目的 系统评价HIV感染儿童照顾者病情披露状况及影响因素.方法 计算机检索Web of Science、PubMed、Embase、Cochrane Library、CNKI、CBM、万方医学、维普数据库等文献数据平台,搜集HIV感染儿童照顾者病情披露状况及影响因素的相关文献,检索时间为建库至2023年12月.采用Stata 14.0进行系统评价.结果 最终纳入24篇文献,包含4 740例HIV感染儿童及其照顾者.HIV感染儿童照顾者披露率为34.8％(95％CI:30.0％～40.0％).儿童被披露时的平均年龄为(10.5±2.3)岁.最主要的披露照顾者为儿童父母57.0％(95％CI:43.0％～70.0％).照顾者病情披露的最主要原因为让孩子更好地照顾自己53.0％(95％CI:31.0％～75.0％);不披露的最主要原因为孩子小,无法理解病情60.0％(95％CI:47.0％～72.0％).照顾者病情披露的影响因素有:照顾者[年龄:41～50(OR=2.14)、50岁及以上(OR=1.78);HIV阳性(OR=0.74);亲生父母(OR=0.74)]、儿童[年龄大于10岁(OR=8.25);已经上学(OR=4.74);抗病毒治疗(OR=1.50);治疗时间大于12个月(OR=1.87)].结论 HIV感染儿童照顾者病情披露情况水平较低,披露主要由儿童的亲生父母进行,在披露时照顾者顾虑较多并受到个人因素和儿童因素的影响,因此医务人员在进行相关干预时应综合考虑双方的因素,根据照顾者病情披露的需求提供适当的医疗支持.
Meta-analysis of disease disclosure status and influencing factors among caregivers of HIV infected children
Objective To systematically evaluate the status of disease disclosure among caregivers of HIV-infected children and its influencing factors.Methods Literature searches were conducted in databases such as Web of Science,PubMed,Embase,Cochrane Library,China National Knowledge Internet(CNKI),China Biology Medicine disc(CBM),Wanfang Data Knowledge Service Platform,and VIP Chinese Journal Service Platform to collect relevant studies on the status of disease disclosure and its influencing factors among caregivers of HIV-infected children.The search period was from database inception to December 2023.The systematic review was conducted using Stata 14.0.Results A total of 24 articles were included,involving 4 740 HIV infected children and their caregivers.The rate of disease disclosure among caregivers of HIV infected children was 34.8％(95％CI:30.0％-40.0％).The mean age of children at the time of disclosure was(10.5±2.3)years.The primary caregivers involved in disclosure were parents,accounting for 57％(95％CI:43％-70％).The main reason for disease disclosure was to ensure better care for the child,accounting for 53％(95％CI:31％-75％).The main reason for non-disclosure was that the child was too young to understand the disease,accounting for 60％(95％CI:47％-72％).Factors influencing disease disclosure by caregivers included caregiver age(41-50 years:OR=2.14;≥50 years:OR=1.78),caregiver being HIV positive(OR=0.74),caregiver being the biological parent(OR=0.74),child age(＞10 years:OR=8.25),child attending school(OR=4.74),child receiving antiretroviral therapy(OR=1.50),and treatment duration＞12 months(OR=1.87).Conclusions The level of disease disclosure among caregivers of HIV-infected children is relatively low,and the disclosure is mainly carried out by the biological parents of children.Caregivers have concerns about disclosure,and personal and child-related factors influence their decision.Therefore,healthcare providers should comprehensively consider the factors of both caregivers and children when providing relevant interventions and offer appropriate medical support based on the disclosure needs of caregivers.
HIV infected individualschildrencaregiversdisease disclosuremeta-analysis
NETL
NSTL
万方数据
