HIV感染者/AIDS患者参与同伴支持体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2024.01.015

摘要/Abstract

摘要：

目的系统评价和整合HIV感染者/AIDS患者参与同伴支持的体验，为完善对HIV感染者/AIDS患者的同伴支持提供参考和建议。方法计算机检索PubMed、CINAHL、Web of Science Core Collection、ProQuest、中国知网、万方数据库等中英文数据库，搜集有关HIV感染者/AIDS患者参与同伴支持体验的质性研究，检索时限为1996年1月—2022年9月。采用澳大利亚乔安娜布里格斯研究所质性研究质量评价标准（2020版）对纳入文献进行方法学质量评价，采用汇集性整合方法对原始研究结果进行整合，按照提高定性研究合成报告透明度的指南撰写论文。结果共纳入7篇质性研究，提取出26个原始研究结果，归纳为12个类别，综合为4个整合结果，分别是同伴支持为患者提供信息支持，帮助患者建立和维持健康生活方式；患者在同伴支持中获得心理和情感支持；患者在同伴支持中获得社会支持；开展同伴支持的客观要求及情景。结论同伴支持对AIDS防治工作有积极作用，对解决HIV感染者/AIDS患者实际需求具有重要意义。AIDS同伴支持的实践需要进一步的理论支持及科学指导，构建AIDS同伴支持模式，对AIDS同伴进行系统的培训和专业的指导，有利于提升AIDS同伴支持行为的准确性，促进AIDS同伴支持活动的开展，优化HIV感染者/AIDS患者同伴支持的有效性和可持续性。

关键词: 获得性免疫缺陷综合征, 同伴支持, Meta整合, 循证护理学

Abstract:

Objective To systematically evaluate and integrate the experiences of people living with HIV in peer support，and to provide references and suggestions for improving peer support for HIV patients in clinical practice. Methods The computer retrieval was performed in PubMed，CINAHL（EBSCO），Web of Science，ProQuest，CNKI and Wanfang Data from January 1，1996 to September 30，2022，to collect qualitative studies in the experience of people living with HIV participating in peer support. This qualitative systematic review was conducted under the Joanna Briggs Institute guideline. This paper was written according to the enhancing transparency in reporting the synthesis of qualitative research（ENTREQ）. Results A total of 7 qualitative studies were included，and 26 findings were extracted，which were summarized into 12 categories and integrated into 4 synthesized findings. Findings included that peer support provides patients with information and help them establish and maintain a healthy lifestyle；patients receive emotional support in peer support；patients receive instrumental support in peer support；the objective requirements and scenarios of peer support. Conclusion AIDS peer support has a positive effect on AIDS prevention and treatment，and it is important to address the practical needs of people living with HIV/AIDS. The practice of HIV peer support needs further theoretical support and scientific guidance. Building an HIV peer support model，providing systematic training and professional guidance to HIV peers is conducive to improving the accuracy of HIV peer support behaviors，the development of HIV peer support activities，and optimizing the effectiveness and sustainability of peer support for people living with HIV/AIDS.

Key words: Acquired Immunodeficiency Syndrome, Peer Support, Meta-Synthesis, Evidence-Based Nursing

常可意, 吴杨峰, 单锶楷, 韩舒羽, 全晓丽, 韩佳凝, 吴冬霞, 张莉莉. HIV感染者/AIDS患者参与同伴支持体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(1): 108-116.

CHANG Keyi, WU Yangfeng, SHAN Sikai, HAN Shuyu, QUAN Xiaoli, HAN Jianing, WU Dongxia, ZHANG Lili. Experiences of people living with HIV participating in peer support：a qualitative meta-synthesis[J]. Chinese Journal of Nursing, 2024, 59(1): 108-116.

图/表 5

图1 PubMed检索策略

Figure 1 PubMed search strategy

图2 文献筛选流程

Figure 2 Flow chart of literature screening

表1 纳入文献的基本特征(n=7)

Table 1 The basic characteristics of the included literature(n=7)

表2 纳入文献的方法学质量评价(n=7)

Table 2 Methodological quality evaluation of the included literature(n=7)

表3 整合结果的ConQual评级

Table 3 ConQual rating of integrated findings

参考文献 30

[1]	Dennis CL. Peer support within a health care context:a con-cept analysis[J]. Int J Nurs Stud, 2003, 40(3):321-332. DOI URL
[2]	陈庆玲, 李惠琴, 张莎, 等. 艾滋病医护人员职业倦怠调查[J]. 中国艾滋病性病, 2013, 19(9):679-682.
	Chen QL, Li HQ, Zhang S, et al. Study on job burnout among medical staff in caring for HIV/AIDS[J]. Chin J AIDS STD, 2013, 19(9):679-682.
[3]	Kalichman SC, Katner H, Banas E, et al. Cumulative effects of stigma experiences on retention in HIV care among men and women in the rural southeastern United States[J]. AIDS Patient Care STDS, 2020, 34(11):484-490. DOI URL
[4]	Sakyi KS, Lartey MY, Kennedy CE, et al. Barriers to maternal retention in HIV care in Ghana:key differences during pregnancy and the postpartum period[J]. BMC Pregnancy Child-birth, 2020, 20(1):398.
[5]	孙文秀, 卢洪洲, 鲍美娟, 等. 初治HIV阳性患者同伴支持效果探讨[J]. 护理学杂志, 2018, 33(11):83-86.
	Sun WX, Lu HZ, Bao MJ, et al. Effect of peer support inter-ventions in HIV positive patients on initial antiretroviral therapy[J]. J Nurs Sci, 2018, 33(11):83-86.
[6]	Berg RC, Page S, Øgård-Repål A. The effectiveness of peer-support for people living with HIV:a systematic review and meta-analysis[J]. PLoS One, 2021, 16(6):e0252623.
[7]	Boucher LM, Liddy C, Mihan A, et al. Peer-led self-management interventions and adherence to antiretroviral therapy among people living with HIV:a systematic review[J]. AIDS Behav, 2020, 24(4):998-1022. DOI PMID
[8]	Jackson K, Wadley AL, Parker R. Managing pain in HIV/AIDS:a therapeutic relationship is as effective as an exercise and education intervention for rural amaXhosa women in South Africa[J]. BMC Public Health, 2021, 21(1):302. DOI PMID
[9]	Van Tam V, Larsson M, Pharris A, et al. Peer support and im-proved quality of life among persons living with HIV on antiretroviral treatment:a randomised controlled trial from north-eastern Vietnam[J]. Health Qual Life Outcomes, 2012, 10:53. DOI URL
[10]	孙文秀, 卢洪洲, 鲍美娟, 等. 初治HIV感染者同伴支持体验的质性研究[J]. 中国艾滋病性病, 2020, 26(5):496-499.
	Sun WX, Lu HZ, Bao MJ, et al. Experience of treatment naive HIV patients receiving peer support:a qualitative study[J]. Chin J AIDS STD, 2020, 26(5):496-499.
[11]	Øgård-Repål A, Berg RC, Skogen V, et al. Peer support in an outpatient clinic for people living with human immunode-ficiency virus:a qualitative study of service users’ experiences[J]. BMC Health Serv Res, 2022, 22(1):549. DOI PMID
[12]	Hallum-Montes R, Morgan S, Rovito HM, et al. Linking peers,patients,and providers:a qualitative study of a peer integration program for hard-to-reach patients living with HIV/AIDS[J]. AIDS Care, 2013, 25(8):968-972. DOI PMID
[13]	Tong A, Flemming K, McInnes E, et al. Enhancing transparen-cy in reporting the synthesis of qualitative research:ENTREQ[J]. BMC Med Res Methodol, 2012, 12:181. DOI URL
[14]	Lockwood C, Porritt K, Munn Z, et al, Stannard D. Chapter 2:Systematic reviews of qualitative evidence[EB/OL].(2022-09-28)[2023-02-14]. https://jbi-global-wiki.refined.site/space/MANUAL/4688637/Chapter+2%3A+Systematic+reviews+of+qualitative+evidence.
[15]	Antiretroviral Therapy Cohort Collaboration. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013:a collaborative analysis of cohort studies[J]. Lancet HIV, 2017, 4(8):e349-e356. DOI URL
[16]	Munn Z, Porritt K, Lockwood C, et al. Establishing confidence in the output of qualitative research synthesis:the ConQual approach[J]. BMC Med Res Methodol, 2014, 14:108. DOI URL
[17]	Gusdal AK, Obua C, Andualem T, et al. Peer counselors’ role in supporting patients’ adherence to ART in Ethiopia and Uganda[J]. AIDS Care, 2011, 23(6):657-662. DOI URL
[18]	Harris GE, Larsen D. HIV peer counseling and the develop-ment of hope:perspectives from peer counselors and peer counseling recipients[J]. AIDS Patient Care STDS, 2007, 21(11):843-860. DOI URL
[19]	Houston E, Osborn A, Lyons T, et al. Exploring perceived social support from peer facilitators in an HIV treatment adherence intervention for African American patients:a content analysis of participant perspectives[J]. J Community Appl Soc Psy-chol, 2015, 25(6):487-501.
[20]	Mantell JE, Masvawure TB, Mapingure M, et al. Engaging men in HIV programmes:a qualitative study of male engagement in community-based antiretroviral refill groups in Zimbabwe[J]. J Int AIDS Soc, 2019, 22(10):e25403. DOI URL
[21]	Khalpey Z, Fitzgerald L, Howard C, et al. Peer navigators’ role in supporting people living with human immunodeficiency virus in Australia:qualitative exploration of general practitio-ners’ perspectives[J]. Health Soc Care Community, 2022, 30(4):1353-1362. DOI URL
[22]	Han SY, Zhang YZ, Yang XX, et al. The effectiveness and sustainability of peer support interventions for persons living with HIV:a realist synthesis[J]. BMJ Glob Health, 2023, 8(2):e010966. DOI URL
[23]	Iryawan AR, Stoicescu C, Sjahrial F, et al. The impact of peer support on testing,linkage to and engagement in HIV care for people who inject drugs in Indonesia:qualitative perspectives from a community-led study[J]. Harm Reduct J, 2022, 19(1):16. DOI
[24]	余静, 谢幸尔, 钱湘云, 等. 艾滋病患者积极应对疾病的真实体验研究[J]. 中华护理杂志, 2021, 56(3):399-403. DOI URL
	Yu J, Xie XE, Qian XY, et al. Study on the real experience of AIDS patients actively coping with the disease[J]. Chin J Nurs, 2021, 56(3):399-403.
[25]	Mead S, Cheryl M. Peer support:what makes it unique?[J]. Int J Psychosoc Rehabil, 2006, 10(2):29-37.
[26]	Øgård-Repål A, Berg RC, Fossum M. Peer support for people living with HIV:a scoping review[J]. Health Promot Pract, 2023, 24(1):172-190. DOI URL
[27]	孙文秀, 卢洪洲, 张林, 等. 同伴支持在HIV阳性患者中运用的研究进展[J]. 中华护理杂志, 2018, 53(2):238-241.
	Sun WX, Lu HZ, Zhang L, et al. Research progress of peer support in HIV positive patients[J]. Chin J Nurs, 2018, 53(2):238-241.
[28]	颜婵, 蔡卫平, 万秀兰, 等. 诊断披露对艾滋病患者社会支持的影响[J]. 护理学报, 2015, 22(3):38-40.
	Yan C, Cai WP, Wan XL, et al. Influence of disclosure of diagnosis on social support of AIDS patients[J]. J Nurs, 2015, 22(3):38-40.
[29]	廖敏, 唐杰, 王冬华. HIV感染者和AIDS患者病耻感的研究进展[J]. 中华护理杂志, 2019, 54(4):619-623. DOI URL
	Liao M, Tang J, Wang DH. Research progress of stigma in HIV-infected and AIDS patients[J]. Chin J Nurs, 2019, 54(4):619-623.
[30]	Peterson JL, Rintamaki LS, Brashers DE, et al. The forms and functions of peer social support for people living with HIV[J]. J Assoc Nurses AIDS Care, 2012, 23(4):294-305. DOI PMID