Abstract:

Objective To understand the current situation and problems of HIV/AIDS symptoms management under the HIV/AIDS designated hospital system in China.Methods From April to July,2017,36 healthcare staff were recruited from four HIV/AIDS designated hospitals in Shanghai,Hengyang （Hunan Province）,Nanning （Guangxi Province）,and Kunming（Yunnan Province）. Semi-structured interviews were conducted to collect data.Results Thirteen themes were grouped into four major themes including the content of symptom management under the HIV/AIDS designated hospital system,advantages and difficulties,current problems of current HIV/AIDS symptom management,and recommendations for optimizing current symptom management under HIV/AIDS designated hospital system.Conclusion This study found that the current clinical practice for HIV/AIDS symptom management was diversified but with a low degree of specialization. Although symptom management under HIV/AIDS designated hospital system could satisfy the social need of patients,it also increased the difficulties of professional care. We suggested one-stop service between other disciplines and HIV/AIDS designated hospitals should be promoted under the HIV/AIDS designated hospital system. Nurse-led symptom assessment and information platform for follow-ups should also be strengthened.

Key words: Acquired Immunodeficiency Syndrome, HIV Infections, Symptom Management, Medication Adherence, Qualitative Research

摘要：

【目的】了解我国艾滋病定点诊疗模式下,艾滋病症状管理的现状和存在的主要问题。【方法】选取2017年4月—7月在上海市、湖南省衡阳市、广西壮族自治区南宁市、云南省昆明市4所艾滋病定点诊疗机构艾滋病门诊及病房的医护人员36名。采用半结构化访谈的方法收集资料,对访谈资料进行转录、编码、类属分析、描述和组织。【结果】提炼出定点诊疗模式下症状管理的实践内容、定点诊疗模式下症状管理的优势和实践难点、定点诊疗模式下症状管理的问题分析和完善定点诊疗模式下症状管理服务体系的建议4个部分,共13个一级主题。【结论】目前定点诊疗模式下症状管理服务形式多样但专业化程度低;虽然保障了患者社会性需求,但也加大了症状管理中专业照护的难度;构建综合性医院与艾滋病定点诊疗机构间的医联体,明晰护士及个案管理师的自身定位和实现随访工作信息化是未来艾滋病定点诊疗模式下症状管理发展的方向。

关键词: 获得性免疫缺陷综合征, HIV感染, 症状管理, 服药依从性, 质性研究