【作者】 张栋栋；

【导师】 孙业桓；

【作者基本信息】 安徽医科大学 ， 流行病学与卫生统计学， 2011， 硕士

【摘要】 目的了解安徽省农村地区艾滋病毒感染者/艾滋病患者(People Living With HIV/AIDS,PLWHAS)家庭成员的相关生活事件及家庭内部关怀特征,探讨其生存特征及生活环境中特有的影响因素,为提高其生存质量提供科学依据。方法调查选择安徽省阜阳市颍州区京九乡的190名PLWHAS家庭成员,同时在地理位置相近的安徽省萧县地区抽取216名正常居民作为对照,使用自编一般人口学特征问卷、相关生活事件调查问卷、艾滋病知识、态度和行为(KAP)问卷、家庭功能指数问卷(Family APGAR Index,APGAR)和安全感量表(Security Questionnaire,SQ)等对目标人群进行评测。以是否为PLWHAS家庭成员为分组变量,对两组人群一般人口学特征、负性生活事件指标、艾滋病知识、态度和行为得分、家庭功能及安全感等指标进行比较分析。结果本次调查共访谈406人,其中PLWHAS家庭成员190人,对照者216人。性别分布为PLWHAS家庭成员中男性70人(36.8%),女性120人(63.2%),对照者中男性87人(40.3%),女性129人(59.7%),年龄分布:PLWHAS家庭成员平均年龄为(37.89±16.41)岁,对照者平均年龄为(42.41±14.76)岁。艾滋病知识、态度和行为(KAP)比较结果显示PLWHAS家庭成员平均得分为(9.37±2.45)分,对照组平均得分为(5.52±3.86)分,PLWHAS家庭成员有着更高的艾滋病相关知识水平。相关生活事件调查结果显示,两组人群在自杀意念(χ~2=33.603,P<0.001)和自杀未遂(χ~2=10.464,P=0.001)方面的差异存在统计学意义,对PLWHAS家庭成员人群的进一步研究显示,造成PLWHAS家庭成员自杀意念产生的主要影响因素为:配偶患病(OR=8.574,OR 95% C.I.=3.199~22.985)、其他亲属(非直系亲属)患病(OR=4.055,OR 95%C.I.=1.550~10.607)、家庭适应度低(OR=5.857,OR 95% C.I.=1.517~22.608)和被他人看不起(OR=4.445,OR 95% C.I.=1.640~12.051)。在客观歧视的接受程度调查中,对照者相对于PLWHAS家庭成员组,对艾滋病相关歧视的接受程度更为严重,且差别有统计学意义(t=7.508,P<0.001)。协方差分析校正年龄后,结果显示PLWHAS家庭成员在家庭功能的适应度、合作度和亲密度三个维度和安全感上的评分均低于对照者。结论与感染艾滋病相关的暴露因素、歧视和部分相关的生活事件在不同层面影响着PLWHAS家庭成员的生存状况,在提供支持的过程中,应当加强对心理健康状况和社会支持情况的重视。更多还原

【Abstract】 Objective To investigate the relative life events and family function among family members of PLWHAS (People Living With HIV/AIDS) in Anhui rural area and to explore the related life events and influential factors in their life environment.Methods 190 family members of PLWHAS were selected from Jingjiu township of Yingzhou district Fuyang City and 216 residents selected from Xiaoxian district of non-epidemic areas in Anhui province were as control group. Questionnaires including general conditions, relative life events, AIDS knowledge, attitude and practice, Family APGAR Index (APGAR) and Security Questionnaire (SQ) were used to survey.Results The subjects of the survey included 406 peoples, 190 of them were family member of PLWHA. There are 70 men (36.8%), 120 women (63.2%) in the family member of PLWHA group, and 87 men (40.3%), 129 women (59.7%) in the control group. The average age was 37.89±16.41 and 42.41±14.76 years old in the family members of PLWHA group and control group, respectively. The KAP result indicated the family members of PLWHA got more knowledge about HIV: the average score of knowledge about HIV among the family members of PLWHA group was 9.37±2.45, while the control group was 5.52±3.86. The results of associated events survey showed that there has great difference on suicide ideation (χ~2=33.603, P<0.001), suicide attempt ion (χ~2=10.464, P=0.001) between the family member of PLWHA group and control group. Logistic regression analysis indicated that spouses with HIV (OR=8.574, OR 95% C.I.=3.199~22.985), other relations with HIV (OR=4.055, OR 95% C.I.=1.550~10.607) discriminated by other peoples (OR=4.445, OR 95% C.I.=1.640~12.051), and lower family adaptation level (OR=5.857, OR 95% C.I.=1.517~22.608) were the main risk factors of suicide ideation. The result of acceptance to an objective discrimination showed that the control group was more serious than the family member of PLWHA group, and the difference was statistically significant (t = 7.508, P <0.001). Analysis of covariance adjusting for age showed that the scores of fitness function, cooperation and intimacy in the family members of PLWHA were lower than the controls.Conclusion HIV/AIDS - related exposure factors, discrimination and relative life events might affect living plight of family members of PLWHAS in rural areas of northern Anhui. The psychological health should be cared about when the society helped the PLWHAS and their families.更多还原