HIV/AIDS Hastalığı ile Yaşam: Öz Yönetim ve Psikososyal Uyum

Yıl 2020, Cilt: 2 Sayı: 3, 183 - 190, 30.12.2020

Sümeyye Başoğlu Ülkü Polat , Canan Güngör

https://doi.org/10.48071/sbuhemsirelik.696645

Öz

HIV/AIDS hastalığı; yaşam kalitesini olumsuz etkileyen ve epidemik özellik gösteren küresel bir halk sağlık sorunudur. Progresif (ilerleyici) ve kronik seyirli olan HIV/AIDS hastalığı fiziksel, psikososyal ve ekonomik açıdan bireyin ve ailesinin yaşamını olumsuz etkilemektedir. Özellikle hastaların yaşadığı damgalanma ve ayrımcılık korkusu psikolojik ve sosyal uyum sorunlarına neden olabilmektedir. Yapılan çalışmalarda, bu sorunların azaltılmasında hastaların öz yönetim becerilerinin geliştirilmesine yönelik destek programlarının yararlı olduğu gösterilmiştir. HIV/AIDS hastalarında, tedavi ve bakım yönetiminin başarısı, bireyin öz yönetim ve öz bakımının yeterli olması ile mümkün olabilmektedir. HIV/AIDS’li bireylerde öz yönetimi gerektiren başlıca sorunlar arasında; diyet ve egzersize yönelik bilgi eksikliği, hastalık ve tedaviye uyumsuzluk, damgalanma, anksiyete ve depresyon sorunları yaşama, özgüvende azalma, sosyal ilişkilerde değişim ve yaşam kalitesinde düşme yer almaktadır. Kronik hastalıklarda, öz yönetim bakımın önemli bir bileşenidir. Bu nedenle sağlık profesyonellerinden özellikle hemşireler tarafından HIV/AIDS’li bireylere öz yönetim desteğinin sağlanması çok önemlidir. Bu derlemede; HIV/AIDS hastalığının epidemiyolojisi, bulaşma yolları, klinik belirtileri ve tanı ve tedavisi ile ilgili bilgilere ve ilgili araştırmalar ışığında hastaların hastalığa psikososyal uyumlarını etkileyen faktörlere ve uyumu artırmada öz yönetim desteği ve hemşirenin rollerine yer verilmiştir. 

Anahtar Kelimeler

AIDS, HIV, öz yönetim, uyum

Living with HIV / AIDS: Self Management and Psychosocial Adjustment

Öz

HIV / AIDS disease is a global public health problem that negatively affects the quality of life and shows an epidemic character. HIV / AIDS disease, which is a progressive and chronic disease, negatively affects the life of an individual and his family in terms of physical, psychosocial and economic aspects. Especially the stigma experienced by the patients and the fear of discrimination can cause psychological and social adjustment problems in individuals. Previous studies have shown that the support programs for improving patients' self-management skills are beneficial in reducing these problems. The success of treatment and care management in HIV/AIDS patients is possible with the self-management and self-care of the individual. Lack of information about diet and exercise, disease and medicine nonadherence, experiencing stigma, anxiety and depression problems, decreased self-confidence, changes in social relationships and decreased quality of life are among the main problems that require self-management in individuals with HIV/AIDS. Self-management is an important component of care in chronic diseases. For this reason, it is very important to provide self-management support to individuals with HIV/AIDS, especially by nurses from health professionals. In this review; information about epidemiology, transmission ways, clinical symptoms and diagnosis and treatment of HIV / AIDS, and in the light of relevant researches, factors affecting the psychosocial adjustment of patients to the disease and the self-management supports and nurses' roles in increasing psychosocial adjustment to disease have been included.

Anahtar Kelimeler

Adherence, AIDS, HIV, self-management

Kaynakça

• Akgül, Ö., Çalışkan, R., ve Öner, Y.A. (2018). HIV/AIDS: Güncel yaklaşımlar. Tıp Fakültesi Klinikleri, 1(1), 19-31.
• Akpama, E.G. (2013). Effect of group counselling on the psychological adjustment of people living with HIV/AIDS in Central Senatorial Zone, Cross River State, Nigeria. Journal of Educational and Social Research, 3(2),377-385. doi:10.5901/ jesr. 2013. v3v2p377
• Anuradha, S., Joshi, A., Negi, M., Nischal, N., Rajeshwari, K., & Dewan, R. (2013). Factors influencing adherence to ART new ınsights from a center providing free ART under the National Program in Delhi, India. Journal of the International Association of Providers of AIDS Care, 12, 195-201. doi:10.1177/1545109711431344
• Areri, H.A., Marshall, A., & Harvey, G. (2020). Interventions to improve self-management of adults living with HIV on Antiretroviral Therapy: A systematic review. PLoS One, 15, e0232709. doi:10.1177/1545109711431344
• Attonito, J., Dévieux, J.G., Lerner, B.D., Hospital, M.M, & Rosenberg, R. (2014). Antiretroviral treatment adherence as a mediating factor between psychosocial variables and HIV viral load. Journal of the Association of Nurses in AIDS Care, 26, 720–731. doi:10.1016/j.jana.2014.08.001
• Basha, E.A., Derseh, B.T., Haile, Y.G.E., & Talere, G. (2019). Factors affecting psychological distress among people living with HIV/AIDS at selected hospitals of North Shewa Zone, Amhara Region, Ethiopia. AIDS Research and Treatment, 22, e8329483. doi: 10.1155/2019/8329483
• Basti, B.D., Mahesh, V., Bant, D.D., & Bathija, G.V. (2017). Factors affecting antiretroviral treatment adherence among people living with human immunodeficiency virus/acquired immunodeficiency syndrome: a prospective study. Journal of Family Medicine and Primary Care, 6, 482-486. doi: 10.4103/2249-4863.222014
• Belayihun, B., ve Negus, R. (2015). Antiretroviral treatment adherence rate and associated factors among people living with HIV in Dubti Hospital, Afar Regional State, East Ethiopia. International Scholarly Research Notices, 5,1-5. doi:10.1155/2015/187360
• Camp, Y.P.V., Rompaey, B.V., & Elseviers, M.M. (2013). Nurse-led interventions to enhance adherence to chronic medication: Systematic review and meta-analysis of randomised controlled trials. European Journal of Clinical Pharmacology, 69, 761–770. doi:10.1007/s00228-012-1419
• Ceylan, E., ve Koç, A. (2017). HIV (+) / AIDS hastalarında antiretroviral tedaviye uyumun önemi (literatür çalışması). Jinekoloji- Obstetrik ve Neonatoloji Tıp Dergisi, 14 (2), 74 –81.
• Ceylan, E., Koç, A. İnkaya, A.Ç., & Ünal, S. (2019). Determination of medication adherence and related factors among people living with HIV/AIDS in a Turkish university hospital. Turkish Journal of Medical Sciences, 49,198-205.
• Court, R., Leisegang, R., Stewart, A., Sunpath, H., Murphy, R., Winternheimer , P., … Maartens, G. (2014). Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy: an observational cohort study. BMC Infectious Diseases, 14, 1-7. doi: 10.1186/s12879-014-0664-3
• Çam, O., Saka,Ş., ve Gümüş, A.B.(2009). Meme kanserli hastaların psikososyal uyumlarını etkileyen faktörlerin incelenmesi. Meme Sağlığı Dergisi, 5(2), 73-81.
• Düzgün, N. (2014). İmmün Sistemin Tanıtımı. Erişim adresi (02.02.2020): https://personel. omu.edu.tr/docs/ders_dokumanlari/1329_1307_305.pdf)
• Enç, N. (Ed.). (2014). İç Hastalıkları Hemşireliği. İstanbul: Nobel Tıp Kitabevleri.
• Fonsah, J.Y., Njamnshi, A.K., Kouanfack, C., Qiu, F., Njamnshi, D.M., Tagny, C.T., ...Kanmogne G.D. (2017). Adherence to antiretroviral therapy (ART) in Yaoundé-Cameroon: Association with opportunistic ınfections, depression, ART regimen and side effects. PLoS One. 12(1), e0170893. doi: 10.1371/journal.pone.0170893
• Grodensky, C.A., Golin, C.E., Jones, C., Mamo, M., Dennis, A.C., & Abernethy, M.G., Patterson, K.B. (2015). “I should know better”: the roles of relationships, spirituality, disclosure, stigma, and shame for older women living with HIV seeking support in the South. Journal Assocaition Nurses in AIDS Care, 26, 12- 23. doi: 10.1016/j.jana.2014.01.005
• Heestermans, T., Browne, J.L., Aitken, S.C., Vervoort, S.C., Klipstein-Grobusch, K. (2016). Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: a systematic review. BMJ Global Health, 1,e000125. doi: 10.1136/bmjgh-2016- 000125
• Intasan, J., Bunupuradah, T., Vonthanak, S., Kosalaraksa, P., Hansudewechakul, R., Kanjanavanit, S., ... Puthanakit, T. (2014). Comparison of adherence monitoring tools and correlation to virologic failure in a pediatric HIV clinical trial. AIDS Patient Care STDS, 28, 296–302. doi: 10.1089/apc.2013.0276
• Karadakovan, A., ve Aslan, F.E. (Ed.). (2014). Dâhili ve cerrahi hastalıklarda bakım. (3bs). Ankara: Akademisyen Tıp Kitabevi.
• Kaymaz, T.T, ve Akdemir, N. (2016). Diyabetli bireylerde hastalığa psikososyal uyum. Psikiyatri Hemşireliği Dergisi, 7(2), 61–67.
• Kenya, S., Jones, J., Arheart, K., Kobetz, E., Chida, N., Baer, S., … Carrasquillo,O. (2013). Using community health workers to improve clinical outcomes among people living with HIV: a randomized controlled trial. AIDS and Behavior, 17, 2927–2934. doi: 10.1007/s10461-013-0440-1
• Köse, S., Mandiracioglu, A., Mermut, G., Kaptan, F., & Özbel,Y. (2012). The social and health problems of people living with HIV/AIDS in Izmir, Turkey. Eurasian Journal of Medicine, 44, 32- 39. doi:10.5152/eajm.2012.07
• Kurnıawan, D., Devıantony, F., & Yunanto, R. (2019). Impact of HIV-Related Stigma: Self-Efficacy, Self-Esteem, and Social Isolation on ARV Medication Adherence among Persons Living With HIV in Turen, Malang. Pakistan Journal of Medical and Health Sciences,13,1112-1114.
• Kurt, A.S., ve Yılmaz, S.D. (2012). Sağlık yüksekokulu öğrencilerinin HIV/AIDS hakkındaki bilgi düzeyleri ve bilgi kaynakları. Hemşirelikte Eğitim ve Araştırma Dergisi, 9(3), 47-52.
• Lowenson, R. (2007). Exploring equity and inclusion in the responses to AIDS. AIDS Care, 19, 1, 2 – 11.doi: 10.1080/09540120601114790
• Maartens, G., Celum, C., & Lewin, S.R. (2014). HIV infection: epidemiology, pathogenesis, treatment, and prevention. Lancet, 19, 384, 258-271.doi: 10.1016/ S0140-6736(14)60164-1
• Martin, S., Chinnock, P., Perales, J., Lee, H., Lee, C.Y., Wu, Y., & Mavrodaris, A. (2017). Self-management interventions for people living with HIV/AIDS. CochraneDatabase of Systematic Reviews, 8, 1-9. doi:10.1002/14651858.CD008731.pub2
• Millard, T., Elliott, J., & Girdler, S. (2013). Self-management education programs for people living with HIV/AIDS: A Systematic Review. AIDS patient care and STDs, 27,103-113.doi: 10.1089/apc.2012.0294
• Moskowitz, J.T., Wrubel, J., Hult, J.R., Maurer, S., & Acree, M (2013). Illness appraisals and depression in the first year after HIV diagnosis. PLoS One, 8, e78904. doi: 10.1371/journal.pone.0078904
• Nachega, JB., Leisegang, R., Bishai, D., Nguyen,H., Hislop, M., Cleary, S., … Maartens, G. (2010). Association of antiretroviral therapy adherence and health care costs. Annals of Internal Medicine, 152, 18-25. doi:10.7326/0003-4819-152-1-201001050-00006
• Naif H.M. (2013). Pathogenesis of HIV ınfection. Infectious Disease Reports, 5(Suppl 1), e6. doi:0.4081/idr.2013.s1.e6
• Neupane, S., Dhungana ,G.P., & Ghimire, H.C. (2019). Adherence to antiretroviral treatment and associated factors among people living with HIV and AIDS in CHITWAN, Nepal. BMC Public Health, 19, 720.doi:10.1186/s12889-019-7051-3
• Okoronkwo, I., Ishaku, S., & Chinweuba, A. (2015). Assessing self care practices of people living with AIDS attending antiretroviral clinic Kafanchan, Kaduna State, Nigeria. Journal of AIDS & Clinical Research, 6, 2-6. doi: 10.4172/2155-6113.1000528
• Oran, N.T., ve Şenuzun, F. (2008). Toplumda kırılması gereken bir zincir: HIV/AIDS stigması ve baş etme stratejileri. Uluslararası İnsan Bilimleri Dergisi, 5 (1), 1-16.
• Özdemir, Ü., ve Taşçı, S. (2012). Kronik hastalıklarda psikososyal sorunlar ve bakım. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 1(1), 57-72.
• Özdemir, H.Ö., Tosun, S., Özdemir, D., & Korkmaz, E. (2020). The determinants of employability of people living with HIV/AIDS in Turkey. American Journal of Industrial Medicine, 63(3), 92–98. doi:10.1002/ajim.23056
• Özkaya, G. (2006). İnsan immün yetmezlik virüsünün serüveni: nereden nereye? Mikrobiyoloji Bülteni, 40, 435–443.
• Parienti, J.J., Tran. A.B., Duval, X., Nembot, G., Descamps, D., Vigan,M., … Goujard, C. (2013). Adherence profiles and therapeutic responses of treatment-naive HIV-infected patients starting boosted atazanavir-based therapy in the ANRS 134-COPHAR 3 Trial. Antimicrobial Agents and Chemotherapy, 57, 2265– 2271. doi: 10.1128 / AAC.02605-12
• Plach, S.K., Stevens, P.E., &, Heidrich,S.M. (2006). Social roles and health in women living with HIV/AIDS: A pilot study. Journal of the Associatıon of Nurses İn AIDS care, 17, 58- 64. doi: 10.1016/j.jana.2006.01.006
• Rouleau, G., Richard, L., Côté, J., Gagnon, M.P., & Pelletier, J. (2019). Nursing practice to support people living with HIV with antiretroviral therapy adherence: a qualitative study. Journal of the Association of Nurses in AIDS Care, 30, e20–e37. doi: 10.1097/JNC.0000000000000103
• Szaflarski, M. (2013). Spırıtualıty and relıgıon among hıv-ınfected ındıvıduals. Current HIV/AIDS Reports, 10, 324–332. doi:10.1007/s11904-013-0175-7
• Saadat, M., Behboodi, Z.M., & Saadat, E. (2015). Comparison of depression, anxiety, stress, and related factors among women and men with human immunodeficiency virus infection. Journal of Human Reproductive Sciences, 8, 48-51. doi:10.4103/0974-1208.153128
• Smith, C.J., Ryom, L., Weber, R., Morlat, P., Pradier, C., Reiss,P., … Lundgren, J.D. (2014). Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. The Lancet, 384, 241–248. doi:10.1016/S0140-6736(14)60604-8
• Souza, C.I. (2012). “Because this is not the end.” motivation and change in people living with HIV/AIDS. Sociology Honors Projects, 37, 4-30.
• Swendeman, D., Ingram, B.L. &, Rotheram Borus, M.J. (2009). Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care, 21, 1321–1334. doi:10.1080/09540120902803158
• T.C. Sağlık Bakanlığı. (2018). HIV-AIDS İstatistik. Erişim adresi (06.02.2020): https://hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/hiv-aids/hiv-aids-liste/hıv-aids-istatislik.html
• T.C. Sağlık Bakanlığı. (2019). Türkiye HIV/AIDS Kontrol Programı 2019-2024. Erişim adresi (02.02.2020): https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/ hastalıklar/ HIV-ADS/Tani-Tedavi_Rehberi/HIV_AIDS_Kontrol_Programi.pdf
• T. C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu. (2013). HIV AIDS Tanı Tedavi Rehberi. Erişim adresi (09.01.2020): https://dosyaism.saglik.gov.tr/Eklenti/29508,hiv-aids-tani- tedavi-rehberi-1pdf.pdf?0
• Traore, M, & Gbagbo, M. (2019). Social adaptation logics of people living with HIV/AIDS in abidjan, Cote D'ivoire. International Journal of Current Research,11, 6066-6071. doi: 10.24941/ijcr.34241.08.2019
• Tümer, A. HIV/AIDS Epidemiyolojisi ve Korunma. Erişim adresi (18.09.2020): http://www.hatam.hacettepe.edu.tr/Epid_web_10.pdf.
• Umberson, D., & Montez, JK. (2010). Social relationships and health: a flashpoint for health policy. Journal of Health and Social Behavior, 51, 54-66. doi: 10.1177/0022146510383501
• UNAIDS. (2019). AIDS By The Numbers. Retrievent From (06.02.2020): https://www. unaids.org/sites/default/files/media_asset/2019-UNAIDS-data_en.pdf.
• Wang, H., Chen, A.C., Wan, S., & Chen, H. (2019). Status and associated factors of self- management in people living with HIV/AIDS in Liangshan area, China: a cross-sectional study. Patient Preference and Adherence, 13, 863-870.doi:10.2147/PPA.S203799
• Wang, P.L., Liu, Y.K., Zhao, T., Shi, X.Z., & Sun, L. (2019) Current social support and social adaptation of HIV/AIDS patients in Henan province. Zhonghua Liu Xing Bing Xue Za Zhi, 40(7):800-804. doi:10.3760/cma.j.issn.0254-6450.2019.07.013
• Wantland, D.J., Holzemer, W.L., Moezzi, S., Willard, S.S., Arudo, J, Kirksey, K.M., … Huang, E. (2008). A randomized controlled trial testing the efficacy of an HIV/AIDS symptom management manual. Journal of Pain and Symptom Management, 36, 235–246. doi:10.1016/j.jpainsymman.2007.10.011
• Watson, S. (2019). HIV as a long-term condition and role of the annual health review. HIV Nursing, 19, 43-50. doi: 10.1016/j.jpainsymman.2007.10.011
• Webel, A.R., Cuca, Y., Okonsky, J.G., & Asher, A.K. (2013). The impact of social context on self-management in women living with HIV. Social Science & Medicine, 87, 147–154. doi:10.1016/j.socscimed.2013.03.037
• Webel, A.R., & Holzemer, W.L. (2009). Positive self-management program for women living with HIV: A Descriptive Analysis. Journal of the Association of Nurses in AIDS Care,20, 458-467. doi:10.1016/j.jana.2009.05.003
• World Health Organization WHO. (2019). HIV/AIDS. Retrievent From (02.02.2020): https://www.who.int/news-room/fact-sheets/detail/hiv-aid.
• Yıldırım, Y.K. (2006). HIV/AIDS ve hemşirelik yönetimi, Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi, 22(2), 199-214.