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Mitchell MM, Tseng TY, Rubin LH, Cruz-Oliver D, Catanzarite Z, Clair CA, Moore DJ, Knowlton AR. Social support network factors associated with verbal fluency among vulnerable persons living with HIV. AIDS Care 2024; 36:358-367. [PMID: 37345842 PMCID: PMC10739652 DOI: 10.1080/09540121.2023.2216925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023]
Abstract
Vulnerable persons living with HIV (PLWH) are at high risk of cognitive impairment and challenges accessing quality social support in later life. Impaired verbal fluency (VF), a cognitive domain linked to HIV, could impede social support associated with health and well-being for already vulnerable PLWH. We examined the structure of social support, using latent class analysis, and the associations among quantity, specific forms and quality of social support and VF among PLWH. Participants enrolled in the BEACON study (n = 383) completed the Controlled Oral Word Association test (COWAT) and a social support network inventory. Latent class analysis with count variables was used to determine the number of classes of PLWH based on their social network characteristics. The majority of PLWH were male (61.4%) and African American (85.9%). Two distinct latent classes, with a major distinction in the number of network members who were female, knew participants' HIV status and HIV medication usage. Fewer support network members (β = -.13, p < 0.01), greater negative interactions (β = -.16, p < 0.01), and less positive interactions with network members (β = .15, p < 0.05) were significantly associated with lower COWAT scores. Comprehensive screening of high-risk PLWH and early intervention with those with cognitive impairment are important for addressing social support needs.
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Affiliation(s)
- Mary M. Mitchell
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - Tuo-Yen Tseng
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - Leah H. Rubin
- Departments of Neurology and Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
| | - Dulce Cruz-Oliver
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Zachary Catanzarite
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - Catherine A. Clair
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
| | - David J. Moore
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Amy R. Knowlton
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA
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Atanuriba GA, Apiribu F, Dzomeku VM, Amooba PA, Boamah Mensah AB, Afaya RA, Gazari T, Laari TT, Akor MH, Abnory L. "Some believe those who say they can cure it" perceived barriers to antiretroviral therapy for children living with HIV/AIDS: Qualitative exploration of caregivers experiences in tamale metropolis. PLoS One 2022; 17:e0275529. [PMID: 36194615 PMCID: PMC9531795 DOI: 10.1371/journal.pone.0275529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/19/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND HIV/AIDS is now a chronic disease, as adherence to anti-retrovirals impacts positively on the quality as well as expectancy of life. However, there exist multifaceted barriers to treatments for which children are most disadvantaged. Since Ghana subscribed to the "treat all" policy less percentage (25.5%) of children (2-14 years) living with HIV/AIDS have been enrolled on the antiretroviral program compared to other categories of the population by 2019. At present no study has explored these barriers to children living with HIV/AIDS enrollment and adherence. This study aims to explore the perceived barriers of caregivers of children living with HIV/AIDS in the Tamale Metropolis. METHODS We used descriptive phenomenology to explore the phenomena. Caregivers were purposively selected and interviewed till information became repetitive at the ninth (9th) caregiver. A semi-structured interview guide was used to collect data through face-to-face in-depth interviews which were audio recorded. The interviews lasted an average of 47 minutes. Audio interviews were transcribed verbatim (English) and translated back-to-back (Daghani) before analysis was done manually according to Collaizi's seven-step approach. We used the Guba and Lincoln guidelines to ensure the rigour of the study and its findings. Results are presented in themes and supported with quotes. RESULTS Six themes emerged from the analysis of the caregivers' transcripts; (1) denial of HIV/AID diagnosis, (2) stock-outs and privacy at the clinic, (3) busy schedule and poor support, (4) ignorance and alternative herbal cure, (5) stigma and discrimination, (6) transportation and distance. CONCLUSION Perceived barriers are multi-dimensional and encountered by all PLWHA, especially children. These barriers could derail the gains of HIV/AIDS interventions among children. Adherence counselling among caregivers alongside campaigns among faith and herbal healers are of grave concern to reduce myths of cure.
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Affiliation(s)
| | - Felix Apiribu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health, Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Veronica Millicent Dzomeku
- Department of Nursing, Faculty of Allied Health Sciences, College of Health, Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Philemon Adoliwine Amooba
- Department of Nursing, Faculty of Allied Health Sciences, College of Health, Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, Faculty of Allied Health Sciences, College of Health, Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Adongo Afaya
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Timothy Gazari
- School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Timothy Tienbia Laari
- Department of Nursing, Faculty of Allied Health Sciences, College of Health, Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Presbyterian Primary Health Care (PPHC), Bolgatanga, Ghana
| | - Moses Haruna Akor
- Nurses and Midwifery Training College-Damongo, Savanna Region, Ghana
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Park D, Morano C, Savage A. Understanding the role of social support and social support network for depression among informal dementia caregivers: a pilot clinical project on caregivers in NYC. SOCIAL WORK IN HEALTH CARE 2021; 60:599-613. [PMID: 34651558 DOI: 10.1080/00981389.2021.1987374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 08/23/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
This study aims to explore the association of depressive symptoms with the informal social support network reported by dementia caregivers participating in a community-based caregiver support program. Caregivers in a community-based dementia caregiver program completed an intake assessment, including the social support network instrument. Measures were completed for caregivers' social support network, using the social support network instrument (SSNI). Measures also included depression, caregiver strain, basic activities of daily living, instrumental activities of daily living, and demographics. Findings suggest the effects of social supports and social network on caregivers' depressive symptoms. Caregivers who had financial supports were less likely to have depressive symptoms. Also, the frequency of contact among social network variables predicted the decrease of depressive symptoms.
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Affiliation(s)
- Daejun Park
- Department of Social Work, Ohio University, Athens, OH, USA
| | - Carmen Morano
- School of Social Welfare, University at Albany, SUNY, Albany, NY, USA
| | - Andrea Savage
- Silberman School of Social Work, Hunter College, CUNY, New York, NY, USA
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Cruz-Oliver DM, Tseng TY, Mitchell MM, Catanzarite Z, Budhathoki C, Smith TJ, Rushton CH, Knowlton AR. Support Network Factors Associated With Naming a Health Care Decision-Maker and Talking About Advance Care Planning Among People Living With HIV. J Pain Symptom Manage 2019; 58:1040-1047. [PMID: 31446009 PMCID: PMC6915303 DOI: 10.1016/j.jpainsymman.2019.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 02/08/2023]
Abstract
CONTEXT Little attention has been given to social environmental factors associated with advance care planning (ACP) among African Americans or people living with advanced HIV (PLHIV). OBJECTIVES The present study aimed to identify support network factors that affect the likelihood of naming a decision-maker and of talking to family/friends and doctors about ACP among vulnerable PLHIV. METHODS PLHIV were recruited from a large urban HIV clinic. A social support network inventory was used to calculate number of persons available for various types of support. Characteristics of network members were also collected. Multivariable logistic regression models were fit to examine associations between social network factors and ACP discussion, adjusting for age, sex, education, and total number of network members. RESULTS The sample (N = 370) was mostly African American (95%), male (56%), and 48% had less than a high school education. Almost half the sample (48%) had talked to their family/friends or doctor about ACP, and 34% had named a medical decision-maker. Adjusted analysis revealed that talking about ACP with family/friends was associated with female sex and a larger closer support network who provided health information and physical assistance. Talking to doctors about ACP was associated with larger support networks who provided physical assistance but lower numbers from whom emotional support was received. Naming a decision-maker was associated with greater numbers of network members who provided emotional support, health information, and medication adherence reminders. CONCLUSION The findings revealed aspects of family/support network structures and caregiving function associated with ACP in a population with often vital yet vulnerable networks.
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Affiliation(s)
- Dulce M Cruz-Oliver
- Internal Medicine, Palliative Medicine Program, Johns Hopkins Hospital, Baltimore, Maryland, USA.
| | - Tuo-Yen Tseng
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Zachary Catanzarite
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chakra Budhathoki
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Thomas J Smith
- Palliative Medicine Program, JHMI, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Cynda H Rushton
- Berman Institute of Bioethics-Research Program, Johns Hopkins School of Nursing, Maryland, USA
| | - Amy R Knowlton
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Characteristics of Persons Living With HIV Who Have Informal Caregivers in the cART Age of the Epidemic. J Assoc Nurses AIDS Care 2017; 29:152-162. [PMID: 28941571 DOI: 10.1016/j.jana.2017.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/30/2017] [Indexed: 01/06/2023]
Abstract
People living with HIV (PLWH) are aging and many suffer with multimorbidities, making caregiving a relevant and important area of study. The purpose of our study was to understand the occurrence and role of informal caregivers in the current stage of the HIV epidemic. We conducted a Web-based survey with 1,373 PLWH to assess: how many had an informal, unpaid caregiver; the type of relationship with the informal caregiver; and the number of hours the caregiver provided support each day. Among respondents, 333 had an informal caregiver. Blacks, those with low income, individuals who ever had an AIDS diagnosis, those with basic cellphone service, and those living with other comorbid conditions were significantly more likely to have an informal caregiver. Given the demographic profile of those PLWH who were most likely to have caregivers, further study is needed to understand the needs of both caregivers and care recipients.
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