HIV阳性男男性行为者医学应对方式和社会支持的相关性研究
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摘要
目的调查艾滋病病毒(HIV)抗体阳性男男性行为者(MSM)的医学应对方式和社会支持现状,并探讨两者之间的关系。方法采用自制一般资料问卷,医学应对方式问卷(MCMQ)和医疗社会支持量表(MOS-SSS-C)对长沙市某传染病医院艾滋病门诊的300名HIV阳性MSM开展调查。结果回收有效问卷274份,有效率为91.3%。其中,211例(77.0%)采取回避应对,45例(16.4%)采取屈服应对,18例(6.6%)采取面对应对。与常模比较,HIV阳性MSM的回避、屈服维度得分较高,面对维度得分较低,差异均有统计学意义(P<0.01)。HIV阳性MSM的社会支持总分为(67.58±19.29)分(范围为19～95分)。相关分析显示,HIV阳性MSM的社会支持总分及4个维度得分与面对应对和屈服应对分别呈显著正相关、负相关(P<0.01);除社会互动性支持未与回避应对呈显著相关,其他社会支持均与回避应对呈显著正相关(P<0.01)。结论 HIV阳性MSM趋向于选择回避和屈服应对方式,其应对方式与社会支持相关。建议医务人员在日常工作中,为HIV阳性MSM,特别是屈服应对的患者提供多形式、多渠道的社会支持,引导其采取积极的面对应对方式。
Objective To investigate the status of coping mode and social support, and to explore its correlation among HIV-positive men who have sex with men(MSM) in Changsha. Methods 300 HIV-positive MSM at the HIV outpatient clinic of one infectious disease hospital in Changsha were recruited and invited to fill in self-designed general information questionnaire, medical coping modes questionnaire(MCMQ) and medical outcomes study-social support survey(MOS-SSS-C). Results 274 valid questionnaires were collected with an efficient rate of 91.3%. Avoidance ranked at the top accounting for 77.01%, followed by 16.42% of acceptance-resignation, and 6.57% of confrontation, the smallest percentage. The scores of avoidance dimension and acceptance-resignation were higher than domestic norm(P<0.01), while the score of confrontation was lower than domestic norm(P<0.01). The mean score of social support was 67.58(rang 19-95,SD=19.29). The significantly positive relation between social and its all dimensions and confrontation, and negative relation existed between these variables above. Except for positive social active score, the scores for social support and its dimensions were significantly correlated with avoidance. Conclusion HIV-positive MSM are prone to take avoidance and acceptance-resignation coping mode. The coping mode of HIV-positive MSM is correlated with various social supports. Medical staff are suggested to provide HIV-positive MSM, especial for those taking acceptance-resignation coping, with multiple forms of support to confront the disease.
Objective To investigate the status of coping mode and social support, and to explore its correlation among HIV-positive men who have sex with men(MSM) in Changsha. Methods 300 HIV-positive MSM at the HIV outpatient clinic of one infectious disease hospital in Changsha were recruited and invited to fill in self-designed general information questionnaire, medical coping modes questionnaire(MCMQ) and medical outcomes study-social support survey(MOS-SSS-C). Results 274 valid questionnaires were collected with an efficient rate of 91.3%. Avoidance ranked at the top accounting for 77.01%, followed by 16.42% of acceptance-resignation, and 6.57% of confrontation, the smallest percentage. The scores of avoidance dimension and acceptance-resignation were higher than domestic norm(P<0.01), while the score of confrontation was lower than domestic norm(P<0.01). The mean score of social support was 67.58(rang 19-95,SD=19.29). The significantly positive relation between social and its all dimensions and confrontation, and negative relation existed between these variables above. Except for positive social active score, the scores for social support and its dimensions were significantly correlated with avoidance. Conclusion HIV-positive MSM are prone to take avoidance and acceptance-resignation coping mode. The coping mode of HIV-positive MSM is correlated with various social supports. Medical staff are suggested to provide HIV-positive MSM, especial for those taking acceptance-resignation coping, with multiple forms of support to confront the disease.
引文
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[13] Xiao Z,Li X,Qiao S,et al.Coping,social support,stigma,and gender difference among people living with HIV in Guangxi,China[J].Psychological Health & Medicine,2018,23(1):18-29.DOI:10.1080/13548506.2017.1300671.
[2] Orban LA,Stein R,Koenig LJ,et al.Coping strategies of adolescents living with HIV:disease-specific stressors and responses[J].Aids Care,2010,22(4):420-430.DOI:10.1080/09540120903193724.
[3] Stine M,Baum A.Chronic disease[M].New York:Psychology Press,2013.
[4] Feifel H,Strack S,Tong Nagy V.Degree of life-threat and differential use of coping modes[J].Journal of Psychosomatic Research,1987,31(1):91-99.DOI:10.1016/0022-3999(87)90103-6.
[5] Kerry Gibson,Leslie Swartz,Sandenbergh R.Counselling and coping[M].OUP Southern Africa,2002:150.
[6] 沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中华行为医学与脑科学杂志,2000,9(1):18-20.
[7] 张爱英,王艳玲,付猛,等.泌尿系肿瘤患者希望水平及应对方式的相关性研究[J].护理学杂志,2016,31(6):16-18.
[8] 黎欢.医疗社会支持量表简体中文版在艾滋病患者中的心理测量学评定及应用研究[D].长沙:中南大学,2012.
[9] Choi K,Steward WT,Miège P,et al.Sexual stigma,coping styles,and psychological distress:A longitudinal study of men who have sex with men in Beijing,China[J].Archives of Sexual Behavior,2016,45(6):1483-1491.DOI:10.1007/s10508-015-0640-z.
[10] Cherenack EM,Sikkema KJ,Watt MH,et al.Avoidant coping mediates the relationship between self-efficacy for HIV disclosure and depression symptoms among men who have sex with men newly diagnosed with HIV[J].Aids & Behavior,2018,22(10):3130-3140.DOI:10.1007/s10461-018-2036-2.
[11] Earnshaw V,Bogart L,Laurenceau J,et al.Internalized HIV stigma,ART initiation and HIV-1 RNA suppression in south Africa:exploring avoidant coping as a longitudinal mediator[J].Journal of the International AIDS Society,2018,21(10):e25198.DOI:10.1002/jia2.25198.
[12] Ye Z,Chen L,Lin D.The relationship between posttraumatic stress disorder symptoms and posttraumatic growth among HIV-infected men who have sex with men in Beijing,China:The mediating roles of coping strategies[J].Frontiers In Psychology,2018,9.(Epub ahead of print).DOI:10.3389/fpsyg.2018.01787.
[13] Xiao Z,Li X,Qiao S,et al.Coping,social support,stigma,and gender difference among people living with HIV in Guangxi,China[J].Psychological Health & Medicine,2018,23(1):18-29.DOI:10.1080/13548506.2017.1300671.
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