Calidad de vida de ancianos viviendo con VIH/SIDA en acompañamiento ambulatorial

Caliari, Juliano de Souza; Reinato, Lilian Andreia Fleck; Pio, Daiana Patrícia Marchetti; Lopes, Letícia Pimenta; Reis, Renata Karina; Gir, Elucir

doi:10.1590/0034-7167-2017-0127

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RESEARCH • Rev. Bras. Enferm. 71 (suppl 1) • 2018 • https://doi.org/10.1590/0034-7167-2017-0127 copiar

Calidad de vida de ancianos viviendo con VIH/SIDA en acompañamiento ambulatorial

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Analizar los factores relacionados con la calidad de vida de ancianos que viven con VIH/SIDA.

Método:

Estudio transversal realizado con personas de edad igual o superior a 50 años en un ambulatorio especializado. La recolección de datos fue por medio de entrevista. Para el análisis de los datos y caracterización de la muestra, se utilizó la estadística descriptiva y pruebas de comparación. El proyecto cumplió con los requisitos éticos.

Resultados:

Participaron 81 usuarios de 50 a 75 años, cuya media fue 57,8 (±6,1)) años, siendo 71,6% hombres. Se observó una relación estadísticamente significativa con la calidad de vida, las cuales fueron: sexo, hijos, ocupación, religión, tiempo de diagnóstico, exposición al VIH, efectos adversos, interrupción del tratamiento, recuento de carga viral, internación, dependencia para actividades diarias y uso de medicamentos.

Conclusión:

Los resultados sugieren que el déficit de calidad de vida no está relacionado sólo a los cambios físicos, sino a las angustias y al estigma relacionado con el VIH/SIDA.

Descriptores:
Síndrome de Inmunodeficiencia Adquirida; VIH; Seropositividad para el VIH; Calidad de Vida; Infecciones por VIH

Sociodemographic variables	n	%
Gender
Male	58	71.6
Female	23	28.4
Education (finished years)
0	10	12.3
1 \|-\| 5	37	45.7
≥ 6	34	42.0
Marital status
Single, widowed and divorced	25	30.9
Married and living together	56	69.1
Children
No	26	32.1
Yes	55	67.9
^* * Minimum wage in force during the survey period was R$724.00 (US$ 224.00) in 2014 and R$788.00 (US$ 241.00) in 2015. Income (MW= minimum wage)
≤ 1 MW	38	46.9
> 1 MW	43	53.1
Occupation
No occupation	5	6.2
Withdrawn/retired	46	56.8
Employed	30	37.0
Household arrengment
Alone	21	25.9
Accompanied	60	74.1
Religion practicing
Yes	60	74.1
No	21	25.9

Clinical variables	n	%
HIV diagnostic time (years)
≤ 5	14	29.7
5,1 \|-\| 10	28	34.6
≥ 10,1	29	35.8
Exposure to HIV
Sexual	62	76.5
Non sexual	10	12.4
Do not know	9	11.1
Adverse effects
No	61	75.3
Yes	20	24.7
Interruption of ART
No	70	86.4
Yes	11	13.6
TCD4+ counts
≤ 350 mm3/blood	19	23.5
>350 mm3/blood	62	76.5
Viral load counts
< 50 copies/ml (undetectable)	64	79.0
≥ 50 copies/ml (detectable)	17	21.0
Hospitalizations/reason HIV/AIDS
No	51	63.0
Yes	30	37.0
Comorbities
No	61	75.3
Yes	20	24.7
Dependence for DLA
No	77	95.1
Yes	4	4.9
Use of drugs (legal and illegal)
No	65	80.2
Yes	16	19.8

Score - categories	Number of items	Minimum	Maximum	Median	Mean	Standard Deviation
General function	6	16.7	100.0	67.1	75.0	27.1
Satisfaction with life	4	6.3	100.0	68.6	75.0	31.6
Concerns about health	4	6.3	100.0	66.8	75.0	33.0
Financial Concerns	3	0.0	100.0	48.5	50.0	38.5
Medication Concerns	5	0.0	100.0	86.2	100.0	20.7
HIVAcceptance	2	0.0	100.0	70.6	75.0	34.0
Concerns about secrecy	5	0.0	100.0	44.6	40.0	37.6
Professional confidence	3	0.0	100.0	88.5	100.0	23.5
Sexual function	2	0.0	100.0	55.0	50.0	39.6

HAT-QoL Survey
Sociodemographic Variables	General funcation		Satisfaction with life		Concerns about health		Financial concerns		Medication concern		HIV acceptance		Concern about secrecy		Professional confidence		Sexual function
Sociodemographic Variables	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M
Gender^(b) (b) Mann-Whitney Test; MW- minimum wage.
Male	75.0	67.6	75.0	69.1	81.2	71.1	62.5	49.7	95.0	85.5	87.5	71.5	37.5	42.6	100.0	92.5	75.0	59.6
Female	62.5	65.9	75.0	67.1	50.0	52.4	33.3	45.3	100.0	87.8	50.0	64.7	40.0	46.1	98.0	78.3	25.0	42.9
p value	0.987		0.953		0.029		0.734		0.698		0.228		0.560		0.043		0.081
Education (finished years)^(a) (a) Kruskal-Wallis test;
0	50.0	56.7	62.5	65.6	21.9	42.1	0.0	35.8	100.0	91.5	100.0	87.5	77.5	56.5	100.0	97.5	75.0	57.5
1 \|-\| 5	75.0	67.3	75.0	67.2	75.0	69.9	50.0	51.1	95.0	89.6	75.0	71.3	40.0	47.8	100.0	91.7	50.0	53.4
≥ 6	81.3	70.0	81.3	71.0	81.3	68.0	58.3	49.3	97.5	80.8	75.0	62.5	22.5	35.3	100.0	82.4	50.0	56.0
p value	0.296		0.742		0.050		0.234		0.727		0.103		0.627		0.309		0.842
Marital status^(a) (a) Kruskal-Wallis test;
Single, widowed and divorced	70.8	65.7	75.0	64.4	75.0	63.6	33.3	41.4	90.0	78.2	75.0	64.8	35.0	40.7	100.0	88.4	75.0	58.7
Married and living together	68.7	63.8	75.0	65.8	59.4	56.0	25.0	38.8	85.0	77.5	81.3	66.9	40.0	40.0	100.0	86.6	75.0	62.6
p value	0.367		0.998		0.127		0.722		0.899		0.461		0.898		0.618		0.350
Children^(b) (b) Mann-Whitney Test; MW- minimum wage.
No	83.3	74.1	75.0	70.9	87.5	79.8	66.6	55.1	97.5	82.6	75.0	68.7	20.0	29.6	100.0	94.2	75.0	67.3
Yes	66.6	63.7	75.0	67.5	68.7	59.2	33.3	45.3	100.0	83.5	87.5	70.0	45.0	50.2	100.0	85.7	50.0	49.0
p value	0.141		0.805		0.026		0.341		0.837		0.613		0.024		0.650		0.081
Income^(b) (b) Mann-Whitney Test; MW- minimum wage.
≤ 1 MW	66.7	66.4	75.0	68.4	75.0	67.3	41.6	44.0	100.0	85.1	75.0	72.0	32.5	41.8	75.0	57.2	100.0	90.4
> 1 MW	75.0	67.7	75.0	68.7	75.0	64.5	58.3	52.3	95.0	87.0	75.0	67.4	40.0	45.2	50.0	52.9	100.0	86.8
p value	1.00		0.558		0.641		0.350		0.615		0.850		0.663		0.951		0.666
Occupation^(a) (a) Kruskal-Wallis test;
No occupation	50.0	67.5	93.7	81.3	50.0	60.0	16.7	46.7	100.0	92.0	37.5	55.0	5.0	9.0	100.0	85.5	25.0	45.0
Withdrawn/retired	72.9	68.8	75.0	66.8	75.0	65.6	54.2	51.4	97.5	89.7	81.3	73.6	50.0	51.3	100.0	91.1	50.0	52.4
Employed	75.0	64.4	75.0	69.2	81.3	67.0	45.8	44.2	85.0	79.8	75.0	65.8	25.0	37.7	100.0	85.5	75.0	60.4
p value	0.834		0.861		0.990		0.627		0.294		0.444		0.043		0.377		0.599
Household arrengments^(b) (b) Mann-Whitney Test; MW- minimum wage.
Alone	83.3	76.1	81.2	76.7	75.0	71.7	50.0	46.8	100.0	89.0	75.0	73.8	20.0	39.2	100.0	94.0	75.0	65.4
Accompanied	66.6	63.9	75.0	65.7	71.8	63.7	50.0	49.0	95.0	85.1	75.0	68.1	40.0	45.2	100.0	86.5	50.0	51.2
p value	0.085		0.160		0.493		0.836		0.364		0.768		0.442		0.061		0.061
Religion practicing^(b) (b) Mann-Whitney Test; MW- minimum wage.
Yes	81.3	70.4	75.0	73.2	75.0	73.2	41.7	46.3	100.0	86.7	75.0	70.4	30.0	38.8	100.0	89.3	75.0	58.8
No	66.7	57.7	62.5	55.4	62.5	55.4	66.7	54.7	95.0	84.7	75.0	67.3	60.0	57.4	100.0	86.1	25.0	44.0
p value	0.039		0.045		0.952		0.365		0.301		0.865		0.030		0.193		0.210

Questionário HAT-QoL
Sociodemographic Variables	General funcation		Satisfaction with life		Concerns about health		Financial concerns		Medication concern		HIV acceptance		Concern about secrecy		Professional confidence		Sexual function
Sociodemographic Variables	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M	^* * Md = median; M = mean; Md	^* * Md = median; M = mean; M
HIV diagnostic time (years)^(a) (a) Kruskal-Wallis test;
≤ 5	64.6	65.6	75.0	62.0	81.3	71.0	58.3	47.2	97.5	86.7	75.0	64.6	35.0	41.3	100.0	89.2	74.0	62.5
5.1 \|-\| 10	68.8	63.5	75.0	69.2	59.4	58.5	41.7	43.2	92.5	86.4	93.8	73.2	27.5	35.2	100.0	86.3	25.0	38.4
≥ 10.1	83.3	71.8	81.3	73.5	75.0	68.7	75.0	54.6	100.0	85.5	75.0	70.3	60.0	53.8	100.0	89.9	75.0	63.8
p value	0.504		0.176		0.414		0.626		0.592		0.629		0.293		0.883		0.014
HIV exposure^(a) (a) Kruskal-Wallis test;
Sexual	68.7	64.7	75.0	64.5	71.4	61.0	25.0	36.7	90.0	78.9	75.0	64.6	35.0	39.3	100.0	89.9	62.5	57.4
Non sexual	50.0	57.5	56.3	55.4	50.0	56.6	33.3	48.8	80.0	75.5	50.0	61.2	40.0	43.1	97.0	70.7	99.0	69.0
Do not know	83.3	74.5	99.0	79.2	75.0	59.3	66.7	57.7	85.0	72.9	99.0	78.7	40.0	45.9	98.0	87.8	87.5	73.1
p value	0.087		0.006		0.844		0.006		0.159		0.167		0.581		0.004		0.096
Adverse effects^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
No	79.1	69.0	75.0	69.9	75.0	65.8	50.0	48.7	100.0	87.6	75.0	70.0	40.0	43.4	100.0	90.2	75.0	57.9
Yes	54.1	53.3	62.5	58.7	87.5	65.6	33.3	46.6	67.5	75.5	81.2	66.2	30.0	45.0	87.5	75.8	25.0	33.7
p value	0.037		0.466		0.821		0.971		0.018		0.958		0.873		0.046		0.098
Interruption of ART^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
No	75.0	68.8	75.0	70.0	75.0	66.4	50.0	48.0	100.0	87.1	75.0	65.8	35.0	39.9	100.0	90.2	75.0	60.0
Yes	50.0	56.4	50.0	59.6	68.7	61.9	50.0	50.7	75.0	80.0	99.0	93.1	80.0	67.3	100.0	77.2	25.0	22.7
p value	0.226		0.231		0.695		0.727		0.047		0.005		0.026		0.078		0.005
TCD4+ counts (mm3/blood)^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
≤ 350	66.7	63.0	75.0	60.0	56.3	53.5	25.0	33.3	80.0	73.0	75.0	62.7	40.0	45.9	100.0	85.4	75.0	64.5
>350	70.8	65.5	75.0	66.6	75.0	62.5	33.3	42.5	90.0	79.4	75.0	66.6	35.0	38.7	100.0	88.4	75.0	59.0
p value	0.653		0.266		0.155		0.097		0.052		0.840		0.274		0.186		0.434
Viral load counts (copies/ml)^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
< 50	83.3	68.8	81.3	71.7	75.0	66.8	54.2	50.8	100.0	86.6	75.0	67.6	40.0	43.4	100.0	89.5	75.0	57.8
≥ 50	66.7	60.8	62.5	57.0	75.0	62.1	25.0	39.7	90.0	84.4	99.0	77.2	40.0	44.7	100.0	84.8	25.0	44.1
p value	0.196		0.031		0.667		0.313		0.181		0.166		0.879		0.155		0.259
Hospitalizations/ HIV/AIDS^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
No	79.1	70.6	75.0	76.1	75.0	64.4	41.6	43.6	100.0	89.1	75.0	71.0	20.0	35.0	100.0	92.0	62.5	55.1
Yes	56.2	61.3	56.3	55.8	84.3	68.1	70.8	56.6	95.0	81.1	75.0	67.0	60.0	58.0	100.0	82.0	50.0	54.6
p value	0.157		0.045		0.415		0.107		0.248		0.551		0.008		0.054		0.964
Comorbities^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
No	75.0	65.4	75.0	70.0	68.7	63.1	50.0	47.9	95.0	84.0	75.0	67.4	35.0	41.1	100.0	87.4	50.0	54.9
Yes	72.9	72.5	65.6	64.0	96.9	74.0	50.0	50.0	100.0	92.7	87.5	76.3	52.5	51.3	100.0	91.7	56.3	55.0
p value	0.276		0.401		0.097		0.833		0.131		0.366		0.324		0.848		0.978
Dependence for DLA^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
No	75.0	69.3	75.0	69.8	75.0	67.5	50.0	49.4	100.0	86.1	75.0	68.7	40.0	42.5	100.0	88.4	62.5	56.5
Yes	25.0	25.0	43.7	43.7	28.1	34.4	12.5	29.2	85.0	86.3	99.0	87.5	80.0	65.0	100.0	89.6	12.5	25.0
p value	0.001		0.083		0.038		0.293		0.577		0.283		0.293		0.992		0.122
Use of drugs^(b) (b) Mann-Whitney test; ART - antiretroviral therapy; TCD4 + - T lymphocytes; DLA - daily life activities
No	75.0	69.0	75.0	68.3	75.0	67.9	50.0	50.1	100.0	87.4	75.0	71.7	40.0	42.7	98.0	86.0	75.0	58.5
Yes	56.2	59.4	75.0	69.9	50.0	57.0	33.3	41.6	75.0	81.3	75.0	60.9	37.5	47.5	100.0	98.4	25.0	40.6
p value	0.281		0.966		0.322		0.560		0.182		0.435		0.635		0.042		0.143

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[1] CORRESPONDING AUTHOR: Juliano de Souza Caliari E-mail: julianocaliari@yahoo.com.br