RESUMEN
We designed an infographic intervention to help clinicians provide health information to persons living with HIV. In this study, we assessed the extent to which our intervention may improve objectively and subjectively measured health outcomes (CD4 count, viral load, and engagement with clinician among others) when integrated into routine visits in the Dominican Republic. In this pretest-posttest study, we followed participants for 9 months at 3-month intervals. Physicians administered the intervention during participants' first 3 visits. Outcome measures, selected using a conceptual model, were assessed at 4 time points. We assessed changes in outcomes over time with general linear regressions and Wilcoxon Signed-Rank tests. Participants (N = 50) were mostly female (56%) and had been living with HIV for a mean of 6.3 years (SD = 6.1). All outcomes, except CD4 count, demonstrated statistically significant improvements by study end. This provides preliminary evidence our intervention may improve outcomes, but further testing is needed.
RESUMEN: Diseñamos una intervención infográfica para ayudar a los médicos brindar información médica a personas viviendo con el VIH. En este estudio, evaluamos en qué medida nuestra intervención puede mejorar los resultados de salud (conteo de CD4, carga viral, y compromiso con el médico entre otros), medidos de una manera objetiva y subjetiva, cuando se incorpora en las visitas médicas de rutina en la República Dominicana. En este estudio de prueba previo y posterior, seguimos los participantes durante 9 meses a intervalos de 3 meses. Los médicos administraron la intervención durante las primeras 3 visitas de los participantes. Seleccionamos las medidas de resultado utilizando un marco conceptual y las evaluamos en los 4 puntos de tiempo. Evaluamos cambios a lo largo del tiempo usando regresiones lineales generales y pruebas de asociación de Wilcoxon Signed-Rank. Los participantes (N = 50) fueron mayormente mujeres (56%) y habían estado viviendo con el VIH durante una media de 6,3 años (DE = 6,1). Todos los resultados, aparte del conteo de CD4, demostraron mejoras estadísticamente significativas al final del estudio. Esto proporciona evidencia preliminar de que nuestra intervención puede mejorar los resultados de la salud, pero se justifican pruebas adicionales.
Asunto(s)
Visualización de Datos , Infecciones por VIH , Atención Ambulatoria , República Dominicana/epidemiología , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Carga ViralRESUMEN
PURPOSE: The purpose of this study was to identify and prioritize the information that persons living with HIV (PLWH) in a limited-resource setting need to effectively manage their health. DESIGN AND METHODS: A data sources triangulation method was used to compare data from three separate sources: (a) 107 interviews with Spanish-speaking PLWH being seen at a healthcare clinic in the Dominican Republic (DR); (b) 40 interviews with Spanish-speaking healthcare providers from the same clinic in the DR; and (c) an integrative literature review of English- and Spanish-language articles that assessed the health information needs of PLWH in Latin America and the Caribbean. We compared information needs across sources and developed a prioritized list of the topics important to provide PLWH in a clinical setting. FINDINGS: Triangulation identified the most important topics for HIV-related health education for PLWH as medication and adherence, followed by transmission, including risks and prevention strategies, mental health management, and knowledge of HIV in general. CONCLUSIONS: The identification of evidence-based health education priorities establishes a guide that healthcare providers may use to help PLWH effectively manage their health and creates a foundation from which further studies on improving clinical interactions may be generated. CLINICAL RELEVANCE: Using the priorities identified, nurses and other health educators can improve patient education, and consequently self-management, by making evidence-based choices about what information to provide to their patients.
Asunto(s)
Infecciones por VIH , Educación en Salud/normas , Automanejo/educación , Adulto , Anciano , Actitud del Personal de Salud , Información de Salud al Consumidor/normas , República Dominicana , Femenino , Hispánicos o Latinos , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Adulto JovenRESUMEN
There is a paucity of studies centering on the correlates of cancer worry among Hispanics from the Dominican Republic and the potential informatics strategies to address such worries. Data were analyzed using descriptive and correlational statistics, and logistic regression with the dependent variable of cancer worry. Independent variables for the regression were: age, gender, marital status, education, socioeconomic status, previous diagnosis of cancer, anxiety, depression, sleep disturbance, and chronic burden. Four variables significantly increased cancer worry: married marital status (OR = 1.19 [95% CI 1.01, 1.41]), younger age (OR = .992 [95% CI 0.987, 0.997]), less depression (OR = .96 [95% CI 0.94, 0.98]), and cancer diagnosis (OR = 2.12 [95% CI 1.24, 3.65]). New knowledge was generated on the contextual factors that influence these health concerns in a major Hispanic sub-group. Implications for practice, research and education are discussed.