Concept analysis of self-neglect in the elderly: a hybrid model.

PURPOSE: Clarifying the concept of elder self-neglect. METHODS: Researchers investigated the concept of elder self-neglect using a hybrid approach, including theoretical, fieldwork, and final analysis phases. After an extensive review of related literature to define the concept of self-neglect and describe its characteristics, the fieldwork phase was carried out to illustrate its empirical features. Accordingly, it led to the extraction of the elder self-neglect attributes from the first two phases. FINDINGS: Elder self-neglect includes "subjective and objective high-risk behaviors pertinent to physical and spiritual health as well as restricted social interactions, disregarding the living environment, and a lack of compliance to personal hygiene routines that the elderly demonstrate deliberately or unintentionally. Various factors can contribute to such behaviors, including individual features, poor physical performance, elderly-oriented psychological disorders, financial challenges, detrimental stressors, unsuccessful social interactions, inaccessible supportive resources, inadequate educational resources, and inappropriate cultural norms. Consequently, such behaviors result in impaired physical and psychological health status, higher risk of misbehavior, poor quality of life, extra caregiving-treatment burden, and affected mental security in society." CONCLUSION: Given that elder self-neglect is considered a relatively unknown concept in Iran, the study findings can pave the way for future extensive research in the Iranian context by clarifying the concept. It can play a significant role in developing related tools to design more efficient interventions and improve the quality of nursing care services. IMPLICATIONS FOR NURSING PRACTICE: The elder self-neglect concept can lead to numerous health-related disorders among the elderly in society. Nurses cannot deal with an unknown phenomenon without exploring and identifying its exact meaning. It is, therefore, imperative to illustrate the different dimensions of this concept to help create a deep understanding among the nurses and perform timely diagnosis and interventional procedures.

Nature, prevalence, and risk factors for self-neglect among older people: a pilot study from Vellore, South India.

Changes in demography in developing countries haves led to new issues among older rural populations, such as self-neglect which is under researched.Self-neglect identified as poor self-care, unsafe living quarters, inadequate medical care and poor utilization of services increase the odds of morbidity and mortality.Methods Our study was conducted in Kaniyambadi, a rural block in Vellore district in the state of Tamil Nadu, India. Ten villages were randomly selected. The study was conducted among people older than 60 years who were selected by random sampling using a computer-generated list. The following assessments were done: (i) A 19-item questionnaire was used to assess self-neglect, (ii) Katz index of daily living to assess functional activity, (iii) Mini Mental State Examination to evaluate cognition, (iv) Geriatric Depression Scale to identify depression, (v) Duke Social Support Index to measure social supports. Clinical data and anthropometric data were also collected. Data were entered into Epidata v3.1. All analyses were performed using SPSS v23.0.Results One hundred fourteen people above 60 years of age participated. The prevalence of self-neglect was 21.1% (95% CI 14.9%-29%); about half of the elderly population (47.38%) refused to seek or follow medical advice. Lower levels of education (OR 3.678, 95% CI 1.017 - 13.301), lower social class (OR 4.455, 95% CI 1.236 - 16.050) and functional impairment (3.643, 95% CI 1.373 - 9.668) were found to be significant factors associated with self-neglect. Though prevalence of comorbidities (70%) and depression (27%) were high, there was no statistical evidence of association with self-neglect.

Household factors and prevalence of squalor: meta-analysis and meta-regression.

BACKGROUND: Severe domestic squalor occurs when a person lives in a dwelling that is significantly unclean, disorganised and unhygienic. The limited previous research has primarily focused on the characteristics of those who live in squalor and the associated risk factors. Robust and reliable studies of squalor prevalence have not been conducted. This study sought to produce a reliable estimate of the point prevalence of squalor. METHODS: Using data from 13-years of the English Housing Survey, N = 85,681 households were included in a prevalence meta-analysis. Squalor prevalence over time, subgroup analysis and logistic regression investigated the role played by household and community characteristics. RESULTS: The point prevalence of squalor was estimated to be 0.85% and squalor was seen to decrease significantly over time. More significant community deprivation, a rented dwelling, lower income and high numbers of people in the home was associated with a greater risk of squalor. CONCLUSIONS: Squalor prevalence was higher than previous estimates and supports community care services in associated service planning. The results regarding household characteristics help to inform which households and individuals may be at a higher risk of living in squalid conditions.

Defiance or Self-Neglect?

A brief consideration of the term "self-neglect" as used in the gerontological nursing literature is in this column. It will serve as an introduction to the main article that reports on a survey of family members in Japan about their elder family members who refuse nursing care.

Refusal of Nursing Care as a Factor That Hinders Long-Distance Care in Japan.

In this column, the author examines older adults' refusal of nursing care. Results from a questionnaire survey revealed that over 25% of children who lived away from their parents were troubled by their refusal of care. In addition, the author summarizes self-neglect like care refusal, which can explain older adults' care refusal. Interviews with care professionals showed that parental care refusal did not particularly relate to "parents refusing necessary services" as perceived by their children but to parents' perception of "children forcing unnecessary services" on them. The solution involves care provision geared toward older adults' daily needs rather than alleviating children's anxiety.

Mediation effect of self-neglect in family resilience and medication adherence in older patients undergoing maintenance hemodialysis. / è‡ªæˆ‘å¿½è§†åœ¨ç»´æŒæ€§è¡€æ¶²é€æžè€å¹´æ‚£è€ å®¶åº­å¤åŽŸåŠ›ä¸Žç”¨è¯ä¾ä»Žæ€§é—´çš„ä¸­ä»‹æ•ˆåº”.

OBJECTIVES: Chronic kidney disease (CKD) patients with regular dialysis treatment for more than 3 months are called maintenance hemodialysis (MHD). The degree of patients' adherence with the doctor's advice to take medicine on time is called medication adherence, which is very important for the control of the disease and the improvement of the quality of life for MHD patients. Living alone, lack of communication with children and self-neglect are risk factors for medication adherence in the older adults. Inappropriate substance use behaviors are common among older adults with self-neglect. Family resilience denotes the ability of a family to retain the stability of its structure by relying on its internal and external resources when facing a difficult situation. Family resilience entails the combination of family beliefs, interaction styles, problem-solving skills, and emotional communication which reflect supportive and positive psychological adjustment effects to benefit older persons. This study aims to provide a theoretical basis for clinical intervention level to improve medication adherence of older patients on MHD through examineing the correlation among family resilience, self-neglect, and medication adherence based on the self-reports. METHODS: A random sampling method was used to gather information from 632 older patients receiving MHD treatment in Hemodialysis Center of Hunan Province between July to December 2021. For this purpose, a self-designed demographic questionnaire, the Family Resilience Questionnaire (FRQ), the Scale of the Elderly Self-Neglect (SESN), and the Morisky Medication Adherence Scale-4 (MMAS-4) were used to investigate the questionnaire data of the participants. Pearson correlation was used to examine the relationship between family resilience, self-neglect, and medication adherence in older patients and gain insight into their current status. AMOS 24.0 was used for mediation modeling. Bootstrap mediation effect test was used to evaluate the mediation effect among the 3 variables. RESULTS: The questionnaires survey showed that the scores of FRQ, SESN, and MMAS-4 were 78.60±12.49, 7.99±5.60, and 5.93±1.40, respectively; and the medication adherence rate was 18.8%. Pearson correlation analysis showed that family resilience was negatively correlated with self-neglect (r=-0.432, P<0.001), and was positively correlated with medication adherence (r=0.169, P<0.001). Self-neglect was negatively correlated with medication adherence (r=-0.217, P<0.001). Mediating effect analysis showed that the total effect of family resilience on medication adherence was significant (ß=0.214, 95% CI 0.121 to 0.313, P<0.001), and the direct effect was not significant (ß=0.058, 95% CI -0.073 to 0.187, P>0.05). Self-neglect played a major mediating effect between family resilience and medication adherence (ß=0.156, 95% CI 0.088 to 0.240, P<0.001). CONCLUSIONS: Family resilience, self-neglect, and medication adherence among older patients on MHD are significantly related, with family resilience primarily influencing medication adherence indirectly through self-neglect.

Adaptation and validation of the Abrams geriatric self-neglect assessment scale among older Chinese people admitted to the hospital.

OBJECTIVES: Elder self-neglect is a global public health problem, and older people admitted to the hospital may have a higher risk of self-neglect due to their deteriorating health conditions. This study aimed to translate, adapt and validate the Abrams geriatric self-neglect assessment scale (AGSS) among older Chinese people admitted to the hospital. METHODS: Data were derived from a cross-sectional survey of a convenience sample of 452 older people admitted to a general hospital. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the structural validity of the AGSS. Content validity, criterion validity, internal consistency reliability, and test-retest reliability were also conducted to assess the psychometric properties of the scale. RESULTS: EFA yielded a 6-item one-factor model, which was supported by CFA and explained 44.74% of the total variance. The internal consistency was acceptable (Cronbach α = 0.740), and the test-retest reliability with a 14-day interval was good (intraclass correlation coefficient, ICC = 0.966). Significantly positive correlations with the caregiver-rated elder self-neglect assessment scale (r = 0.648) supported the concurrent validity of the scale. Significant differences in scores between respondents with different ages, marital statuses, educational levels and numbers of chronic diseases demonstrated the discriminative validity. CONCLUSION: The Chinese version of the AGSS is an easy-to-use, reliable and valid measure with satisfactory psychometric properties. Future studies should recruit a more representative sample of older people in China to verify the applicability of the scale. IMPLICATIONS FOR PRACTICE: The Chinese version of the AGSS enables clinical staff to accurately screen for and assess elder self-neglect upon hospital admission, which can inform the development of specific interventions and assignment of additional guardianship to those at risk of elder self-neglect.

Subgroups of self-neglect and effects on suicidal ideation among the older adults.

The issue of self-neglect among older adults is receiving attention in modern societies where aging is accelerating. To help expand our understanding of this phenomenon, this study identified its different types using latent profile analysis and verified the main variables that distinguish these types from each other. The three profiles that were identified are high self-neglect (HSN: 28.8%), low self-neglect (LSN: 35.6%), and poor personal hygiene (PPH: 35.6%). Interestingly, PPH showed a high rate and was identified as a noticeable type of elder self-neglect. Gender, age group, SES, support size, and suicidal ideation were significant in classifying the types of self-neglect. Men were more likely to be within the HSN group, and late elderly were more likely to be within the PPH group. The higher SES and social support, the higher the probability of being within the LSN group. The higher the suicidal ideation, the higher the possibility of falling under the HSN group. To reduce self-neglect among older adults, this study suggests to older adults vulnerable to self-neglect, expansion of the social support available to them, and provision of mental health services to this population.

Plica Neuropathica as a Presenting Rare Dermatologic Symptom of Schizophrenia.

Plica neuropathica (PN), also known as plica polonica, trichoma, matting, felting, or bird's nest hair, is a common but rarely reported hair disorder. It is characterized by the abrupt onset of irreversible hair entanglement, forming a densely matted hair mass. PN has been associated with the use of ionic or herbal shampoos, vigorous hair care practice, self-neglect, systemic infection, parasitic infestation, immunosuppressive drugs, and psychiatric conditions. However, literature supporting the coexistence of PN in psychiatric disorders is scarce. PN may be one of the presenting symptoms observed by physicians. In some cases of psychiatric illness, patients consult more readily with non-mental health professionals than psychologists or psychiatrists. To highlight this issue, we herein report a case of PN in a 32-year-old woman with a 1-month history of being unable to detangle her hair. The patient initially visited the dermatology department and was subsequently diagnosed with schizophrenia following psychiatric consultation. After establishing the fundamental diagnosis apparently underlying the PN, psychiatric treatment with antipsychotic medication and dermatological treatment of the hair condition were instituted. There was an improvement in both at the four-week follow-up. This case history highlights a rare presentation of schizophrenia.

Effect of an elder abuse and self-neglect intervention on repeat investigations by adult protective services: RISE project.

BACKGROUND: Adult Protective Services (APS) is the primary agency responsible for investigating elder abuse and self-neglect (EASN) allegations in the United States. The harms of EASN are well established; however, APS lacks a conceptually derived evidenced-based intervention phase. RISE is a community-based intervention designed to complement APS that provides enhanced services and a longer intervention phase. The objective of this study was to test whether exposure to the RISE/APS collaboration was associated with reducing the case outcome of recurrence (repeat investigations) compared to usual care APS only services. METHODS: A retrospective observational study (n = 1947) of two counties in Maine where RISE was available to provide enhanced services to persons referred from APS. An extended regression endogenous treatment Probit model using APS administrative data was used to predict case recurrence. RESULTS: Between July 2019 and October 2021, 154 cases participated in RISE and 1793 received usual APS only services. 49% of cases in RISE had 2 or more prior substantiated allegations versus 6% for those receiving usual APS care, and 46% of cases in RISE had a recurrence during the observation period versus 6% for usual care group. However, after accounting for the non-random treatment assignment, RISE was associated with a significantly lowered likelihood of recurrence compared to persons receiving usual care provided by APS (probability of recurrence reduced by 0.55 for the Average Treatment Effect on the Treated and 0.26 for the Average Treatment Effect). CONCLUSIONS: A reduction in recurrence carries important implications for APS clients, costs, resources, and workflow. It may also serve as a proxy indicating a reduction in revictimization and harm for EASN victims.

Use of Motivational Interviewing by Advocates in the Context of an Elder Abuse Response Intervention: The RISE Project.

Purpose: Despite the increasing number of elder abuse and self-neglect (EASN) cases, many older adults are reluctant to engage with formal support services, such as Adult Protective Services (APS). This study examined the use of motivational interviewing (MI) by advocates, as a component of a larger EASN intervention, RISE (Repair Harm, Inspire Change, Support Connection, Empower Choice), implemented in partnership with APS. Advocates applied MI as part of RISE to help clients explore and resolve ambivalence around pursuing change and ultimately enhance service engagement. Methods: This study conducted qualitative interviews and a focus group with all RISE advocates (n = 4) to understand how MI is applied in the context of an EASN intervention with older adult clients. A descriptive phenomenological approach involving two independent assessors was used to code verbatim transcripts into themes. Results: Three domains were identified: (1) therapeutic relationship, which describes the importance of foundational relationship building in MI to support older adults who have experienced EASN; (2) techniques, which refers to MI strategies advocates apply and adapt in the context of EASN intervention; and (3) implementation challenges, which reflects the difficulties advocates encounter when using MI in cases of EASN. Conclusions: The experiences of advocates suggest MI is a beneficial and amenable approach to help older adults who have experienced EASN navigate issues of ambivalence and explore their motivation for change. This study represents the first in-depth exploration of MI in the context of EASN intervention.

The role of frailty, social networks, and depression in self-neglect in an older Chinese population: A cross-sectional descriptive study.

OBJECTIVES: To identify the role of frailty, social networks, and depression in self-neglect in an older Chinese population. METHODS: The study was conducted in 521 older adults recruited from four community healthcare centers in a district in Beijing, China. Participants were investigated by a set of questionnaires. RESULTS: Frailty (ß=0.150, p=0.759) was not associated with self-neglect of older adults. Social isolation (ß=1.980, p<0.001) and depression (ß=3.606, p<0.001) were both factors associated with self-neglect in older adults. CONCLUSION: Management of depression and improvement of social networks of older adults should be incorporated into interventional strategies to effectively control self-neglect. Understanding self-neglect and its associated factors will ultimately contribute to the intervention development and well-being of older adults.

The five self-harm behavior groupings measure: empirical and thematic data from a novel comprehensive self-harm assessment.

Introduction: The Five Self-Harm Behavior Groupings Measure (5S-HM) is a novel assessment that evaluates behaviours which may go undetected by existing measures. Self-harm is formulated across directness and lethality spectra, including under-studied behaviors such as indirect self-harm, harmful self-neglect and sexual self-harm. Aims of the study were to: (1) empirically evaluate the 5S-HM; (2) to determine whether the 5S-HM generates relevant new information with respect to the forms and functions given by participants for self-harm within a clinical sample; (3) to test the utility and novel contributions of the Unified Model of Self-Harm and the 5S-HM by extension. Methods: Data were collected from N = 199 individuals (Mage = 29.98, SD = 8.41, 86.4% female), receiving specialized evidence-based treatments for self-harm, borderline personality disorder or eating disorders. Construct validity was determined via Spearman correlations, and internal consistency was established from Cronbach's alpha. Inductive thematic analysis was used to analyze and interpret qualitative data on reasons, forms and functions participants reported in relation to self-harm following Braun and Clarke's analytic guidelines. Thematic mapping was used to summarize qualitative data. Results: Test-retest reliability on a subsample of n = 24, tested 14 days after Time 1 was supported by a good intraclass correlation (0.68). Internal consistency (Cronbach's alpha = 0.75) was acceptable to good, as was construct validity comparing the 5S-HM total score to two validated self-harm measures (rho = 0.40, p < 0.01; rho = 0.26, p < 0.01). A thematic map depicting antecedents and consequences of self-harm over time suggests that self-harm is initiated by negative emotional states and self-intolerance. Novel findings in relation to sexual self-harm indicated that reasons for these behaviors were either to improve or worsen one's situation through being hurt by someone else. Discussion: The empirical analyses of the 5S-HM demonstrate that it is a robust measure for use in clinical and research settings. Thematic analyses proposed explanations for why self-harm behaviors are initiated and how they are reinforced over time. Sexual self-harm in particular requires further careful study.

Case report: Dermatosis neglecta mimicking pemphigus foliaceus in association with obsessive-compulsive disorder.

Dermatosis neglecta (DN) is a frequently underrecognized skin disorder that occurs due to unconscious or conscious neglect of self-cleaning, causing the accumulation of keratin, sweat, sebum, and impurities. It is characterized by asymptomatic yellowish-to-brownish, waxy, adherent papules or plaques with cornflake-like scales that mimic several dermatological conditions. DN awareness is crucial for avoiding unnecessary invasive diagnostic procedures. Its lesions can be removed with some difficulty by ordinary cleansing and efficiently cleared with ethyl or isopropyl alcohol. Individuals with underlying physical or mental disabilities or psychiatric conditions are highly associated with DN. Nevertheless, supportive evidence for the coexistence of DN and psychological conditions is sparse, and most individuals with mental problems usually deny having psychiatric issues. Here, we present a case of DN resembling pemphigus foliaceus on the face with obsessive-compulsive disorder in a 16-years old male. The definitive diagnosis of DN in this patient was confirmed via histopathological examination. The lesions completely disappeared after appropriate facial cleansing and psychiatric management. DN may reveal underlying psychiatric disorders in patients.

Meeting the challenges in conducting research in vulnerable older adults with self-neglect-notes from a field team.

Gaining a systematic understanding of possible ways to increase the quality and lifespan of older adults experiencing self-neglect has unique challenges. These challenges include identifying self-neglect in the community and navigating levels of cognitive, physical, and/or psychological difficulties in this population that impact recruitment, consent, and accurate data collection. Conducting quality research under some of the environmental self-neglect conditions such as squalor, animal and insect infestations and no utilities can also challenge planned study protocols and study validity. This manuscript presents details of these overarching challenges and some of the workable solutions noted and implemented by research field-team members who have enrolled over 300 adults experiencing self-neglect for various studies. Usual research methodology must overcome these barriers to work to create consciousness about the self-neglect population. The classic series of cases is still a good alternative when describing self-neglect. Considerations for conducting future self-neglect research are presented.

Prevalence and predictors in self-neglect: A cross-sectional study of domestic migrant older adults in China.

Insufficient information is available on the prevalence and predictors of self-neglect among Chinese domestic migrant older adults resulting from rapid aging and mass population migration. This cross-sectional study was conducted on 597 older adults in four districts of Wenzhou from May to November 2020. A self-neglect scale was used to assess the prevalence of self-neglect among such adults. Sixteen potential predictors were considered in the domains of sociodemographic, health condition, socioeconomic, social isolation, intergenerational relationship, and filial piety. The prevalence of self-neglect within this population was 72.7%. Social isolation (OR = 0.823; 95%CI 0.684-0.990), physical health (OR = 0.966; 95%CI 0.941-0.992), intergenerational ambivalence (OR = 1.240; 95%CI 1.013-1.519), and affective-cognitive solidarity (OR = 0.796; 95%CI 0.719-0.880) were found to be independent predictors of self-neglect in this population. We suggest that community health service organizations should prioritize migrant older adults with a poor health status and those with intergenerational ambivalence to reduce self-neglect in migrant older adults. Such older adults should also be encouraged to participate in community activities for more social integration.

Chronic corticosterone deteriorates latrine and nesting behaviours in mice.

Self-care behaviours are actions that help maintain good health and surroundings. For example, appropriate toileting, sleeping in the bed, and bathing and washing are among self-care behaviours in humans. Animals also perform similar self-care behaviours such as latrine, nesting and self-grooming. Studies have shown that chronic stress disrupts nesting and self-grooming behaviours. However, the effect of chronic stress on latrine behaviour, preferential, repeated defecation at specific locations, has not yet been clarified. This study aimed to investigate the influence of chronic corticosterone administration on latrine and nesting behaviours in mice. The variation in defecation location was quantified as the degree of the latrine behaviour by using Shannon entropy. The nest quality was scored based on shape. The study showed that mice exposed to chronic corticosterone had scattered defecation sites and lower nest quality compared to the control group. Furthermore, results showed that more scattered defecation behaviour was associated with lower nest quality at an individual level. Additionally, the deterioration of these self-care behaviours was associated with depression-like behaviours such as less open field activity and increased immobility time during the tail suspension test. These results suggest that chronic corticosterone deteriorates self-care behaviours such as latrine and nesting in mice.

The Development and Validation of Elder Self-Neglect Scale (ESNS) in Iranian Community-dwelling Older Population.

The aim of this study was to develop a valid and reliable elder self-neglect scale (ESNS) for field research on Iranian community-dwelling older adults. This mixed-method exploratory study was conducted in three stages: (1) item generation using literature review, (2) item reduction by expert panels, and (3) assessing the psychometric properties. In the third stage, the face, content, and construct validity (exploratory factor analysis) were performed on the first sample (n = 450), and the final 26-item scale was developed. After that, confirmatory factor analysis and reliability were assessed on the second sample (n = 250). Data were analyzed using IBM-SPSS v.23 and AMOS v.24. Exploratory factor analysis identified six factors with a total variance of 77.53%. The goodness of fit was indicated by Structural Equation Modeling. The Cronbach's alpha was estimated at 0.85. The optimal cutoff point was 73. This scale with 26 items seems to be an effective tool in screening elder self-neglect.

Perspectives and experiences of living with self-neglect among older adults: A systematic review and meta-synthesis.

PURPOSE: Given the global trajectory toward an aging population, renewed interest in the phenomena of self-neglect is needed if relevant stakeholders are to be adequately prepared for an expected increase in the number of elder self-neglect cases. This current study is designed to systematically review and synthesize the qualitative literature on the perspectives and experiences of older adults living with self-neglect. DESIGN: A narrative meta-synthesis was used. METHODS: Six English databases (PubMed, Web of Science, CINAHL Plus, Scopus, Embase, and PsycINFO) were comprehensively searched from inception to May 2022. The thematic synthesis method was applied to analyze and synthesize the findings of the included studies. The Critical Appraisal Skills Programme qualitative checklist was applied to evaluate the quality of the included studies. FINDINGS: A total of six qualitative studies were finally included with four studies conducted in the United States, one in Israel, and one in Ireland. Through meta-synthesis, five analytical themes were identified: attributes of self-neglect, life shaped by misery, insufficient social networks and resources, self-protection and preservation, and anchoring beliefs and practices. CONCLUSIONS: This qualitative synthesis provides profound insights into the self-neglect phenomenon from the standpoint of older adults with self-neglect and can provide guidance to relevant stakeholders on how to address elder self-neglect cases with respect to its assessment, reporting and management. Future research across geographical locations on the experiences of older adults with self-neglect are needed to provide a more global understanding of this significant and emerging public health issue. CLINICAL RELEVANCE: The development of future self-neglect management practices based on medical and sociocultural models of care can focus on supporting self-neglecters with positive coping mechanisms and supporting service providers with spiritual care competencies to ensure interventions achieve ethical principles of autonomy, beneficence, and nonmaleficence.

Representações sociais de pessoas vivendo com hiv: do abandono do tratamento à motivação para a retomada / Representaciones sociales de las personas que viven con vih: del abandono del tratamiento a la motivación para reanudar / Social representations of people living with hiv: from treatment abandonment to motivation for resuming

Introdução: O uso contínuo da terapia antirretroviral é eficiente para interromper a replicação viral causada pelo Vírus da Imunodeficiência Humana impedindo o comprometimento do sistema imunológico e o aparecimento das infecções oportunistas. Estima-se que em 2021, 10,2 milhões de pessoas infectadas pelo HIV não se beneficiaram com o uso dos antirretrovirais em todo o mundo. No mesmo ano esse indicador atingiu 333 mil pessoas, e na esfera municipal de Londrina, 288 pessoas vivendo com HIV encontravam-se em abandono do tratamento. Objetivo: Apreender as representações sociais de pessoas vivendo com HIV acerca do abandono do tratamento e a motivação para a retomada. Percurso metodológico: Trata-se de um estudo qualitativo pautado na Teoria das Representações Sociais de Serge Moscovici. O cenário foi um Serviço de Atendimento Especializado em HIV/aids localizado na região Sul do Brasil. A população foi composta por 288 pessoas diagnosticadas com HIV em abandono do tratamento por período superior a 100 dias. Destas, 250 foram excluídas em função de critérios relacionados a informações cadastrais incompletas ou equivocadas, e aspectos impeditivos do comparecimento ao serviço e de contato. Outras 18 pessoas foram consideradas perdas por desistência. A amostra foi composta por 20 pessoas que se enquadraram aos critérios de elegibilidade e aceitaram participar do estudo. A coleta das informações ocorreu entre junho de 2021 e junho de 2022 em entrevistas semiestruturadas audiogravadas e transcritas na íntegra. Para análise das falas foi utilizado o discurso do sujeito coletivo. Resultados: Participaram do estudo 20 pessoas vivendo com HIV, sendo 12 homens e oito mulheres, com idade entre 27 e 55 anos. O tempo de abandono variou entre 210 e 1580 dias. A análise das entrevistas permitiu a emersão de 18 ideias centrais e duas ancoragens, as quais foram agrupadas em quatro grandes temas: 1) Abandono do tratamento por questões intrínsecas à pessoa vivendo com HIV; 2) Abandono do tratamento por questões ligadas à terapia medicamentosa; 3) Abandono do tratamento por dogmas sociais; 4) Forças propulsoras para a retomada do tratamento. Considerações finais: A análise qualitativa das representações sociais das pessoas vivendo com HIV indicou que o abandono da terapia antirretroviral é multifatorial, e envolve questões socioculturais, geográficas, familiares e biológicas. É essencial considerar todas as questões que permeiam e impactam as vidas das pessoas vivendo com HIV em abandono do tratamento para além das questões biológicas, viabilizando a implementação de ações que contribuam para a efetividade das políticas públicas de saúde no intuito de estimular a adesão e encorajar a retomada ao tratamento. Almeja-se que esta investigação possa despertar para as questões subjetivas ao universo da pessoa que vive com HIV e estas respeitadas na prática humanizada, voltadas ao incentivo do tratamento contínuo para controle da infecção e promoção da qualidade de vida.

Introduction: The continuous use of antiretroviral therapy is efficient to interrupt viral replication caused by the Human Immunodeficiency Virus, preventing the compromise of the immune system and the appearance of opportunistic infections. It is estimated that in 2021, 10.2 million people infected with HIV did not benefit from the use of antiretrovirals worldwide. In the same year, this indicator reached 333,000 people, and at the municipal level of Londrina, 288 people living with HIV were abandoning treatment. Objective: To apprehend the social representations of people living with HIV about abandoning treatment and the motivation for resuming it. Methodological path: This is a qualitative study based on Serge Moscovici's Theory of Social Representations. The setting was a Specialized Care Service for HIV/AIDS located in the south of Brazil. The population consisted of 288 people diagnosed with HIV who had abandoned treatment for more than 100 days. Of these, 250 were excluded due to criteria related to incomplete or wrong registration information, and aspects that impeded attendance at the service and contact. Another 18 people were considered dropout losses. The sample consisted of 20 people who met the eligibility criteria and agreed to participate in the study. Data collection took place between June 2021 and June 2022 in semi-structured interviews that were audio-recorded and transcribed in full. For the analysis of the speeches, the collective subject discourse was used. Results: 20 people living with HIV participated in the study, 12 men and eight women, aged between 27 and 55 years. The abandonment time varied between 210 and 1580 days. The analysis of the interviews allowed the emergence of 18 central ideas and two anchors, which were grouped into four major themes: 1) Abandonment of treatment due to issues intrinsic to the person living with HIV; 2) Abandonment of treatment due to issues related to drug therapy; 3) Abandonment of treatment by social dogmas; 4) Driving forces for the resumption of treatment. Final considerations: The qualitative analysis of the social representations of people living with HIV indicated that the abandonment of antiretroviral therapy is multifactorial, and involves sociocultural, geographic, family and biological issues. It is essential to consider all the issues that permeate and impact the lives of people living with HIV who abandon treatment in addition to biological issues, enabling the implementation of actions that contribute to the effectiveness of public health policies in order to stimulate adherence and encourage resumption of treatment. It is hoped that this investigation may awaken to the subjective issues of the universe of the person living with HIV and these respected in humanized practice, aimed at encouraging continuous treatment to control the infection and promote quality of life.

Introducción: El uso continuo de la terapia antirretroviral es eficaz para interrumpir la replicación viral provocada por el Virus de la Inmunodeficiencia Humana, previniendo el compromiso del sistema inmunológico y la aparición de infecciones oportunistas. Se estima que en 2021, 10,2 millones de personas infectadas por el VIH no se beneficiaron del uso de antirretrovirales en todo el mundo. En el mismo año, este indicador alcanzó a 333.000 personas, ya nivel municipal de Londrina, 288 personas viviendo con VIH estaban abandonando el tratamiento. Objetivo: Aprehender las representaciones sociales de personas viviendo con VIH sobre el abandono del tratamiento y la motivación para retomarlo. Camino metodológico: Se trata de un estudio cualitativo basado en la Teoría de las Representaciones Sociales de Serge Moscovici. El escenario fue un Servicio de Atención Especializada en VIH/SIDA ubicado en el sur de Brasil. La población estuvo conformada por 288 personas diagnosticadas con VIH que habían abandonado el tratamiento por más de 100 días. De estos, 250 fueron excluidos por criterios relacionados con información de registro incompleta o incorrecta, y aspectos que impidieron la asistencia al servicio y contacto. Otras 18 personas fueron consideradas pérdidas por deserción. La muestra estuvo conformada por 20 personas que cumplieron con los criterios de elegibilidad y aceptaron participar en el estudio. La recolección de datos ocurrió entre junio de 2021 y junio de 2022 en entrevistas semiestructuradas que fueron grabadas en audio y transcritas en su totalidad. Para el análisis de los discursos se utilizó el discurso del sujeto colectivo. Resultados: Participaron del estudio 20 personas viviendo con VIH, 12 hombres y ocho mujeres, con edades entre 27 y 55 años. El tiempo de abandono varió entre 210 y 1580 días. El análisis de las entrevistas permitió el surgimiento de 18 ideas centrales y dos anclas, que fueron agrupadas en cuatro grandes temas: 1) Abandono del tratamiento por cuestiones intrínsecas a la persona que vive con VIH; 2) Abandono del tratamiento por cuestiones relacionadas con la farmacoterapia; 3) Abandono de tratamiento por dogmas sociales; 4) Fuerzas impulsoras de la reanudación del tratamiento. Consideraciones finales: El análisis cualitativo de las representaciones sociales de las personas viviendo con VIH indicó que el abandono de la terapia antirretroviral es multifactorial, e involucra cuestiones socioculturales, geográficas, familiares y biológicas. Es fundamental considerar todas las cuestiones que permean e impactan la vida de las personas que viven con el VIH que abandonan el tratamiento además de las cuestiones biológicas, posibilitando la implementación de acciones que contribuyan a la efectividad de las políticas públicas de salud para estimular la adherencia y alentar la reanudación. De tratamiento se espera que esta investigación pueda despertar a las cuestiones subjetivas del universo de la persona que vive con VIH y estas respetadas en la práctica humanizada, con el objetivo de incentivar el tratamiento continuo para el control de la infección y promover la calidad de vida.