- 學位論文
愛滋病毒感染者知會性伴侶之過程
The Process of Sexual Partner Notification among People Living with HIV/AIDS
摘要
研究目的：愛滋病毒感染者可藉由知會性伴侶，協助其及早檢測感染情況、獲得早期治療、減少高危險性行為發生，避免愛滋病毒感染傳播。因此本研究為建構愛滋病毒感染者知會性伴侶決策過程理論架構，並探討影響此過程因素。期望專業人員可透過了解決策過程，協助感染者克服困難，增加知會機率。 研究方法：本研究採紮根理論研究法。於南部某醫學中心感染科門診，以理論性抽樣選取13位於確認診斷前後擁有性伴侶，且曾與其發生危險性行為的愛滋病毒感染者為對象。以半結構式訪談大綱進行深度訪談，並以ATLAS.ti 5.0版進行持續比較分析法分析文本。 研究結果：感染者知會決策理論架構歸納為7個主軸編碼，其中「知會意向」為本研究核心編碼，「知會問題知覺」為此歷程先驅範疇。主軸編碼包含：(1)知會問題知覺；(2)知會意向評估：個人層次、伴侶層次與疾病脈絡層次；(3)知會意向；(4)行動策略評估：尋找知會對象、知會方式、內容、時間及所需協助；(5)知會行動；(6)知會後結果自我感受；(7)再評價。決策過程呈現感染者透過知會意向評估決定知會意向，以行動策略評估架構知會策略，而後再評估知會結果，修改後續知會意向及策略。 結論：伴侶特性及愛滋污名是影響知會意向及行動策略的關鍵。醫療人員可藉此協助感染者釐清知會過程恐懼，並針對伴侶關係、反應及不同知會階段提供個別協助。
並列摘要
Background: Individuals with HIV/AIDS should notify their sexual partners of their disease as a means to help sexual partners learn of their HIV status, gain early access to treatment, reduce risky sexual behaviors, and prevent transmissions of HIV. However, the experience and process of sexual partner notification has not been thoroughly examined in past research. Understanding the process of sexual partner notification would help health professionals to assist partner notification for people with HIV/AIDS. Objectives: Construct the theoretical framework of the decision-making process of sexual partner notification among people living with HIV/AIDS. Methods: Grounded theory was utilized to construct the theoretical framework of the process in sexual partner notification. Theoretical sampling was applied and a total of 13 participants who had risky sexual behaviors before and after the diagnosis of HIV were recruited. In-depth semi-structured interviews were conducted 1-2 times with each participant. The length of interviews ranged from 90-120 minutes. Interviews were tape recorded and transcribed verbatim. Data was analyzed using the constant comparative method by ATLAS.ti 5.0. Results: This study surveyed the theoretical framework of the decision-making process of sexual partner notification among people living with HIV/AIDS which were further categorized into seven axial codes, including: (1) perception of partner notification; (2) assess the intention to notify; (3) the intention to notify; (4) assess notification strategies; (5) inform partner; (6) self-emotions for the consequence; (7) re-evaluation. Finally, a selecting code, “the intention to notify,” was established which linked and described the relationship between the axial codes, and illustrated the process of decision-making and factors that influenced the process. Conclusions: The partner characteristics and stigma were two key factors that influenced the decision-making of partner notification. Based on the process of partner notification, health professionals can assist clients in accordance to their individual needs.