階段性諮商措施於提升初得知愛滋病毒感染者生活品質之成效探討

Effects of Stepped Counseling Intervention on Quality of Life Among Newly Diagnosed HIV-Positive Patients

本研究目的為瞭解階段性諮商措施對初得知感染愛滋病毒之個案生活品質之影響。本研究採取類實驗性研究設計法，於平均天數45天內介入結合理情治療、認知行為治療與衛生教育之理論架構的三次階段性深度訪談諮商，研究對象於諮商前、後各填寫一次結構式問卷以進行資料收集。研究樣本為北區某性病防治機構血清篩檢首次得知愛滋病毒抗體呈陽性反應個案，分為實驗組與控制組各16人，共32人。研究工具為世界衛生組織生活品質問卷愛滋病版（WHOQOL-HIV）（方、熊、游、陳、王，2002），以SPSS操作分析，結果顯示實驗組前後測生活品質得分之改變量為25分（SD＝3.2），控制組前後測生活品質得分之改變量為──6分（SD＝4.3），研究結果可知針對初得知感染愛滋病毒者介入適當且階段性之諮商措施，對加速其適應生理、心理、社會、環境的壓力上，具有相當顯著的成效。建議各醫療機構應將階段性諮商應用於愛滋病患診斷前、後，以因應愛滋病毒感染者面對診斷時帶來的衝擊，促進調適能力進而提昇生活品質，甚至預防愛滋病毒的散播。

The purpose of this research was to understand how stepped counseling intervention affects quality of life in newly diagnosed HIV-positive patients. The study made use of quasi-experimental methodology that included a three-step interview process over 45 days. The theoretical framework supporting interviews with 32 newly diagnosed HIV-positive patients in northern Taiwan included a combination of rational-emotive therapy, cognitive-behavior therapy, and health education. Participants were divided into an experimental and control group of equal size. Data collection also included responses to the WHOQOL-HIV instrument at the beginning and end of each interview session. Responses were analyzed with the SPSS software package. The results showed a 25-point difference between pre- and post-test scores in the experimental group (SD=3.2) and a 6 point difference in the control group (SD=4.3). The results indicate that stepped counseling techniques are effective in helping this patient population to adjust to the physical, emotional, social, and environmental stresses associated with their newly diagnosis. The researchers suggest that stepped counseling be used with all newly diagnosed HIV-positive Taiwanese patients in all hospitals and clinics to promote adaptive abilities and to control the further spread of HIV.