Data Collection and Measurement
opportunistic infection, depression, depressive, HIV symptoms
CHRONIC DISEASE, OPPORTUNISTIC INFECTION, -20
The following data were obtained from participants: (1) demographic and patient characteristics, (2) risk behaviors, (3) visual analog scale (VAS) of ART Adherence, (4) HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES), and (5) HIV Symptom Management Self-Efficacy Scale. Before collecting data, the questionnaire was piloted in a group of HIV patients to resolve logical issues and adjust questions to improve accuracy. A face-to-face interview of 15-20 minutes was conducted in a closed room to ensure privacy and limit outside influences. Trained staff members assisted in data collection. These data were collected at baseline and at 1-month and 3-month follow-ups during their ART medication visits with doctors. Participants were asked about three risk behaviors, including drinking, smoking, and drug use, at baseline. At the 3-month follow-up, they were further asked “Compared to before participating in the study, how do you assess your drinking/smoking/drug use now?” with three answer options (increase, constant, decrease) to explore the change of the participant’s risk behaviors.The VAS of ART Adherence is a self-reported scale that was used to assess adherence to ART treatment among participants; scores range from 0 (nonadherent) to 100 (completely adherent) [The HIV-ASES includes 12 items and is used to assess patients’ confidence in adherence to treatment plans, including medications, diet, exercise, and the consumption of vitamins. Scores range from 0 (cannot do at all) to 10 (certainly able to do) [The HIV Symptom Management Self-Efficacy Scale has a total of 10 items adapted from the abbreviated 6-item Chronic Disease Self-Efficacy Scale. The scale evaluates four domains, including symptom control, role function, emotional function, and communication with physicians. This scale measures the confidence in patients’ capacity to manage HIV symptoms. Scores range from 1 (not at all confident) to 10 (completely confident). The total score is calculated as the sum of means; higher scores indicate higher confidence levels [Although these two scales, the HIV-ASES and the HIV Symptom Management Self-Efficacy Scale, are important measures to assess patients’ readiness and capacity to initiate treatment, after the pilot trial, we found that these scales were not able to accurately reflect the change in the first month of ART among patients at Bach Mai Hospital, resulting in a very high ceiling effect with almost all patients showing the highest scores. Thus, we decided not to apply these scales in the 1-month follow-up. The reason was that Bach Mai Hospital is the largest special-level hospital in Vietnam; thus, the procedure for initiating treatment was implemented very comprehensively. The patients’ readiness was improved substantially by various interventions, including family, group, and individual counseling; peer support; health checkups; and opportunistic infection treatment.Demographic and HIV patient characteristics were included as covariates for analysis. We asked participants to report their background information, including gender, age, education, occupation, and marital status. Some characteristics related to health status and HIV patient characteristics were also collected such as the CD4 cell count at treatment initiation (cells/µL), duration of ART (years), and the presence of comorbidities/acute symptoms.Patients’ mental health status was assessed with the 9-item Patient Health Questionnaire (PHQ-9), including 9 questions that assess depressive symptoms over the last 14 days. For each question, participants were asked to respond on a 4-point Likert scale ranging from 0 to 3 (0, not at all; 1, several days; 2, more than half the days; and 3, nearly every day). The total score ranges from 0 to 27, with scores above 10 being categorized as depression [In addition, the overall study included quality of life assessments as a measure of the impact of this intervention; however, this outcome is presented in a separate analysis. In this manuscript, we focus on immediate outputs to examine the efficacy of the intervention.