Relação entre sintomatologia psicopatológica, adesão ao tratamento e qualidade de vida na infecção HIV e AIDS

Abstract

ResumoO presente estudo observou a existência de relações significativas entre sintomatologia psicopatológica (BSI), adesão ao tratamento (CEAT-VIH) e qualidade de vida (WHOQOL-Bref) em 125 pessoas HIVpositivo/AIDS em tratamento antirretroviral, atendidos em um hospital do Porto (Portugal). A sintomatologia psicopatológica correlacionou-se negativamente com adesão ao tratamento e qualidade de vida, e a adesão ao tratamento associou-se positivamente com a qualidade de vida. O modelo preditor de adesão ao tratamento, mediante análise de regressão múltipla, incluiu a ausência de sintomatologia psicopatológica, o comportamento de retirada dos medicamentos na farmácia hospitalar e a presença de efeitos colaterais do tratamento (R 2 =0,30). Ademais, observou-se um efeito mediador de sintomatologia psicopatológica entre a adesão ao tratamento e a qualidade de vida das pessoas com HIV/AIDS. Palavras-chave: Adesão ao Tratamento; HIV/AIDS; CEAT-VIH; Qualidade de Vida; Saúde Mental. AbstractThe study shows evidence of statistical association among psychopathological symptoms (BSI), treatment adherence (CEAT-VIH) and quality of life (WHOQOL-Bref) in 125 HIV-positive/AIDS patients followed at Porto Hospital (Portugal). The psychopathological symptoms present a negative correlation with treatment adherence and quality of life. On the other hand, adherence was positively correlated with quality of life. The model of adherence to the antiretroviral treatment using multiple regression analysis includes absence of psychopathological symptoms, an adherence behavior (i.e. to get the medication at the hospital's pharmacy) and the experience of side effects because of medication (R 2 = 0.30). Besides, psychopathological symptoms have a mediation effect between adherence and quality of life in people with HIV/AIDS.

An evaluation of quality of life and its determinants among people living with HIV/AIDS from Southern Brazil

“…Other authors 13,36 found negative correlations between the presence of depressive symptoms and anxiety with quality of life. Reis et al 37 highlighted that psychopathological symptoms negatively affect quality of life and adherence to antiretroviral treatment. Moreover, the literature reports that increased levels of stress and depression accelerate the deterioration of the immune system and disease progression 38 .…”

Self-Reported Adherence to Antiretroviral Therapy in HIV+ Colombian Population

“…Currently, the instrument is available in six language versions with a bilingual user's manual (Spanish/English), and published psychometric information is available for several countries as Brazil, Chile, Colombia, Mexico, Panama, Peru, Portugal, Puerto Rico, Romania, and Spain (Remor, 2013). Thus, the questionnaire has been used as a measure of adherence in other several studies (e.g., Lorscheider, Geronimo, & Colacite, 2012;Reis, Lencastre, Guerra, & Remor, 2010;Remor, Penedo, Shen, & Schneiderman, 2007) The PRO measure CEAT-VIH is a multidimensional instrument including items targeting behavioral indicators of adherence (i.e., during the past week, from the beginning of treatment, in relation to the medication schedule, global selfevaluation, and accuracy of remembering current medication), and also focus on determinants of adherence: antecedents of nonadherence behaviors (i.e., feeling physically better, feeling worse, feeling sad or depressed), doctorpatient interaction (i.e., frequency of doctor's reinforcement of adherence behaviors, global assessment of the quality of the relationship), patient's beliefs regarding the adherencerelated effort, time, degree of difficulty, self-efficacy, and outcome expectations, patient's perception of side-effects intensity, level of personal knowledge regarding medication, satisfaction with treatment, improvements in health attributed to treatment (Remor, 2002).…”

Quality of life in the context of hiV/aiDS: a comparatiVe StuDy with the general population

“…In this sense, it is not only necessary to think about the means to fight HIV/AIDS, but also how seropositive living affects the lives and well being of those infected by it. With this in mind, over the last years there has been an increase in academic interest regarding the connection between HIV/AIDS and the quality of life of HIV+ individuals (3)(4)(5) . The World Health Organization's (6) definition of quality of life comprises an individual's perception regarding his or her position in life.…”

“…Studies (1,4,5,8) have shown that the analysis of quality of life within an HIV/AIDS context is very important, because it enables HIV+ individuals to express the perception they have regarding their lives and provides health professionals with better means of treating the adversities resulting from the disease.…”

“…The emphasis on quality of life for seropositive individuals can comprise, among other things, the manner in which HIV+ individuals perceive and deal with day-to-day situations, as well as their commitment to the treatment and the effect of these treatments in the well being of these individuals, especially regarding their mental health (9,5) . However, despite the relevance of this connection, understanding the factors that affect the quality of life evaluation of HIV+ individuals is quite difficult, especially when considering how the perception of quality of life is determined by the seropositive condition or due to a set of clinical manifestations, or even if it is an association of these factors with other dimensions of life, such as social, psychological or environmental dimensions (10) .…”