Engagement with Health Care Providers affects People Living with HIV/AIDS in Self efficacy, Self-esteem, Medication Adherence and Quality of Life
Presentation
Overview
Overview
Description
Abstract
Background:
Health care providers play an important role from the HIV diagnosis, treatment, adherence to the patient’s illness self-management. Prior research shows that more engagement between the patients and their HCPs result in improved quality of life (QOL), better antiretroviral treatment (ART) adherence, and improved life satisfaction compared to those not engaged with their HCP. This study compares country-level differences of engagement with HCPs and assesses relationships relative to adherence, self-efficacy, self esteem, QOL, and symptom self report.
Methods:
A convenience sample of 2,182 PLHIV were enrolled from HIV clinics and AIDS service organizations in the United States, Canada, Puerto Rico, Namibia, China, and Thailand from February, 2010 to July, 2011. The cross-sectional survey assessed demographics, adherence, self-efficacy, self esteem, QOL and symptoms. Data analyses included descriptive statistics, t-test, odds ratio and ANOVA.
Results:
Participants´ mean age was 45.1 years (+/-1.36). Gender identity was 68% male, 29% female, and 1.9% transgender. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.90, P< 0.005), and PLHIV in China had the least engagement with their providers (OR -6.93, P< 0.0001), compared to the PLHIV in North America. Individuals having better HCP engagement showed higher self-efficacy for adherence (t=-4.67, P<0.0001), missed fewer medication doses (t=2.33, P<0.05), had lower self-esteem ratings (t=2.33, P<0.05), fewer self-reported symptoms (t= 3.35, P<0.001), and better overall physical QOL (t=-3.08, P<0.05).
Conclusions:
Under an authoritarian environment, Chinese PLHIV might have less negotiation opportunities to discuss their care with HCPs. However, promoting engagement with HCP can positively impact PLHIV’s self-efficacy, self-esteem, medication adherence, and decrease symptom reports, therefore, enhancing their physical QOL. Hence, promoting engagement with HCP is necessary to facilitate PLHIV to learn skills to self manage their illness and be more active in their health care, to live better with HIV.
