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Cho H, Li P, Ngien A, Tan MG, Chen A, Nekmat E. The bright and dark sides of social media use during COVID-19 lockdown: Contrasting social media effects through social liability vs. social support. COMPUTERS IN HUMAN BEHAVIOR 2023; 146:107795. [PMID: 37124630 PMCID: PMC10123536 DOI: 10.1016/j.chb.2023.107795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 04/13/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
There exist ongoing discussions regarding whether, when, or why heightened reliance on social media becomes benefits or drawbacks, especially in times of crisis. Using the concepts of social liability, social support, and cognitive appraisal theory, this study examines distinct theoretical pathways through which the relational use of social media has contrasting impacts on cognitive appraisals of and emotional responses to the COVID-19 lockdown. We collected online survey data from 494 social media users in the U.S. during the COVID-19 lockdown. The results based on structural equation modeling (SEM) showed double-edged social media effects. When social media use results in perceived social support, it has a favorable impact on coping appraisals of the COVID-19 lockdown. This, in turn, is associated with lower levels of negative affective responses, such as anger, anxiety, and loneliness. In contrast, when social media use results in increased social liability (i.e., obligation to provide support to others), it negatively impacts cognitive appraisals and affective responses. The study makes significant contributions by unpacking two distinct theoretical mechanisms underlying social media effects: particularly social liability which has been underexplored but was found to be an essential concept to explain the dualistic impact of social media.
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Affiliation(s)
- Hichang Cho
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Pengxiang Li
- School of Journalism and Communication, Minzu University of China, China
| | - Annabel Ngien
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Marion Grace Tan
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Anfan Chen
- Chinese University of Hong Kong, Hong Kong
| | - Elmie Nekmat
- Department of Communications and New Media, National University of Singapore, Singapore
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Associations between Maternal and Infant Illness and the Risk of Postpartum Depression in Rural China: A Cross-Sectional Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249489. [PMID: 33352886 PMCID: PMC7765791 DOI: 10.3390/ijerph17249489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022]
Abstract
This study explored how maternal and infant illness correlated with the risk of postpartum depression in the Chinese Qinba Mountains region. In total, 131 villages comprising 435 families with infants (≤6 months old) were randomly sampled. We collected data on maternal and infant illnesses and maternal health knowledge level. The Depression, Anxiety, and Stress Scale-21 was used to measure the risk of postpartum depression. We used descriptive statistics and multivariate logistic regression for the analysis. Infant overall health status was a risk factor for postpartum depression (odds ratio (OR) = 1.90, 95% Confidence Interval (95% CI) = 1.10~3.28), whereas maternal overall health status was not correlated with postpartum depression (OR = 1.36, 95% CI = 0.55~3.39). For specific illnesses, infants experiencing over two common illnesses in the past two weeks (OR = 1.98, 95% CI = 1.13~3.45) and mothers experiencing over two common pains within two weeks after delivery (OR = 1.77, 95% CI = 1.02~3.08) were risk factors for postpartum depression, whereas infants with mild and severe stunted growth, maternal C-section, and postpartum body mass index (normal or overweight) were not correlated with it (all p > 0.050). Maternal health knowledge was an important moderator of maternal and infant illnesses on the risk of postpartum depression. In conclusion, maternal and infant illness were essential factors for the risk of postpartum depression in a poor rural region in western China, which may be mainly affected by the feeling of uncertainty of illness. Improved maternal and infant health and enhanced maternal health knowledge might alleviate the risk of postpartum depression.
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Esteban-Gonzalo S, González-Pascual JL, Caballero-Galilea M, Esteban-Gonzalo L. Psychosocial Correlates of Mental Health and Well-Being During the COVID-19: The Spanish Case. Front Psychol 2020; 11:609815. [PMID: 33324307 PMCID: PMC7723862 DOI: 10.3389/fpsyg.2020.609815] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
Background The COVID-19 pandemic has hit almost all countries around the globe, seriously affecting the welfare of populations. Spain is especially hard-hit. In this context, the purpose of the present study is to analyze social, demographic, and economic correlates of mental health during the COVID-19 pandemic in the population residing in Spain. Method The sample of this cross-sectional study was comprised of 801 participants aged 18 or older and residing in Spain. Data collection was carried out during March and April 2020. Data of mental health (GHQ12) and well-being (Positive and Negative Affect Schedule) indicators, and those of a wide number of social, demographic, and economic variables were recorded. Linear regression models were built to value associations between mental health and social, demographic, and economic indicators. Results Mental health morbidity was higher in women, younger people, individuals with medium studies, people with fewer children, singles, students, and unemployed individuals. Positive affect was higher among women, people with a high level of studies, those not co-living with dependent seniors, the self-employed, the employed, and those working outside home. Negative affect was negatively associated with age and number of children and was higher among women, people with basic studies, singles, individuals co-living with dependent seniors, homemakers, and students. Conclusion The most vulnerable populations were found to be women, younger people, people with basic or medium studies, students and individuals with no remunerated activities, single populations, and those co-living with dependent seniors as well as those with a reduced number of children.
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Affiliation(s)
- Sara Esteban-Gonzalo
- Faculty of Biomedicine, Department of Psychology, Universidad Europea de Madrid, Madrid, Spain
| | | | | | - Laura Esteban-Gonzalo
- Faculty of Biomedicine, Department of Nursing, Universidad Europea de Madrid, Madrid, Spain.,Faculty of Medicine, Department of Nursing, Universidad Autónoma de Madrid, Madrid, Spain
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Psaros C, Smit JA, Mosery N, Bennett K, Coleman JN, Bangsberg DR, Safren SA. PMTCT Adherence in Pregnant South African Women: The Role of Depression, Social Support, Stigma, and Structural Barriers to Care. Ann Behav Med 2020; 54:626-636. [PMID: 32128556 PMCID: PMC7459185 DOI: 10.1093/abm/kaaa005] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Depression is a robust predictor of nonadherence to antiretroviral (ARV) therapy, which is essential to prevention of mother-to-child transmission (PMTCT). Women in resource-limited settings face additional barriers to PMTCT adherence. Although structural barriers may be minimized by social support, depression and stigma may impede access to this support. PURPOSE To better understand modifiable factors that contribute to PMTCT adherence and inform intervention development. METHODS We tested an ARV adherence model using data from 200 pregnant women enrolled in PMTCT (median age 28), who completed a third-trimester interview. Adherence scores were created using principal components analysis based on four questions assessing 30-day adherence. We used path analysis to assess (i) depression and stigma as predictors of social support and then (ii) the combined associations of depression, stigma, social support, and structural barriers with adherence. RESULTS Elevated depressive symptoms were directly associated with significantly lower adherence (est = -8.60, 95% confidence interval [-15.02, -2.18], p < .01). Individuals with increased stigma and depression were significantly less likely to utilize social support (p < .01, for both), and higher social support was associated with increased adherence (est = 7.42, 95% confidence interval [2.29, 12.58], p < .01). Structural barriers, defined by income (p = .55) and time spent traveling to clinic (p = .31), did not predict adherence. CONCLUSIONS Depression and social support may play an important role in adherence to PMTCT care. Pregnant women living with HIV with elevated depressive symptoms and high levels of stigma may suffer from low social support. In PMTCT programs, maximizing adherence may require effective identification and treatment of depression and stigma, as well as enhancing social support.
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Affiliation(s)
- Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Jennifer A Smit
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
- School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Nzwakie Mosery
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Kara Bennett
- Bennett Statistical Consulting, Inc., Ballston Lake, NY
| | - Jessica N Coleman
- Department of Psychology and Neuroscience, Duke University, Durham, NC
- Duke Global Health Institute, Duke University, Durham, NC
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University–Portland State University, Portland, OR
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL
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Depression and anxiety among pregnant women living with HIV in Kilimanjaro region, Tanzania. PLoS One 2019; 14:e0224515. [PMID: 31671160 PMCID: PMC6822761 DOI: 10.1371/journal.pone.0224515] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Mental health disorders in pregnant women living with HIV are associated with poor maternal and child outcomes, and undermine the global goals of prevention of mother-to-child transmission of HIV (PMTCT). This study aimed to determine prevalence of depression and anxiety and identify factors associated with these common mental health disorders among HIV-infeced pregnant women in Tanzania. METHODS We enrolled 200 pregnant women living with HIV from antenatal care clinics in the Kilimanjaro region. Women were eligible if they were in the second or third trimester of pregnancy and had been in PMTCT care for a minimum of one month. Data were collected via interviewer administered surveys. Participants self reported depression symptoms (Edinburgh Postnatal Depression Scale, EPDS) and anxiety symptoms (Brief Symptom Index, BSI). Multivariate logistic regression models examined factors associated with depression, anxiety, and comorbid depression and anxiety. RESULTS 25.0% of women met screening criteria for depression (EPDS ≥10). Depression was significantly associated with being single (aOR = 4.2, 95% CI = 1.1-15.5), food insecurity (aOR = 2.4, 95% CI = 1.0-6.4), and HIV shame (aOR = 1.2, 95% CI = 1.1-1.3). 23.5% of participants met screening criteria for anxiety (BSI ≥1.01). Anxiety was associated with being single (aOR = 3.6, 95%CI = 1.1-11.1), HIV shame (aOR = 1.1, 95% CI = 1.1-1.2) and lifetime experience of violence (aOR = 2.3, 95% CI = 1.0-5.1). 17.8% of the sample met screening criteria for both depression and anxiety. Comorbid depression and anxiety was associated with being single (aOR = 4.5, 95%CI = 1.0-19.1), HIV shame (aOR = 1.2, 95%CI = 1.1-1.3) and lifetime experience of violence (aOR = 3.4, 95% CI = 1.2-9.6). CONCLUSION Depression and anxiety symptomatology was common in this sample of pregnant women living with HIV, with a sizable number screening positive for comorbid depression and anxiety. In order to successfully engage women in PMTCT care and support their well-being, strategies to screen for mental health disorders and support women with mental illnesses are needed.
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Abstract
OBJECTIVE To evaluate the state of the science on uncertainty in high-risk pregnancy and identify factors that influence uncertainty in women diagnosed with a high-risk pregnancy. DATA SOURCES Primary research articles from CINAHL, Ovid, MEDLINE, Scopus, and PsycINFO written in English, without date restrictions. STUDY SELECTION Nineteen articles were identified, including 14 qualitative studies and 5 quantitative studies. DATA EXTRACTION This integrative review was guided by Whittemore and Knafl's methodology. Studies were graded on level and quality of evidence as per Dearholt, Dang, and Sigma Theta Tau International. DATA SYNTHESIS Studies were synthesized by using constant comparative methods according to factors influencing, outcomes of, and management of uncertainty. CONCLUSION Uncertainty is a prominent theme in women experiencing a high-risk pregnancy. Uncertainty is influenced by various personal, pregnancy-related, demographic, and healthcare-related factors. Findings may offer insight and empathy for healthcare professionals. Nurses who understand significance of uncertainty in adjusting to two conflicting life events have the opportunity to help women in their understanding of a high-risk diagnosis during pregnancy through anticipatory guidance. Future research is needed to explore factors affecting uncertainty and to understand the experience of high-risk pregnancy to develop interventions aimed at mitigating uncertainty in high-risk pregnant women.
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Wallace DD, Pack A, Uhrig Castonguay B, Stewart JL, Schalkoff C, Cherkur S, Schein M, Go M, Devadas J, Fisher EB, Golin CE. Validity of Social Support Scales Utilized Among HIV-Infected and HIV-Affected Populations: A Systematic Review. AIDS Behav 2019; 23:2155-2175. [PMID: 30276703 DOI: 10.1007/s10461-018-2294-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Social support enhances self-management and prevention of behaviors and is typically assessed using self-report scales; however, little is known about the validity of these scales in HIV-infected or affected populations. This systematic review aims to identify available validated social support scales used in HIV-infected and HIV-affected populations. A systematic literature search using key search terms was conducted in electronic databases. After rounds abstract screenings, full-text reviews, and data abstraction 17 studies remained, two of which assessed multiple social support scales, which increased number of scales to 19. Most scales assessed positive social support behaviors (n = 18). Most scales assessed perceived social support (n = 14) compared to received social support. Reliability ranged from 0.67 to 0.97. The most common forms of validation reported were content validity and construct validity and the least was criterion-related validity. Future research should seek to build evidence for validation for existing scales used in HIV-infected or HIV-affected populations.
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Abstract
BACKGROUND The concept of uncertainty in illness has been well described and applied to many different areas of nursing and other disciplines. Specifically, parental uncertainty in illness of an infant is a meaningful concept that has specific attributes and implications. A current concept analysis that considers the changing healthcare setting, historical conceptual inconsistencies, and a lack of information concerning parents of infants is needed. PURPOSE To identify essential antecedents, attributes, and consequences of parental uncertainty in illness using Rodgers' Evolutionary Concept Analysis method. METHODS A literature search was conducted using PubMed, CINAHL, and PsycInfo. The following keywords were used in combination using the Boolean terms "AND" and "OR": parental uncertainty; infants; parental uncertainty in illness; preterm infants; parent; uncertainty. INCLUSION CRITERIA articles published between 2000 and 2017 and published in English. The search included 38 articles published from 2000 to 2017 with a specific focus on parental uncertainty in illness. FINDINGS Parental uncertainty in illness of an infant is a paradoxical, cognitive, and emotional experience in which there is an inability to create meaning and may cause disruption in parental role development. IMPLICATIONS FOR PRACTICE Nursing care of parents with ill infants and children must include sensitivity to parents' experiences of uncertainty in illness. Nurses are uniquely positioned to normalize parental uncertainty and facilitate healthy coping.
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Lee SO, Kim MJ. Impact of Maternal Uncertainty on Coping: Experiences from a General Hospital Pediatric Ward. CHILD HEALTH NURSING RESEARCH 2018. [DOI: 10.4094/chnr.2018.24.4.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Momplaisir FM, Storm DS, Nkwihoreze H, Jayeola O, Jemmott JB. Improving postpartum retention in care for women living with HIV in the United States. AIDS 2018; 32:133-142. [PMID: 29194122 PMCID: PMC5757672 DOI: 10.1097/qad.0000000000001707] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 02/06/2023]
Abstract
: Research findings have consistently demonstrated that women living with HIV in the United States and globally experience declines in medication adherence and retention in care after giving birth. A number of studies have identified factors associated with postpartum retention in care, but the evidence base for interventions to address the problem and close this gap in the HIV care continuum is limited. Furthermore, the majority of studies have been conducted in low-resource or moderate-resource countries and may be less applicable or require adaptation for use in high resource countries. In the United States, up to two-thirds of women drop out of care after delivery and are unable to maintain or achieve viral suppression postpartum, at a time when maternal and pediatric health are closely linked. We conducted a critical review of the literature to identify existing gaps regarding maternal retention in the United States and conceptualize the problem through the lens of the integrated and ecological models of health behavior. This review describes existing barriers and facilitators to retention in HIV care postpartum from published studies and suggests steps that can be taken, using a multilevel approach, to improve maternal retention. We propose five core action steps related to increasing awareness of the problem of poor postpartum retention, addressing needs for improved care coordination and case management, and using novel approaches to adapt and implement peer support and technology-based interventions to improve postpartum retention and clinical outcomes of women living with HIV.
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Affiliation(s)
- Florence M. Momplaisir
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Deborah S. Storm
- Fairfield, California, (formerly François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey
| | - Hervette Nkwihoreze
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Olakunle Jayeola
- Department of Environmental and Occupational Health, Dornsife School of Public Health at Drexel University
| | - John B. Jemmott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Byun E, Riegel B, Sommers M, Tkacs N, Evans L. Effects of Uncertainty on Perceived and Physiological Stress in Caregivers of Stroke Survivors: A 6-Week Longitudinal Study. J Gerontol Nurs 2017; 43:30-40. [PMID: 28661542 DOI: 10.3928/00989134-20170623-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 05/18/2017] [Indexed: 11/20/2022]
Abstract
Caregivers' stress following a family member's stroke is likely accentuated by its associated uncertainty. The purpose of the current study was to examine the effect of uncertainty on caregivers' perceived and physiological stress (i.e., salivary cortisol). A prospective, longitudinal observational study was conducted with a convenience sample of 40 caregivers and stroke survivors recruited from acute care settings. Linear mixed models were used. Greater uncertainty was associated with higher perceived stress (p < 0.001), but not with physiological stress (p = 0.32 on waking, p = 0.06 evening), over the first 6 weeks post-stroke. A significant association between uncertainty and evening salivary cortisol level was found at 6 weeks post-stroke (p = 0.009). Recognition of uncertainty early in the caregiving period and targeted interventions may be useful in reducing perceived stress for this group. [Journal of Gerontological Nursing, 43(11), 30-40.].
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Technau KG, Kuhn L, Coovadia A, Murnane PM, Sherman G. Xpert HIV-1 point-of-care test for neonatal diagnosis of HIV in the birth testing programme of a maternity hospital: a field evaluation study. Lancet HIV 2017; 4:e442-e448. [PMID: 28711526 PMCID: PMC5623143 DOI: 10.1016/s2352-3018(17)30097-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Point-of-care testing (POCT) among HIV-exposed infants might improve linkage to care relative to laboratory-based testing (LABT). We evaluated HIV-1 POCT at birth in the context of universal LABT in a maternity hospital and describe our implementation experience. METHODS We did a field evaluation study between Oct 1, 2014, and April 30, 2016, at the urban Rahima Moosa Mother and Child Hospital (RMMCH), Johannesburg, South Africa. We aimed to sample consecutive neonates at birth with POCT (Cepheid Xpert HIV-1 Qualitative test) and compared results with those of LABT (Roche COBAS TaqMan HIV-1 Qualitative test) with respect to performance in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's κ coefficient, result return, antiretroviral treatment (ART) initiation, and coverage. FINDINGS 18 268 women delivered livebirths at RMMCH and 4267 (23%) were HIV-positive with 4336 HIV-exposed neonates delivered. Mothers of 4141 (96%) HIV-exposed neonates were offered infant birth testing. Mothers of 4112 (99%) neonates consented. In 78 neonates with consent (2%), a test was not done due to early neonatal death (n=13), mother departing before venesection, or staff unavailability. Among 3970 infants who had LABT, 57 (1%) tested positive, 3906 (99%) tested negative, two (<1%) were indeterminate, and five (<1%) had an error result. 2238 (56%) of these infants had concurrent POCT. POCT detected all 30 HIV-infected neonates (sensitivity 100%; 95% CI 88·4-100) with two additional false-positive results (specificity 99·9%; 99·7-100). All positive and 96·2% of negative POCT results were returned compared with 88·9% of positive and 52·8% of negative LABT results. Although every POCT required 90 min of instrument time, 2·6 h (IQR 2·3-3·1) elapsed between phlebotomy and result return. In days, median time of result return for POCT was 1 day, significantly earlier than 10 days for LABT (p<0·0001). ART was initiated in 30 neonates (100%) with positive POCT compared with 24 (88·9%, p=0·10) of 27 infants who had LABT only, with initiation occurring a median of 5 days earlier in the POCT group (p<0·0001). POCT implementation required additional staff and weekend cover. INTERPRETATION Compared with LABT, POCT was associated with good performance, improved rates of result return, and reduced time to ART initiation. Resources needed to integrate POCT into a routine birth testing programme require further evaluation. FUNDING National Institutes of Health.
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Affiliation(s)
- Karl-Günter Technau
- Empilweni Services and Research Unit, Department of Paediatrics & Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Louise Kuhn
- Gertrude H Sergievsky Center, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ashraf Coovadia
- Empilweni Services and Research Unit, Department of Paediatrics & Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pamela M Murnane
- Empilweni Services and Research Unit, Department of Paediatrics & Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Gertrude H Sergievsky Center, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Gayle Sherman
- Centre for HIV and STI, National Institute for Communicable Diseases, Johannesburg, South Africa
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Biobehavioral Framework of Symptom and Health Outcomes of Uncertainty and Psychological Stress in Parkinson Disease. J Neurosci Nurs 2017; 48:E2-E9. [PMID: 27824807 DOI: 10.1097/jnn.0000000000000244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parkinson disease (PD) is a debilitating, progressive neurodegenerative disorder characterized by complex motor and nonmotor symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. The unpredictable nature of PD and the inability to halt or slow disease progression may result in uncertainty and psychological stress. Uncertainty and psychological stress have important implications for symptom and health outcomes in PD. Uncertainty and psychological stress have been shown to worsen symptoms, functional capacity, and quality of life in chronic illnesses; however, the causal mechanisms have yet to be elucidated. We propose a biobehavioral framework for examining uncertainty and psychological stress in PD. The framework considers factors that may contribute to uncertainty and neuroendocrine-immune mechanisms of uncertainty and psychological stress that may influence symptom and health outcomes in PD, for the ultimate purpose of improving symptom and disease progression, functional capacity, and quality of life.
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Byun E, Riegel B, Sommers M, Tkacs N, Evans L. Caregiving Immediately After Stroke: A Study of Uncertainty in Caregivers of Older Adults. J Neurosci Nurs 2016; 48:343-351. [PMID: 27824803 PMCID: PMC5117631 DOI: 10.1097/jnn.0000000000000238] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Caregivers of stroke survivors experience high rates of mental and physical morbidity. Stroke has sudden onset, and the outcome is not immediately known. Uncertainties surrounding the new caregiving role may not only necessitate major changes in the lives of family caregivers but also contribute to negative health outcomes for the caregiver. PURPOSE The purposes of this study were to describe caregiver uncertainty across the early weeks after a family member's stroke and to explore characteristics of caregivers and stroke survivors associated with that uncertainty. METHODS A prospective, longitudinal exploratory observational study was conducted with a convenience sample of 40 caregivers and older adult (≥65 years) stroke survivors recruited from urban acute care settings in the mid-Atlantic region. Caregivers were enrolled by 2 weeks poststroke (T1) and revisited 4 weeks later (T2). Uncertainty was measured usingthe Mishel Uncertainty in Illness Scale for Family Members. An unadjusted linear mixed model was computed to examine significant associations between each caregiver or stroke survivor characteristic and repeated measures of uncertainty. RESULTS Uncertainty at T1 (83.73 ± 23.47) was higher than reported in other caregiver populations and remained high 6 weeks poststroke (T2: 85.23 ± 23.94). Each of the following characteristics was independently associated with greater caregiver uncertainty: caregivers' older age (p = .019), being a spouse (p = .01), higher stress (p < .001), more depressive symptoms (p = .001), more comorbidities (p = .035), and poorer coping capacity (p = .002) and stroke survivors' recurrent stroke (p = .034), poorer functional status (p = .009), and insurance type (p = .008). CONCLUSIONS Caregivers experienced persistently high uncertainty during the first 6 weeks poststroke. Better understanding of uncertainty, its associated characteristics, and its outcomes may help clinicians identify caregivers at highest risk who may benefit from targeted interventions.
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Affiliation(s)
- Eeeseung Byun
- Department of Family Health Care Nursing, University of California San Francisco School of Nursing, 2 Koret Way, Box 0606, San Francisco, CA 94143
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104-4217, Tel: (215) 898-9927,
| | - Marilyn Sommers
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104-4217, Tel: (215) 746-8320,
| | - Nancy Tkacs
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104-4217, Tel: (215) 573-3045,
| | - Lois Evans
- University of Pennsylvania School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104-4217, Tel: (215) 898-2140,
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Wang K, Chen WT, Zhang L, Bao M, Zhao H, Lu H. Facilitators of and barriers to HIV self-management: Perspectives of HIV-positive women in China. Appl Nurs Res 2016; 32:91-97. [PMID: 27969059 PMCID: PMC5158022 DOI: 10.1016/j.apnr.2016.06.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/21/2016] [Accepted: 06/07/2016] [Indexed: 01/09/2023]
Abstract
AIMS The aim is to explore perceived facilitators of and barriers to HIV self-management for HIV-positive Chinese women. BACKGROUND Little is known about self-management among HIV-positive Chinese women in China. Understanding the experiences of this population is needed to promote self-management. METHODS 27 in-depth interviews were conducted in Beijing and Shanghai. Facilitators included families being supportive after disclosure, patients learning how to live with HIV, antiretroviral therapy (ART) adherence, and rediscovering the meaning of life. Several barriers were also identified, including lack of support, stigma, fatigue, and financial difficulty. RESULTS HIV disclosure is essential to obtaining necessary support. Ironically, disclosing to family members who stigmatize the disease may invite unwelcome responses. Helping HIV-positive women to decrease self-stigma and develop an effective way to disclose, if they choose to, is important. CONCLUSION Future interventions should focus on disclosure strategies development and self-management to prevent isolation, enhance social support, and decrease self-stigma.
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Affiliation(s)
- Kerong Wang
- HIV/AIDS Unit, Beijing Ditan Hospital, Capital Medical University, Beijing 100050, China
| | - Wei-Ti Chen
- School of Nursing, Yale University, Orange, CT 06477, USA
| | - Lin Zhang
- Departemnt of Nursing, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - MeiJuan Bao
- Departemnt of Nursing, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Hongxin Zhao
- HIV/AIDS Unit, Beijing Ditan Hospital, Capital Medical University, Beijing 100050, China.
| | - Hongzhou Lu
- Departemnt of Nursing, Shanghai Public Health Clinical Center, Shanghai 201508, China.
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Sajjadi M, Rassouli M, Bahri N, Mohammadipoor F. The correlation between perceived social support and illness uncertainty in people with human immunodeficiency virus/acquired immune deficiency syndrome in iran. Indian J Palliat Care 2015; 21:231-5. [PMID: 26009679 PMCID: PMC4441187 DOI: 10.4103/0973-1075.156508] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Illness uncertainty is a source of a chronic and pervasive psychological stress for people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWH), and largely affects their quality of life and the ability to cope with the disease. Based on the uncertainty in illness theory, the social support is one of the illness uncertainty antecedents, and influences the level of uncertainty perceived by patients. AIM To examine uncertainty in PLWH and its correlation with social support in Iran. MATERIALS AND METHODS This cross-sectional correlational study was conducted with 80 PLWH presenting to AIDS Research Center, Tehran, Iran in 2013. The data collected using illness uncertainty and social support inventories were analyzed through Pearson's correlation coefficient, Spearman's correlation coefficient, and regression analysis. RESULTS The results showed a high level of illness uncertainty in PLWH and a negative significant correlation between perceived social support and illness uncertainty (P = 0.01, r = -0.29). CONCLUSION Uncertainty is a serious aspect of illness experience in Iranian PLWH. Providing adequate, structured information to patients as well as opportunities to discuss their concerns with other PLWH and receive emotional support from their health care providers may be worthwhile.
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Affiliation(s)
- Moosa Sajjadi
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Maryam Rassouli
- Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Bahri
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemeh Mohammadipoor
- Nursing and Midwifery School, Lorestan University of Medical Sciences, Khorramabad, Iran
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Kapetanovic S, Dass-Brailsford P, Nora D, Talisman N. Mental health of HIV-seropositive women during pregnancy and postpartum period: a comprehensive literature review. AIDS Behav 2014; 18:1152-73. [PMID: 24584458 DOI: 10.1007/s10461-014-0728-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
With growing numbers of HIV-seropositive (HIV+) women of child-bearing age and increased access to effective clinical protocols for preventing mother-to-child transmission (MTCT) of HIV, mental health-related factors have become increasingly relevant due to their potential to affect the women's quality of life, obstetric outcomes and risk of MTCT. This review synthesizes evidence from 53 peer-reviewed publications examining mental health-related variables in pregnant and postpartum HIV+ women. The presentation of results is organized by the level of socioeconomic resources in the countries where studies were conducted (i.e., high-, middle-, and low-income countries). It is concluded that psychiatric symptoms, particularly depression, and mental health vulnerabilities (e.g., inadequate coping skills) are widespread among pregnant HIV+ women globally and have a potential to affect psychological well-being, quality of life and salient clinical outcomes. The current body of evidence provides rationale for developing and evaluating clinical and structural interventions aimed at improving mental health outcomes and their clinical correlates in pregnant HIV+ women.
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Affiliation(s)
- Suad Kapetanovic
- National Institutes of Health, National Institute of Mental Health, Bethesda, MD, USA,
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18
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[Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission]. Enferm Infecc Microbiol Clin 2014; 32:310.e1-310.e33. [PMID: 24484733 DOI: 10.1016/j.eimc.2013.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 12/02/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. METHODS We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. RESULTS AND CONCLUSIONS The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.).
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Hạnh NTT, Rasch V, Chi BK, Gammeltoft T. Prevention of mother-to-child transmission--precarious hopes and childbearing choices among HIV-infected women in a northern province of Vietnam. Women Health 2012; 52:485-502. [PMID: 22747185 DOI: 10.1080/03630242.2012.684372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The world over, increased access to treatment brings reproductive hope to women infected with HIV. Yet, despite the expanding availability of programs for prevention of mother-to-child transmission, HIV-positive women continue to face numerous problems and uncertainties in the realm of reproduction. The results reported here are derived from ethnographic research conducted in a northern province of Vietnam in 2007. The authors interviewed 32 HIV-positive women, exploring the hopes that they invested in prevention of mother-to-child transmission, and examining how this new technology enhanced the women's faith in their futures and childbearing capacities. Based on the findings, the authors discuss the new forms of gendered uncertainty that arise in the era of HIV/AIDS in Vietnam. They conclude that prevention of mother-to-child transmission, including the counseling offered by health providers, plays an important role in building and strengthening reproductive hopes for women living with HIV, while also generating new concerns.
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Affiliation(s)
- Nguyễn Thị Thúy Hạnh
- Department of Population, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No. 1 Ton That Tung Street, Khuong Thuong, Dong Da District, Hanoi, Vietnam.
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Donovan M, Palumbo P. Diagnosis of HIV: challenges and strategies for HIV prevention and detection among pregnant women and their infants. Clin Perinatol 2010; 37:751-63, viii. [PMID: 21078448 DOI: 10.1016/j.clp.2010.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Diagnosis and management of perinatally acquired human immunodeficiency virus infection poses many challenges in the areas of diagnosis, clinical and psychosocial intervention, and public health policy. Diagnostic tests have evolved over the years and many are currently used in the perinatal setting. Considerable progress has been realized in each of these areas through cooperative efforts of laboratory scientists, clinical teams, and stakeholders. However, there remain multiple challenges to address in the future.
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Affiliation(s)
- Margery Donovan
- Dartmouth-Hitchcock-Medical Center, Dartmouth Medical School, 1 Medical Center Drive, Lebanon, NH 03756, USA
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Abstract
AIM The aim of this study was to investigate factors determining HIV viral testing of infants in the context of Prevention of Mother-to-Child Transmission of HIV (PMTCT). METHODS Post-delivery HIV infected mothers 18 years and above with babies aged 3-6 months were interviewed on HIV viral testing of infants and factors associated with it. RESULTS Among 311 HIV infected women 61.7% had their infant tested for HIV between 4 and 8 weeks. Bivariate analyses found that older age of the mothers, lower depression scores, higher PMTCT knowledge, low PMTCT risk behaviour (maternal and infant nevirapine adherence, health facility delivery and exclusive formula feeding), HIV status disclosure and attending a support group were associated with PCR test participation. In multivariate analyses higher PMTCT knowledge, infant nevirapine adherence, and not exclusive breast feeding were associated with polymerase chain reaction test participation. CONCLUSION Various determinants of acceptance of participation in HIV viral testing of infants in the context of PMTCT were identified that can guide infant testing and diagnosis counselling and support services of PMTCT programmes.
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Affiliation(s)
- K Peltzer
- Human Sciences Research Council, Pretoria, South Africa.
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