探討HIV感染者之憂鬱症狀及其相關因素

Depressive Symptoms in People Living with HIV: Related Factors

背景：人類免疫缺乏病毒（human immunodeficiency virus, HIV）感染者因面臨病程變化及疾病相關的壓力，易誘發憂鬱症狀的發生。然而，憂鬱的情緒不易由病人的外觀察覺，憂鬱症狀不僅影響其生活品質，減少對藥物的遵從性，進而使疾病病程惡化。目的：本研究旨在(1)探討HIV感染者之免疫指數、壓力知覺感受、社會污名化與其憂鬱症狀之關係，及(2)預測影響憂鬱症狀發生的危險因子。方法研究對象來自南部某醫學中心160位於門診追蹤治療之HIV感染者，以貝克憂鬱量表、壓力知覺量表、自覺社會支持的多面向量表、社會衝擊量表及病歷回顧方式收集資料。結果：感染者有憂鬱症狀者（貝克憂鬱量表 ≥ 14分）約68位（42.5%），重度憂鬱症狀為（貝克憂鬱量表 ≥ 29分）約25位（15.6%）；HIV感染者的免疫指數與其憂鬱症狀呈顯著負相關（p < .05）；HIV感染者所感受到的社會污名化、壓力知覺感受與憂鬱症狀呈顯著正相關（p < .01）。逐步多變項廻歸分析顯示壓力知覺感受、社會污名化對憂鬱症狀之解釋力約44.4%。結論：降低感染者其自覺壓力感受、社會污名化作為預防HIV感染者憂鬱症狀之介入性措施的參考。

Background: People living with HIV (human immunodeficiency virus) are at a high risk of depressive symptoms attributed to disease progression and HIV-related stress. While depressive symptoms are difficult to detect, in HIV patients they may negatively impact upon quality of life, decrease adherence to antiretroviral therapies, and further exacerbate disease progression.Purpose: Study purposes were to: (1) explore relationships among immune function indicators, perceived stress, social stigma and depressive symptoms and (2) identify depressive symptom indicators in HIV patients.Methods: Researchers recruited a total of 160 participants from infectious disease outpatient clinics at a university hospital in southern Taiwan. Chart reviews and four self-administered questionnaires (Beck Depression Inventory-Ⅱ (BDI-Ⅱ), Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and Social Impact Scale) were used to collect data.Results: Symptoms of depression (BDI ≥ 14) were observed in 68 (42.5%) patients and symptoms of major depression (BDI ≥ 29) in 25 (15.6%). We found immune function indicators negatively associated with depressive symptoms (p ＜ .05) and perceived stress and social stigma positively associated with depressive symptoms (p ＜ .01). Stepwise multiple regression analysis indicated that perceived stress and social stigma accounted for 44.4% of depressive symptom variance.Conclusion: Findings suggest that reducing perceived stress and social stigma may positively affect perceived depressive symptoms in this population and may be referenced in future development of related interventions.