Publication
Title
Physical and emotional health outcomes after 12 months of public-sector ART in the Free State Province of South Africa: a longitudinal study using structural equation modeling
Author
Abstract
Background: African and Asian cohort studies have demonstrated the clinical efficacy of antiretroviral treatment (ART) in resource-limited settings. However, reports of the long-term changes in the physical and emotional quality of life (QoL) of patients on ART in these settings are still scarce. In this study, we assessed the physical and emotional QoL after six and 12 months of ART of a sample of 268 patients enrolled in South Africa's public-sector ART programme. The study also tested the impact of the adverse effects of medication on patients' physical and emotional QoL. Methods: A stratified random sample of 268 patients undergoing ART was interviewed at baseline (< 6 months ART) and follow-up (< 12 months ART). A model of the relationships between the duration of ART, the adverse effects of medication, and physical and emotional QoL (measured using EUROQOL-5D) was tested using structural equation modelling. Results: The improved physical and emotional QoL shown at baseline was sustained over the 12-month study period, because treatment duration was not significantly associated with changes in the patients' QoL. Physical QoL significantly and positively influenced the patients' emotional QoL (subjective well-being [SWB]) (beta = 0.33, P < 0.01). Longitudinal data showed that patients reported significantly fewer adverse effects at follow-up than at baseline (beta = -0.38, P < 0.001) and that these adverse effects negatively influenced physical (beta = -0.27, P < 0.01) and emotional QoL (beta = -0.15, P < 0.05). Conclusion: This study provides evidence that the South African public-sector ART programme is effective in delivering sustained improvement in patient well-being. However, the results should encourage clinicians and lay health workers to be vigilant regarding the adverse effects of treatment, because they can seriously affect physical and emotional QoL.
Language
English
Source (journal)
BMC public health. - London
Publication
London : 2009
ISSN
1471-2458
Volume/pages
9:103(2009), p. 1-8
ISI
000265928400001
Note
General: doi:10.1186/1471-2458-9-103
Full text (Publishers DOI)
Full text (open access)
UAntwerpen
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Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
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Creation 11.05.2009
Last edited 17.05.2017
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