【摘要】 目的 本研究基于社会认知理论，探讨结果预期在老年HIV感染者医患信任与用药依从性间的中介作用，为制定有效的干预策略提供依据。方法 本研究于2024年7—10月，在襄阳市6个区（县、市）采用分层随机抽样法进行横断面调查，使用Morisky用药依从性量表、医患信任量表及结果预期量表收集数据，并采用分层回归分析以检验结果预期的中介效应。结果 共获得有效样本203例。结果显示，性别、居住地、家庭月均收入、职业状况、饮酒及药物不良反应等因素对老年HIV感染者抗病毒用药依从性有显著影响（P<0.05）。医患信任、结果预期与用药依从性呈显著正相关（r=0.37,P<0.001）。结果预期在医患信任与用药依从性之间的中介效应为10%。结论 医患信任可通过结果预期显著改善老年HIV感染者用药依从行为。建议在老年HIV感染者抗病毒治疗过程中，注重提高感染者对抗病毒治疗结果的正向获益预期，以提升感染者用药依从性。更多还原

【Abstract】 Objective Based on the social cognitive theory, this study aimed to examine the mediating role of outcome expectations in the relationship between physician-patient trust and medication adherence among older adults living with HIV, so as to provide evidence for developing effective intervention strategies. Methods A cross-sectional survey was conducted from July to October 2024 in six districts(counties, county-level cites) of Xiangyang City, using a stratified random sampling method. Data were collected using the Morisky Medication Adherence Scale, the Physician-Patient Trust Scale, and the Outcome Expectations Scale. Hierarchical regression analysis was employed to test the mediating effect of outcome expectations. Results A total of 203 valid samples were obtained. The analysis revealed that factors such as gender,place of residence, average monthly household income, occupational status, alcohol consumption, and adverse drug reactions had significant effects on medication adherence(P<0.05). Physician-patient trust and outcome expectations were significantly positively correlated with antiretroviral medication adherence(r =0.37, P <0.001). Outcome expectations played a partial mediating role between physician-patient trust and medication adherence, with a mediation effect of 10%. Conclusion Physician-patient trust can significantly improve medication adherence in older adults with HIV by enhancing their positive outcome expectations. It is recommended that antiretroviral therapy programs for this population focus on strengthening patients’ positive perceptions of treatment benefits to improve their medication adherence.更多还原