'We are fragile, but we are strong': A qualitative study of perspectives, experiences and priority outcomes for people living with HIV and frailty.

IF 2.8 3区 医学 Q2 INFECTIOUS DISEASES
HIV Medicine Pub Date : 2024-10-13 DOI:10.1111/hiv.13722
Natalie St Clair-Sullivan, Jaime H Vera, Matthew Maddocks, Richard Harding, Thomas Levett, Jonathan Roberts, Zoe Adler, Stephen Bremner, Gary Pargeter, Katherine Bristowe
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Abstract

Objectives: Advances in antiretroviral therapy have meant that the focus of HIV care has shifted to chronic disease management. The HIV population is ageing, and the prevalence of frailty is increasing. This study aimed to explore the perspectives and experiences of the impact of living with HIV and frailty and priority outcomes in relation to wellbeing and ageing.

Methods: In-depth qualitative interviews were undertaken with older people living with HIV who screened positive for frailty using the FRAIL scale. Participants were recruited from a UK outpatient HIV clinic. Interviews were analysed using reflexive thematic analysis.

Results: In total, 24 people living with HIV were interviewed. Frailty was described as not being able to do the things you could and living with limitations that impacted physical, psychological and social wellbeing. Being identified as frail was not always surprising, but acceptance of this diagnosis required an understanding of what frailty means and what they can do to address it. For people living with HIV, the word 'frail' was largely acceptable when its clinical meaning was explained. However, participants questioned whether a different term is needed if this is a new 'HIV-associated frailty'. Priority outcomes were slowing the progression of frailty, retaining independence and being treated holistically.

Conclusion: When talking about frailty with people living with HIV, professionals need to balance honesty and sensitivity and provide clear information about the meaning and impact for the person. Holistic management plans must recognize the physical and psycho-social impact of frailty and prioritize slowing its progression and reducing its impact on independence.

我们很脆弱,但我们很坚强":关于艾滋病毒感染者和体弱者的观点、经历和优先成果的定性研究。
目的:抗逆转录病毒疗法的进步意味着艾滋病护理的重点已转向慢性病管理。艾滋病毒感染人群正在老龄化,体弱的患病率也在增加。本研究旨在探讨艾滋病毒感染者和体弱者的观点和经历,以及与福祉和老龄化相关的优先结果:对使用 FRAIL 量表筛查出体弱的感染艾滋病毒的老年人进行了深入的定性访谈。参与者是从英国一家艾滋病门诊诊所招募的。访谈采用反思性主题分析法进行分析:共有 24 名艾滋病毒感染者接受了访谈。虚弱被描述为不能做自己能做的事情,生活受到限制,影响身体、心理和社会福祉。被认定为体弱并不总是令人惊讶的事情,但接受这一诊断需要了解体弱意味着什么,以及他们可以做些什么来解决这个问题。对于艾滋病病毒感染者来说,"虚弱 "一词在解释了其临床含义后基本上是可以接受的。然而,与会者质疑,如果这是一种新的 "与艾滋病毒相关的虚弱",是否需要一个不同的术语。优先考虑的结果是减缓虚弱的进展、保持独立和接受整体治疗:结论:在与艾滋病病毒感染者谈论体弱时,专业人员需要在诚实和敏感性之间取得平衡,并提供清晰的信息,说明体弱的意义和对患者的影响。整体管理计划必须认识到体弱对身体和社会心理的影响,并优先考虑减缓体弱的发展和减少其对独立性的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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