Aim: To examine the association between symptoms severity and treatment burden in people living with HIV.
Design: Correlational, secondary analysis of data from participants diagnosed with HIV enrolled in a descriptive, cross-sectional study examining physical activity patterns.
Methods: We analysed data from 103 men and women using self-report data collected between March 2016 - February 2017. Our primary statistical analyses consisted of explanatory multivariate modelling with individual PROMIS-29 scores representing symptom severity and treatment burden measured using the Treatment Burden Questionnaire-13.
Results: Greater symptom severity was associated with higher levels of cumulative treatment burden as well as higher levels of task-specific medication and physical activity burden. Multivariate regression analyses revealed that fatigue was a risk factor of cumulative treatment burden as well as task-specific medication and physical activity treatment burden. Effect sizes of multivariate models ranged from small (0.11) to medium (0.16). Additionally, post hoc analyses showed strong correlations between fatigue and other measured symptoms.
Conclusion: Findings support extant treatment burden literature, including the importance of addressing symptom severity in conjunction with treatment burden screening in the clinical setting. Results also suggest clinical interventions focused on the reduction of fatigue could reduce treatment burden in people living with HIV. Strong correlations between fatigue and other symptoms indicate the potential for reducing fatigue by addressing other highly clustered symptoms, such as depression.
Impact: People living with HIV exhibiting higher levels of fatigue are at high risk for treatment burden and poorer self-management adherence. Clinicians should consider incorporating symptom and treatment burden assessments when developing, tailoring and modifying interventions to improve self-management of HIV and other co-morbid conditions.
目的: 旨在研究艾滋病毒感染者的症状严重程度与治疗负担之间的关系。 设计: 对被诊断为艾滋病毒感染者的参与者的数据进行相关二次分析,这些参与者参加了一项旨在研究体力活动模式的描述性横断面研究。 方法: 我们使用2016年3月至2017年2月期间收集的自我报告数据,对103名男性和女性的数据进行分析。我们的主要统计分析包括解释性多变量建模,其中,个人PROMIS-29评分代表了利用治疗负担问卷-13进行衡量的症状严重程度和治疗负担。 结果: 症状严重程度与较高的累积治疗负担和较高的任务特定型药物和体力活动负担有关。多变量回归分析显示,疲劳是累积治疗负担以及任务特定型药物和体力活动治疗负担的风险因素。多变量模型的效应大小从低值(0.11)到中等值(0.16)不等。此外,事后分析显示,疲劳和其他测得的症状之间有高度相关性。 结论: 研究结果支持现有的治疗负担文献,包括在临床环境中结合治疗负担筛查解决症状严重程度的重要性。研究结果还表明,以减轻疲劳为重点的临床干预可以减轻艾滋病病毒感染者的治疗负担。疲劳和其他症状之间的高度相关性表明,通过解决抑郁症等其他高集中度的症状,有可能减少疲劳。 影响: 表现出较高的疲劳感的艾滋病毒感染者会面临治疗负担和自我管理坚持性较差的高风险。临床医生在制定、调整和修改干预措施时,应考虑纳入症状和治疗负担评估,以改善艾滋病毒和其他合并病症的自我管理。.
Keywords: HIV; fatigue; nursing; self-management adherence; symptom severity; treatment burden.
© 2020 John Wiley & Sons Ltd.