Unmet needs of symptom management and associated factors among the HIV-positive population in Shanghai, China: A cross-sectional study.
Ning Dong, Wei-Ti Chen, Hongzhou Lu and 3 others
PMID 32425335WHAT IT FOUND
More than half of HIV-positive patients in Shanghai reported at least one unmet symptom management need.
Fatigue was most common, along with stress, low mood and sleep problems. Higher symptom burden, stigma, poor self-management and unemployment tracked with more unmet needs.
Key findings
01More than half (53%) had at least one unmet symptom management need in the previous 4 weeks, and fatigue was the most common unmet need at 15%.
02Symptom burden, HIV perceived stigma, self-management capacity and current employment status predicted unmet needs; symptom burden accounted for 29% of variance.
03Among the most common symptoms causing unmet needs were fatigue, feeling stress, feeling down, insomnia/abnormal dreams and feeling fearful.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it can show associations but not cause and effect. Most participants were male, so the results may not apply to HIV-positive women. The study was done in one metropolitan hospital in Shanghai, so results may not apply to other areas in China. Participants with other chronic diseases or severe cognitive impairment were excluded, so people with more complex care needs may be underrepresented. The measured factors explained only 38% of the variance in unmet needs, so other important factors were not captured. Symptoms, needs and self-management were assessed by patient self-report, so the findings depend on patients' perceptions.
Declared interests
The authors declared no conflict of interest. Funding came from the National Natural Science Foundation of China (grant no. 71673057) and Fudan University Nursing School (grant no. FNF202013).
The easy way to misread this
Do not conclude that reducing fatigue, stigma or unemployment will lower unmet symptom needs. This was a cross-sectional survey of mostly male HIV-positive patients in Shanghai, so it reports associations, not treatment effects.