「愛滋病個案管理師計畫」對於個案行為與健康狀況之影響

Effects of the HIV Case Management Program on the Behavior and Health Outcomes of Clients

邱珠敏(Chu-Ming Chiu) ； 丁志音(Chih-Yin Lew-Ting)

《台灣公共衛生雜誌》 29卷4期 (2010/08) Pp. 299-310

https://doi.org/10.6288/TJPH2010-29-04-02

摘要

目標：評量「愛滋病個案管理師計畫」對於個案在行為及健康狀況方面的成效，並檢視其相關因素。方法：本研究資料來自2007年「愛滋病個案管理師計畫」資料庫，針對參與初診及後續兩次複診的852名個案之行為與健康狀況進行分析。除了從群體層次觀察整個樣本的行為與健康狀況的整體變化之外，並由個體層次探索每一個案在行為與健康狀況的變化型態，最後以多變量分析檢視個案特質與個管計畫成效的相關性。結果：樣本整體的行為及健康狀況在第一次複診時即呈現正向且顯著之改善，且於第二次複診時多能持續維持或小幅繼續改善。而由個別的變化型態來看，除了告知家人這項之外，個案在所有的行為與健康狀況方面的持續維持正向或改善都能維持在70~90%。改變型態與個人特質的相關較弱，但行為的改變的確與健康狀況的變化有顯著關係。結論：半年的個管介入對於個案在各項行為與健康狀況方面多有正向的影響。應強化感染者對個管計畫的加入與持續參與，確保服務品質，並評估其長期效益。

關鍵字

愛滋病個案管理 ； 性行為 ； 服藥遵從 ； CD4值 ； 健康狀況

並列摘要

Objectives: This study assessed the effects of the HIV Case Management Program (HIVCMP) on behavioral and health outcomes among HIV infected clients in Taiwan. Factors associated with these effects were also explored. Methods: Utilizing the 2007 ”HIV Case Management Program” data set, this study analyzed the behaviors and health status of 852 HIV infected persons who had made a first consultation and two consecutive follow-up visits. Both ”group level” analysis describing the total sample's behavioral and health outcomes at each visit and ”individual level” analysis that followed the changes in individual behaviors and health status across the three visits were conducted. Multivariate analysis was applied to explore the factors associated with program effects. Results: Improvements in almost all aspects of behavior and health status were found from the baseline to the first follow-up visit. These were maintained or slightly increased at the second follow-up visit. Individual level analysis showed that, except for family awareness, other behavioral and health outcomes either maintained a positive condition or made a positive change for 70~90% of the participants. Weak relationships were found between personal characteristics and effects; however, behavioral changes made significant contributions to changes in health outcomes. Conclusions: The initial stage of HIVCMP implementation showed significant effects on clients' behavioral and health outcomes. Extended outreach efforts should be made to increase participation and maintain continuity. The long-term effects of HIVCMP should be regularly evaluated in order to assure quality.

並列關鍵字

HIV case management program ； safer sex ； HAART adherence ； CD4 counts ； health status

參考文獻

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