Aspects that influence the self-care of patients living with human immunodeficiency virus

Alencar, Rúbia Aguiar; Parenti, Ana Beatriz Henrique; Lopes, Camila de Carvalho; Ramos, Fabiana Tomé; Ciosak, Suely Itsuko

doi:10.1590/1518-8345.2746.3112

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 27 • 2019 • https://doi.org/10.1590/1518-8345.2746.3112 copy

Aspects that influence the self-care of patients living with human immunodeficiency virus^* * Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, grant #447511/2014-9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service.

Method:

analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem’s Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software.

Results:

most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (β = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015).

Conclusion:

aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.

Descriptors:
Self Care; Acquired Immunodeficiency Syndrome; HIV; Nursing Care; Adult Health; Ambulatory Care

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author:
Rúbia Aguiar Alencar E-mail: rubia.alencar@unesp.br

Variable	n	%
Sex
Male	76	56.3
Female	59	43.7
Schooling
Illiterate to incomplete primary education	43	31.9
Complete primary education to incomplete high school	33	24.4
Complete high school to incomplete higher education	49	36.3
Complete higher education	10	7.4
Self-referred color
White	76	56.3
Non-white	59	43.7
Religion
Yes	122	90.3
No	13	9.7
Has children
Yes	83	61.4
No	52	38.6
Family income ^†
≤ 1	31	23.0
1.1 to 4	88	65.2
≥ 4.1	16	11.9
Number of family income dependents
1 to 2	42	31.1
3 to 4	53	39.3
5 to 6	29	21.5
7 or more	11	8.1
Residence with garbage collection
Yes	131	97.0
No	7	3.0
Residence with running water
Yes	129	95.5
No	6	4.5
Residence with sewage network
Yes	129	95.5
No	6	4.5
Health care next to residence
Yes	88	65.1
No	47	34.9

Variable	n	%
Sexual orientation
Heterosexual	102	75.6
Homosexual	25	18.5
Bisexual	8	5.9
Has a permanent partner
Yes	68	50.3
No	67	49.7
Active sexual life
Yes	74	54.8
No	61	45.2
Alteration of sexual life after diagnosis
Yes	78	57.7
No	57	42.3
Good relationship with family after diagnosis
Yes	117	86.6
No	18	13.4
Feels loneliness, sadness and/or distress after the diagnosis
Yes	69	51.1
No	66	48.9
Need to hide the diagnosis
Yes	97	71.8
No	38	28.2
Accepts to be with HIV/AIDS*
Yes	104	77.1
No	31	22.9
Learned to live with HIV/AIDS*
Yes	118	87.4
No	17	12.6
Presented a change in lifestyle after diagnosis
Yes	71	52.6
No	64	47.4
Opportunistic disease after diagnosis
Yes	51	37.8
No	84	62.2

Variable	*β (95%CI)** ^† ; p ^‡	β ^§ (95%CI) ^\|\| ; p ^¶
Male sex	0.42 (-0.37,1.22),<0.293
Age	0.01 (-0.01,0.03),<0.272
Non-white	-0.27 (-0.88,0.34),<0.388
Complete higher education	0.89 (-0.45,2.25),<0.194	0.45 (-0.76,1.67),<0.462
Complete high school to incomplete higher education	-0.11 (-0.89,0.67),<0.782	0.42 (-1.16,0.31),<0.257
Complete primary education to incomplete high school	-0.69 (-1.50,0.11),<0.093	-0.77 (-1.57,0.02),<0.058
Residence with garbage collection	-2.77 (-5.82,0.26),<0.074	-0.88 (-2.64,0.87),<0.323
Residence with running water	1.59 (-0.88,4.07),<0.207
Health care next to residence	0.06 (-0.62,0.75),<0.854
Family income ≥ 4.1 minimum wages	-0.19 (-1.36,0.97),<0.749
Family income of 1.1 to 4 minimum wages	-0.32 (-1.10,0.44),<0.403
Has religion	-0.36 (-1.48,0.76),<0.527
With children	0.50 (-0.37,1.37),<0.261
Number of dependents	0.04 (-0.12,0.20),<0.637
Bisexual	-0.57 (-2.02,0.87),<0.440
Homosexual	-0.46 (-1.54,0.61),<0.401
With active sex life	0.25 (-0.45,0.95),<0.484
With permanent partner	0.65 (-0.26,1.57),<0.161	0.58 (-0.02,1.18),<0.059
With change in sex life	0.05 (-0.58,0.69),<0.873
Good family relationship after diagnosis	0.58 (-0.33,1.49),<0.212
Feels loneliness, sadness and/or distress after the diagnosis	-0.23 (-0.89,0.42),<0.484
Need to hide the diagnosis	-0.57 (-1.27,0.12),<0.109	-0.72 (-1.38 , -0.06),<0.031
Accepts to be with HIV/AIDS**	-0.07 (-0.89,0.75),<0.867
Learned to live with HIV/AIDS**	0.52 (-0.47,1.51),<0.305
Had opportunistic disease after diagnosis	-0.57 (-1.19,0.04),<0.071	-0.53 (-1.16,0.089),<0.093
Diagnostic time	0.01 (-0.07,0.10),<0.720
Treatment time	-0.02 (-0.11,0.07),<0.692

Variable	*OR(95%CI)** ^† ; p ^‡	OR ^§ (95%CI) ^\|\| ; p ^¶
Male sex	0.20 (0.04,0.881),<0.033	0.40 (0.13,1.22),<0.110
Age	0.94 (0.89,0.99),<0.026	0.93 (0.89,0.97),<0.003
Non-white	0.62 (0.21,1.79),<0.385
Illiterate to incomplete primary education	4.47 (1.08,18.45),<0.038	0.85 (0.52,1.39),<0.533
Complete primary education to incomplete high school	0.77 (0.20,2.95),<0.707
Complete high school to incomplete higher education	0.52 (0.06,4.08),<0.538
Family income ≤ 1 minimum wage	2.28 (0.66,7.90),<0.191	0.86 (0.40,1.83),<0.703
Family income of 1.1 to 4 minimum wages	0.78 (0.13,4.72),<0.794
Has religion	0.09 (0.00,1.26),<0.075	0.21 (0.02,1.84),<0.161
With children	0.15 (0.02,0.82),<0.029	0.35 (0.10,1.22),<0.102
Number of dependents	0.85 (0.64,1.12),<0.261
Heterosexual	1.13 (0.20,6.26),<0.888
Homosexual	2.77 (0.14,53.93),<0.500
With active sex life	1.09 (0.32,3.75),<0.881
With permanent partner	3.83 (0.72,20.16),<0.113	3.46 (1.27,9.46),<0.015
With change in sex life	0.88 (0.29,2.70),<0.832
Good family relationship after diagnosis	0.47 (0.09,2.30),<0.358
Feels loneliness, sadness and/or distress after the diagnosis	0.57 (0.18,1.76),<0.329
Need to hide the diagnosis	0.76 (0.23,2.45),<0.652
Accepts to be with HIV/AIDS**	1.41 (0.34,5.79),<0.627
Learned to live with HIV/AIDS**	0.43 (0.06,2.89),<0.386
Had opportunistic disease after diagnosis	0.66 (0.22,1.96),<0.465
Diagnostic time	1.05 (0.88,1.25),<0.555
Treatment time	0.92 (0.76,1.11),<0.429

Variable	*OR(95%CI)** ^† ; p ^‡	OR ^§ (95%CI) ^\|\| ; p ^¶
Male sex	1.87 (0.58,6.00),<0.291
Age	0.99 (0.96,1.02),<0.672
Non-white	1.18 (0.49,2.80),<0.708
Illiterate to incomplete primary education	1.40 (0.45,4.37),<0.558
Complete primary education to incomplete high school	1.18 (0.39,3.56),<0.764
Complete high school to incomplete higher education	3.23 (0.44,23.53),<0.246
Family income ≤ 1 minimum wage	1.71 (0.58,5.07),<0.327
Family income of 1.1 to 4 minimum wages	0.55 (0.10,3.03),<0.495
Has religion	2.94 (0.57,15.10),<0.196	2.54 (0.66,9.73),<0.173
With children	2.77 (0.77,9.93),<0.118	1.09 (0.50,2.39),<0.828
Number of dependents	0.86 (0.67,1.10),<0.240
Heterosexual	1.75 (0.38,7.97),<0.465
Homosexual	2.13 (0.22,20.42),<0.511
With active sex life	2.49 (0.87,7.09),<0.087	1.94 (0.88,4.28),<0.100
With permanent partner	0.78 (0.21,2.94),<0.724
With change in sex life	2.43 (0.99,5.96),<0.053	2.79 (1.28,6.09),<0.010
Good family relationship after diagnosis	0.23 (0.05,1.08),<0.064	0.24 (0.06,0.93),<0.038
Feels loneliness, sadness and/or distress after the diagnosis	2.05 (0.80,5.22),<0.130	1.94 (0.87,4.34),<0.107
Need to hide the diagnosis	0.83 (0.31,2.24),<0.719
Accepts to be with HIV/AIDS**	0.46 (0.13,1.52),<0.205
Learned to live with HIV/AIDS**	1.58 (0.36,6.79),<0.537
Had opportunistic disease after diagnosis	1.99 (0.82,4.82),<0.128	2.07 (0.94,4.57),<0.070
Diagnostic time	1.05 (0.92,1.19),<0.422
Treatment time	0.92 (0.81,1.06),<0.269

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Aspects that influence the self-care of patients living with human immunodeficiency virus* * Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, grant #447511/2014-9.

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Aspects that influence the self-care of patients living with human immunodeficiency virus^* * Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, grant #447511/2014-9.