目的 探索中国文化背景下老年HIV/AIDS患者披露对象选择倾向的看法和感受,为制定个性化的披露促进措施提供依据.方法 采用描述性质性研究方法,通过目的抽样法,对无锡市某三级甲等传染病医院的老年HIV/AIDS患者进行面对面半结构化访谈,运用Braun and Clarke的主题分析法进行分析、归纳和提炼主题.结果 共计访谈12名老年HIV/AIDS患者,其中男性9名,女性3名.研究共提炼出4个主题:1)老年HIV/AIDS群体特征对披露对象选择的特殊考量,包括多病共存、交叉污名、失去支持的恐惧;2)社会角色决定披露对象,包括角色地位和角色义务;3)披露对象的反应,包括接纳、排斥与态度不确定;4)披露所致的多维影响,包括积极影响与消极影响.结论 特定的群体特征和社会角色是选择披露对象的前置因素,而披露对象的反应及其引发的多维影响则是后置因素.医疗保健者应结合前置因素提供针对性披露指导,以降低后置因素的负面影响.鉴于披露的积极作用,迫切需要了解该类人群在选择披露对象时的倾向及其背后的原因与动机,以提供个性化的护理支持来促进披露,从而有效提升其健康与社会适应能力及生活质量.
Qualitative analysis on the disclosure recipient selection preferences among elderly people living with HIV in the Chinese cultural context
Objective To explore the preferences and feelings regarding disclosure recipients among elderly people living with HIV(EPLWH)within the Chinese cultural context,aiming to establish a basis for developing personalized strategies to encourage disclosure.Methods A descriptive qualitative study was conducted through face-to-face semi-structured interviews with EPLWH at a tertiary grade A infectious disease hospital in Wuxi City,using purposive sampling.Thematic analysis by Braun and Clarke was applied for the analysis,induction,and refining of themes.Results Twelve EPLWH were interviewed,including nine males and three females.Four themes emerged:1)Special considerations for choosing disclosure recipients,influenced by characteristics of the EPLWH group such as comorbidities,intersecting stigma,and the fear of losing support;2)The influence of social roles on the selection of disclosure recipients,involving role status and obligations;3)Reactions from disclosure recipients,including acceptance,rejection,and uncertainty;4)Multidimensional impacts of disclosure,featuring both positive and negative effects.Conclusions Specific characteristics of the EPLWH group and their social roles significantly influence the choice of disclosure recipients.The reactions of these recipients and the subsequent multidimensional impacts are important post-disclosure considerations.Healthcare providers should provide targeted guidance on disclosure,tailored to these predisposing factors,to reduce the adverse effects after disclosure.Recognizing the positive role of disclosure is essential for understanding EPLWH's disclosure preferences,providing personalized care,and enhancing their health,social integration,and quality of life.
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