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目的探讨与验证艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)中亲密度、社会支持与抑郁的关系,为有效提高HIV/AIDS病人心理健康提供实证依据。方法采用横断面研究设计,通过方便抽样方法和自行设计的调查问卷,于2013年3-6月对广州市第八人民医院住院及门诊部的411名HIV/AIDS病人进行面对面问卷调查。通过问卷调查收集病人的社会人口学特征、社会网络、社会支持与抑郁情况等信息,并对其中有配偶或固定性伴的病人进行分析。建立亲密度、社会支持与抑郁的结构方程模型,探讨亲密度对抑郁的直接与间接作用。结果 411名HIV/AIDS病人中,55.00%(226名)有配偶或固定性伴,其中社会支持得分中位数及四分位间距为52.6分(35.5,72.4),抑郁得分中位数及四分位间距为14分(6,23)。单因素分析显示,月平均收入、社会支持以及与配偶或固定性伴间的亲密度和抑郁相关。对社会支持与抑郁构建测量模型显示,测量模型拟合良好(Chi-Square=35.18,RMSEA=0.06,CFI=0.99,TLI=0.98,SRMR=0.05)。在校正月平均收入后,对亲密度、社会支持和抑郁构建结构模型显示,模型亦拟合良好(ChiSquare=61.83,RMSEA=0.06,CFI=0.98,TLI=0.97,SRMR=0.06)。中介效应分析显示,社会支持在亲密度与抑郁之间的间接作用具有统计学意义(β=-0.27,P=0.03),亲密度与抑郁之间的直接作用无统计学意义(β=-0.43,P=0.21)。社会支持在亲密度与抑郁之间呈完全中介作用。结论今后对感染者心理状况的干预中,应鼓励感染者加强与其配偶/固定性伴的沟通,增进亲密度,有利于提高感染者的社会支持,从而降低其抑郁水平。
Objective To explore and verify the relationship between intimacy, social support and depression in HIV / AIDS patients (HIV / AIDS patients), and to provide evidences for effectively improving the mental health of HIV / AIDS patients. METHODS: A cross-sectional study design was used to conduct a face-to-face questionnaire survey of 411 HIV / AIDS patients in the Inpatient and Outpatient Department of Eighth People’s Hospital of Guangzhou from March to June 2013 through a convenient sampling method and a self-designed questionnaire. Through the questionnaire survey, the patients’ social demographic characteristics, social networks, social support and depression information were collected and the patients with spouses or regular partners were analyzed. Establishing a structural equation model of intimacy, social support and depression to explore the direct and indirect effect of intimacy on depression. Results Among the 411 HIV / AIDS patients, 55.00% (226) had spouses or fixed partners. The median social support scores and interquartile range were 52.6 (35.5, 72.4), the median depression scores and the four Inter-sub-spacing of 14 points (6,23). Univariate analysis showed that monthly average income, social support, and intimacy and depression with spouses or regular partners were related. Building a measurement model for social support and depression showed that the measurement model fitted well (Chi-Square = 35.18, RMSEA = 0.06, CFI = 0.99, TLI = 0.98, SRMR = 0.05). Building a structural model of intimacy, social support, and depression after calibration for monthly average income, the model also fitted well (ChiSquare = 61.83, RMSEA = 0.06, CFI = 0.98, TLI = 0.97, SRMR = 0.06). Median effect analysis showed that the indirect effect of social support between intimacy and depression was statistically significant (β = -0.27, P = 0.03), and there was no significant difference between intimacy and depression (β = -0.43 , P = 0.21). Social support is a complete intermediary between intimacy and depression. CONCLUSIONS In the future, interventions should be encouraged to improve the intimacy of HIV-infected patients by improving their intimacy with their spouses / anchovies, increasing the social support of PLHIV and thus reducing the level of depression.