發(fā)布時間：2018-05-21 13:10

  本文選題：艾滋病 + 抗病毒治療�。� 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]通過對云南省某地抗病毒治療脫失患者進行梳理和脫失因素進行詳細調(diào)查,了解云南省艾滋病國家免費抗病毒治療患者脫失的主要原因,為全省下一步在減少患者脫失方面制定政策和采取措施提供理論依據(jù)。[方法]選取云南省艾滋病國家免費抗病毒治療機構(gòu)中的五個治療點:包括(紅河州一院、個舊、建水、開遠、蒙自)五個醫(yī)院作為研究現(xiàn)場。采取定量研究和定性研究相結(jié)合的研究方法。定量研究:根據(jù)云南省艾滋病數(shù)據(jù)信息系統(tǒng)中患者基本情況數(shù)據(jù)庫信息,初步確定好的研究對象名單,對艾滋病患者一對一發(fā)放問卷進行調(diào)查。運用描述性分析方法,描述在治療和脫失治療的原因,采用單因素和多因素Logistic回歸分析方法探討影響艾滋病患者接受治療和脫失治療的相關(guān)因素。定性研究:采用個人深入訪談,訪談對象為艾滋病抗病毒治療管理者、一線醫(yī)務(wù)工作者、艾滋病患者(在治療患者、脫失患者)、同伴教育者。主要了解艾滋病患者脫失治療的原因,對訪談結(jié)果歸納整理,進行分析。[結(jié)果]本研究共收到有效問卷376份(在治療患者問卷253份,脫失患者問卷123份)。訪談負責艾滋病抗病毒治療醫(yī)務(wù)工作者9名,同伴教育者5名,艾滋病患者20名。1脫失的主要原因:藥物副作用太大58人(47.1%);打工服藥不方便22人(17.9%);距離遠不方便領(lǐng)藥12人(9.8%);羈押9人(7.3%);吃藥身體變差7人(5.7%);擔心服藥暴露感染者身份6人(4.9%);身體還好不想服藥4人(3.3%);經(jīng)濟困難3人(2.4%)。2脫失治療相關(guān)因素分析:飲酒(OR=12.87,95%CI:1.97～84.20)、使用毒品(OR=1.65,95%CI:10.32～17.86)、感染途徑(OR=2.63,95%CI:1.13～8.83)、吃藥困難(OR=4.80,95%CI:1.05～4.92)、藥物不良反應(yīng)(OR=1.91,95%CI:1.20～6.33)是維持治療的危險因素;出現(xiàn)不良反應(yīng)后堅持服藥/去找醫(yī)生(OR=0.00,95%CI:0.00～0.01)、高中/中專學歷(OR=0.00,95%CI:0.00～0.11)是維持治療的保護因素。3通過訪談了解到當?shù)匕滩】共《局委熋撌У挠绊懸蛩?藥物不良反應(yīng)、外出打工不方便、路途遙遠、對艾滋病抗病毒治療認識不足、羈押。[結(jié)論]影響當?shù)匕滩』颊呔S持治療的因素主要有:1).社會人口學特征:有吸毒、飲酒特殊習慣人群更容易脫失。2).對藥物副作用處理辦法不當(不堅持服藥、不主動聯(lián)系醫(yī)生)人群更容易脫失。3).社會環(huán)境:外出打工、戒毒、羈押患者更容易脫失。4).文化程度較低患者更容易脫失。
[Abstract]:[objective] to find out the main causes of free antiviral therapy for AIDS patients in Yunnan province through a detailed investigation of the causes of antiviral therapy in Yunnan province. To provide the theoretical basis for the next step in reducing the loss of patients to formulate policies and take measures. [methods] five treatment points of free antiviral treatment institutions in Yunnan province were selected, including five hospitals (Honghe first Hospital, Gejiu Hospital, Jianshui Hospital, Kaiyuan Hospital, Mengzi Hospital). The method of combining quantitative and qualitative studies is adopted. Quantitative study: according to the basic information database information of patients in Yunnan AIDS data information system, a list of good research objects was preliminarily determined, and a one-to-one questionnaire for AIDS patients was investigated. Descriptive analysis was used to describe the causes of treatment and loss of treatment. Univariate and multivariate Logistic regression analysis was used to explore the related factors affecting the treatment and loss of AIDS patients. Qualitative study: we used personal in-depth interviews to interview AIDS antiviral treatment managers, frontline medical workers, AIDS patients (in the treatment of patients, lost patients, peer educators). To understand the causes of AIDS patients without treatment, the results of the interview summarized and analyzed. [results] A total of 376 valid questionnaires were received in this study. Interviews were conducted with 9 medical workers responsible for HIV / AIDS treatment and 5 peer educators. The main reasons for the loss of 20 AIDS patients are: 58 patients have too many side effects, 22 people are not convenient to take medicine, 12 people are not convenient to get medicine, 9 people are detained, 7 people are ill with medicine, 7 people are worried about exposure to drugs. Status 6: 4. 9; body is fine; 4 are not willing to take medicine; 3 are in financial difficulties. 2. 2. 2. Analysis of the factors related to the treatment of loss: drinking OR12.87 / 95CI1.97: 84.20, using the drug OR1.6595: CI10.3217.866.The route of infection is OR2.6395CIW 1.138.83, the difficulty of taking medicine OR4.80 / 95. The CI1.054.92and the adverse drug reaction OR1.9195CI1.206.33) are the risk factors for the maintenance of treatment. Sticking to medication after adverse reactions / going to the doctor to take medicine / go to the doctor / doctor Long way, AIDS anti-viral treatment insufficient understanding, custody. [conclusion] the main factors affecting the maintenance of local AIDS patients are: 1: 1. Social demographic characteristics: drug use, drinking special habits of people are more likely to lose. 2. People who mismanage side effects (don't stick to medication, don't actively contact doctors) are more likely to lose. Social environment: going out to work, detoxification, detaining patients are more likely to lose. People with a lower level of education are more likely to lose their education.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R512.91

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