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研究生:郭懷晴
研究生(外文):Huai-Ching Kuo
論文名稱:馬拉威北部地區愛滋病毒感染者生活品質及其需求之研究
論文名稱(外文):A Survey on Quality of Life and Needs among HIV/AIDS Patients in the Northern Region of Malawi
指導教授:陳宜民陳宜民引用關係
指導教授(外文):Yi-Ming Chen
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:公共衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:英文
論文頁數:82
中文關鍵詞:馬拉威愛滋病患生活品質
外文關鍵詞:MalawiHIV/AIDS PatientsQuality of life
相關次數:
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依據馬拉威全國愛滋病委員會資料,該國保守估計有70多萬愛滋病人,每年至少有八萬人死於愛滋病。馬拉威成年人愛滋病的盛行率為15%。由於抗反轉錄病毒療法的使用,使得愛滋病患的生命得以延長,因此本論文的目的為瞭解馬拉威北部地區愛滋病患和其他非愛滋病人之需求和生活品質,以及其相關因子。本研究在姆祖祖中央醫院的愛滋病-彩虹門診和醫院內其他科別,針對15歲以上病人,以結構式問卷收案。問卷分為兩部分,第一部分是SF-36(Short form 36)生活品質量表;第二部份是需求評估問卷。研究結果,共有302名愛滋病患80名(26%)為男性,222名(74%)為女性;和600名非愛滋病患參與調查。45%的愛滋病患其年齡介於31~40歲。婚姻況狀中49%為已婚,30%為喪偶。43%男性及32%女性病患其CD4為50-200 cells/mm3;而在非愛滋病患中34%的病患其年齡介於21~30歲,277名(46%)為男性,為323名(54%)女性。在15項需求評估中,營養、宗教信仰、抗反轉錄病毒療法為愛滋病患主要的三大需求;而在非愛滋病患中則在宗教信仰、營養、家人照顧。在生活品質量表八個層面上,愛滋病患在身體生理功能(physical functioning)、因生理功能角色受限(role limitation due to physical problems)、因情緒影響而角色受限(Role Limitation Due to Emotional Problems)、活力狀況(Vitality)、一般健康(general health)部份均較非愛滋病患低;且女性在各個層面分數也均較男性低。此外,愛滋病臨床症狀階段較嚴重的與CD4細胞數低於200 cells/mm3其生活品質分數也較低。在細胞數低於200 cells/mm3且接受治療時間超過於13個月之病人,其心理層面分數(70.99±15.93)相對較低。所以建議在個人家庭及社區方面需加強有關疾病的諮詢輔導,降低愛滋病患者因面臨壓力、社會烙印、憂鬱與沮喪,及惡化與死亡,所造成的心理問題。另外提供教育宣導、愛滋病毒檢驗抽血檢查、抗病毒藥物的提供,食物方面營養的攝取,宗教力量的支持和家人的照顧,對於改善馬拉威北部愛滋病患及非愛滋病患之生活品質將會有所幫助。
Malawi is one of the sub-Saharan countries that has a severe epidemic of HIV infection. According to the Malawi National AIDS Commission, there were 700,000 HIV/AIDS cases in Malawi in 2003. The HIV-1 prevalence rate of adult Malawians was about 15%. However, the government has adopted a treatment program of anti-retroviral therapy that can effectively prolong life. Therefore, improving the quality of life among HIV/AIDS patients is becoming an important issue. The objective of this study was to assess the needs, quality of life and its associated factors among HIV/AIDS patients in the northern region of Malawi. A structured questionnaire was used. Patients who were at least 15 years of age, attending the Rainbow HIV-Clinic and other clinics were invited to participate in the study. A total of 302 HIV/AIDS patients including 80 (26.45%) males and 222 (73.55%) females participated in this study. In their last CD4 count, forty-three percents male and thirty-two percents female patients’ CD4 counts were between 50-200 cells/mm3. Additional subjects who participated in the study included 600 patients from other clinics. These consisted of 277 (46.17%) males and 323 (53.83%) females. Among eight health concepts assessed in the SF-36 quality of life, HIV/AIDS patients’ scores in the following five concepts were lower compared to patients from other clinics: physical functioning, role limitation due to physical problems, general health, role limitation due to emotional problems and vitality. Severe levels of WHO HIV/AIDS clinic stages were associated with lower quality of life. This is the first study on the quality of life of people living with HIV/AIDS in Malawi. The results demonstrated that female patients have lower health related quality of life person compared to their male counterparts. Social support, physical symptom, distress and emotional disturbance were found to be important predicators of quality of life of the cohort.
Contents
List of tables.........................................II
List of figures........................................IV
Abstract................................................1
摘 要...................................................2
1. Introduction.........................................3
1.1 Background..........................................3
1.2 Objectives of the study.............................5
2. Literature review....................................6
2.1 A global overview of the HIV/AIDS epidemic..........6
2.2 Overview of Republic of Malawi......................7
2.3 A brief introduction of Mzuzu Central Hospital.....10
2.4 Highly Active Antiretroviral Treatment for HIV/AIDS patients...............................................11
2.5 Antiretroviral (ARV) Therapy in Malawi.............13
2.6 The quality of life among HIV/AIDS patients........14
2.7 Factors associated the quality of life among people living with HIV/AIDS...................................16
3. Materials and Methods...............................19
3.1 Study design.......................................19
3.2 Subjects...........................................19
3.3 Questionnaire design and data collection...........20
3.4 Validity...........................................21
3.5 Reliability........................................22
3.6 Variables..........................................22
3.7 Data analysis......................................23
4. Results.............................................25
4.1 Description of the subjects........................25
4.2 Multiple regression analysis.......................29
5. Discussion..........................................30
6. Limitations.........................................34
7. Conclusions.........................................35
8. Recommendations .....................................36
9. References..........................................38
10. Appendix...........................................72
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