乏和认知功能障碍症状群是HIV感染者症状网络中最核心的症状群,建议护理人员在随访过程中更多地关注HIV感染者的自我报告症状,并基于随访数据制订精准化的症状管理措施。

关键词: 获得性免疫缺陷综合征, 症状管理, 网络分析, 护理

Abstract:

Objective To explore the prevalence and severity of HIV-related symptoms and to identify symptom networks in people living with HIV（PLWH）.Methods From June to October 2020,we recruited 572 PLWH through a convenient sampling in one HIV/AIDS designated hospital in Kunming,Yunnan Province. HIV Symptom Checklist was used to measure the prevalence and severity of 27 HIV-related symptoms. Spearman association network and Fruchterman-Reingold layout were used to identify symptom networks.Results The most common symptom was fatigue（44.41%）,sleeping disturbance（37.76%）,and memory loss（37.41%）. The most severe symptom was fatigue,sleeping disturbance,and memory loss. The network showed fatigue（r_S=8.62,r_C=1.16,r_B=36） and slow reaction（r_S=8.54,r_C=1.07,r_B=14） were the most central symptoms across three centrality indices including strength,closeness,and betweenness.Conclusion This study suggested that it is particularly important to include assessment and treatment of fatigue and cognitive symptoms as essential components of HIV care. There is a need to evaluate HIV-related symptoms by a structural patient reported outcome measures.

Key words: Acquired Immune Deficiency Syndrome, Symptom Management, Network Analysis, Nursing Care

杨红丽,朱政,胡雁,毕雄凤,徐巾洁,罗兰,张林. HIV感染者随访期间核心症状及严重程度的调查研究[J]. 中华护理杂志, 2021, 56(5): 727-731.

YANG Hongli,ZHU Zheng,HU Yan,BI Xiongfeng,XU Jinjie,LUO Lan,ZHANG Lin. Centrality and serverity of symptoms in people living with HIV: a cross-sectional study[J]. Chinese Journal of Nursing, 2021, 56(5): 727-731.

图/表 3

表1 患者的一般资料（n=572）

Table 1 Participants Characteristics（n=572）

表2 HIV感染者相关症状的发生率和严重程度（n=572）

Table 2 Prevalence and severity of HIV-related symptoms（n=572）

图1 HIV感染者症状网络注：W1=发热;W2=食欲下降;W3=腹泻;W4=体重下降;D1=头晕;D2=头痛;S1=皮疹;S2=肌肉-关节疼痛;S3=手脚发麻;S4=口腔溃疡;P1=感到无法控制的焦虑;P2=感到紧张;P3=做事提不起兴趣;P4=感到心情低落;C1=注意力难以集中;C2=反应变慢;C3=健忘;C4=理解上存在困难;C5=变得更加糊涂;U1=疲乏;U2=咳嗽;U3=睡眠障碍;U4=视力模糊;U5=脂肪转移;U6=性欲下降;U7=脱发。症状间连接线越粗代表2种症状相关性越强。

Figure 1 Network of HIV-related symptoms

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