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Roick J, Esser P, Hornemann B, Ernst J. Control beliefs as mediators between education and quality of life in patients with breast, prostate, colorectal, and lung cancer: a large register based study. BMC Psychol 2024; 12:382. [PMID: 38982524 PMCID: PMC11232264 DOI: 10.1186/s40359-024-01867-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 06/21/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE Control beliefs have been found to influence adaption to a cancer diagnosis. This study explored interrelationships among education, control beliefs, and health-related quality of life (HRQoL) in patients with breast, prostate, colorectal, and lung cancer and tested weather control beliefs act as mediators. METHODS Six hundred and five patients with breast (n = 205), prostate (n = 205), colorectal (n = 124), and lung (n = 71) cancer from two German cancer registries answered standardized questionnaires. Response rate was 54%. HRQoL was assessed with the EORTC QLQ-C30 core questionnaire and control beliefs (internal, external, and fatalistic) were evaluated using the IPC-questionnaire. Education was measured on a scale ranging from 1 to 8. Data were analyzed using multiple mediation models. RESULTS There was a positive correlation between education and HRQoL. Internal beliefs were positive and external beliefs were negative correlated with HRQoL. Internal control beliefs mediated the relationship between education and global health-related quality of life (.299, CI .122, .531), physical functioning (.272, CI .110, .486), emotional functioning (.325, CI .120, .578), and pain (-.288, CI - .558, - .094). External and fatalistic control beliefs did not act as mediators. CONCLUSION Patients with low education feel they have less control over their cancer disease and consequently a poorer health-related quality of life.
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Affiliation(s)
- Julia Roick
- Department of Sport and Health Sciences, Chair for Social Determinants of Health, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Beate Hornemann
- Department of Psychooncology, University Cancer Center (NCT/UCC), University Hospital Carl Gustav Carus, Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
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Medved Kendrick H. Are religion and spirituality barriers or facilitators to treatment for HIV: a systematic review of the literature. AIDS Care 2016; 29:1-13. [PMID: 27410058 DOI: 10.1080/09540121.2016.1201196] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Much attention has been given to the relationship between religion/spirituality (R/S) and HIV in recent years, but comparatively little has been explored in regard to R/S and HIV testing, retention in care, and adherence to medication. Religious views concerning HIV risk behavior pose challenges to communication and education about sexual health in religious communities and may serve as barriers to HIV treatment and care. Conversely, religious coping and spiritual well-being, as well as social support could serve as facilitators to HIV treatment and care. This study aims to fill a gap in the literature by addressing the following questions: (1) what dimensions of R/S have been found to be factors associated with HIV outcomes?; (2) which R/S factors function as barriers or facilitators to care among people living with HIV (PLWH)?; and (3) which R/S factors, if any, vary across socio-demographic groups? Thirty-three empirical articles were identified for systematic review. Of the 33 empirical studies included, 24 studies found that at least one measure of R/S was associated with better adherence and clinical health outcomes. Twelve studies found at least one measure of R/S to be associated with poorer adherence and clinical health outcomes. Seven of the studies found at least one R/S measure to have no significant association with outcomes. Though all of the studies included in this review focused on R/S experiences of PLWH, there was very little consistency in regard to measurement of R/S. Studies in this review included a wide range of R/S measures, including beliefs, religious/spiritual practices, R/S coping, organizational religion, and many more. Of the 33 studies reviewed, only 9 focused on unique populations such as women, people with histories of substance abuse, immigrants, etc. Findings from this review highlight opportunities for more studies in various populations using standardized R/S measures.
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Affiliation(s)
- Haley Medved Kendrick
- a Department of Sociology , University of Alabama at Birmingham , Birmingham , AL , USA
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Gore-Felton C, Koopman C, Spiegel D, Vosvick M, Brondino M, Winningham A. Effects of Quality of Life and Coping on Depression among Adults Living with HIV/AIDS. J Health Psychol 2016; 11:711-29. [PMID: 16908468 DOI: 10.1177/1359105306066626] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This prospective study examined the effect of maladaptive coping strategies and psychological quality of life (QOL) on depression at two time points in a diverse sample of persons living with HIV/AIDS ( N = 85). The use of maladaptive coping strategies to deal with the stress of living with HIV/AIDS, particularly engaging in various kinds of avoidant behaviors, was significantly associated with greater depression at baseline and increased depression at three months. QOL was the single most important predictor of depression. In an effort to develop effective clinical methods aimed at decreasing depression among adults living with HIV, future studies need to focus on improving quality of life and increasing adaptive coping strategies associated with the stress of living with HIV/AIDS.
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Affiliation(s)
- Cheryl Gore-Felton
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Valdez AN, Rubin LH, Neigh GN. Untangling the Gordian knot of HIV, stress, and cognitive impairment. Neurobiol Stress 2016; 4:44-54. [PMID: 27981189 PMCID: PMC5146199 DOI: 10.1016/j.ynstr.2016.02.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/04/2016] [Accepted: 02/09/2016] [Indexed: 12/28/2022] Open
Abstract
As individuals live longer with HIV, this "graying of the HIV epidemic" has introduced a new set of challenges including a growing number of age and inflammation-related diseases such as cardiovascular disease, type II diabetes, cancer, and dementia. The biological underpinnings of these complex and co-morbid diseases are not fully understood and become very difficult to disentangle in the context of HIV and aging. In the current review we examine the contributions and interactions of HIV, stress, and cognitive impairment and query the extent to which inflammation is the linchpin in these dynamic interactions. Given the inter-relatedness of stress, inflammatory mechanisms, HIV, and cognitive impairment, future work will either need to address multiple dimensions simultaneously or embrace the philosophy that breaking the aberrant cycle at any one point will subsequently remedy the other related systems and processes. Such a single-point intervention may be effective in early disease states, but after perpetuation of an aberrant cycle, adaptations in an attempt to internally resolve the issue will likely lead to the need for multifaceted interventions. Acknowledging that HIV, inflammation, and stress may interact with one another and collectively impact cognitive ability is an important step in fully understanding an individual's complete clinical picture and moving towards personalized medicine.
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Key Words
- ACTH, Adrenocorticotropic hormone
- AIDS, Acquired immune deficiency syndrome
- ANI, Asymptomatic neurocognitive impairment
- ART, Antiretroviral therapy
- CBSM, Cognitive behavioral stress management
- CD4
- CNS, Central Nervous System
- CRP, C-reactive protein
- Cognition
- GALT, Gut-associated lymphoid tissue
- GR, Glucocorticoid receptor
- HAD, HIV-associated dementia
- HANA, HIV-associated, Non-AIDS
- HAND, HIV-associated neurocognitive disorders
- HIV
- HPA, Hypothalamic–Pituitary Adrenal
- HRV, Heart rate variability
- IL-12, Interleukin-12
- IL-18, Interleukin-18
- IL-1β, Interleukin-1β
- IL-2, Interleukin-2
- IL-6, Interleukin-6
- INSTIs, Integrase strand transfer inhibitors
- Inflammation
- LPS, Lipopolysaccharide
- LTP, Long-term potentiation
- MND, Mild neurocognitive disorder
- NNRTIs, Non-nucleoside reverse transcriptase inhibitors
- NRTIs, Nucleoside reverse transcriptase inhibitors
- PFC, Prefrontal cortex
- PIs, Protease inhibitors
- PLWH, People living with HIV
- PTSD, Posttraumatic stress disorder
- ROS, Reactive oxygen species
- Stress
- TNFα, Tumor necrosis factor alpha
- Vpr, Viral protein r
- WIHS, Women's Interagency HIV Study
- hsCRP, High-sensitivity C-reactive protein
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Affiliation(s)
- Arielle N Valdez
- Emory University Medical Scientist Training Program, USA; Emory University Department of Cell Biology, USA
| | - Leah H Rubin
- Univeristy of Illinois at Chicago, Department of Psychiatry, USA
| | - Gretchen N Neigh
- Emory University Department of Physiology, USA; Emory University Department of Psychiatry & Behavioral Sciences, USA
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Martin F, Russell S, Seeley J. Adjustment as process and outcome: Measuring adjustment to HIV in Uganda. J Health Psychol 2014; 21:872-83. [PMID: 25030794 DOI: 10.1177/1359105314541313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
'Adjustment' in health refers to both processes and outcomes. Its measurement and conceptualisation in African cultures is limited. In total, 263 people living with HIV and receiving anti-retroviral therapy in clinics in Uganda completed a translated Mental Adjustment to HIV Scale, depression items from the Hopkins checklist and demographic questions. Factor analysis revealed four Mental Adjustment to HIV factors of active coping, cognitive-social adjustment, hopelessness and denial/avoidance. Correlations with depression supported the Mental Adjustment to HIV's validity and the importance of active adjustment, while the role of cognitive adjustment was unclear. Factors were process or outcome focussed, suggesting a need for theory-based measures in general.
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Affiliation(s)
- Faith Martin
- University of Bath, UK University of East Anglia, UK
| | | | - Janet Seeley
- University of East Anglia, UK MRC/UVRI Uganda Research Unit on AIDS, Uganda
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Chauhan VS, Chaudhury S, Sudarsanan S, Srivastava K. Psychiatric morbidity in asymptomatic human immunodeficiency virus patients. Ind Psychiatry J 2013; 22:125-30. [PMID: 25013313 PMCID: PMC4085804 DOI: 10.4103/0972-6748.132925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. AIM The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. MATERIALS AND METHODS A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically. RESULTS Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. CONCLUSION Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness.
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Affiliation(s)
- V S Chauhan
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Pravara Institute of Medical Sciences (Deemed University), Rural Medical College, Loni, District Ahmednagar, Maharashtra, India
| | - S Sudarsanan
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Kalpana Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
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Chou CC, Chronister J, Chou CH, Tan S, Macewicz T. Responsibility attribution of HIV infection and coping among injection drug users in Malaysia. AIDS Care 2013; 25:1551-8. [PMID: 23713718 DOI: 10.1080/09540121.2013.793267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study explored responsibility attribution (RA) of HIV/AIDS infection (i.e., how an individual perceives the cause of their HIV/AIDS infection) and its relationship to coping styles among injection drug users (IDUs) with HIV/AIDS. In addition, this study investigated whether self-esteem, social support, and religiosity mediate the relationship between RA and coping styles of IDUs with HIV/AIDS. Participants were 201 adult IDUs with HIV/AIDS participating in the National Drug Rehabilitation Center in Malaysia. Five measures were used to assess the above constructs. Cluster analysis, analysis of variance, and mediation analyses were conducted. Results of this study indicated that IDUs with HIV/AIDS in Malaysia can be classified into four homogenous attribution groups: external, fatalistic, internal, and indeterminate. Mediator analyses revealed that combination of self-esteem, social support, and religiosity mediate the relationship between RA and coping behaviors. Clinicians working with IDUs with HIV/AIDS need to address the role of RA, self-esteem, religiosity, and social support as these psychosocial constructs are linked to coping with HIV/AIDS. Future researchers should investigate whether enhancing self-esteem, social support, and religiosity can promote active problem-solving coping and reduce the use of avoidance coping behaviors.
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Affiliation(s)
- Chih-Chin Chou
- a Department of Disability and Psychoeducational Studies , University of Arizona , Tucson , AZ , USA
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Martinez DA, Goggin K, Catley D, Gerkovich MM, Williams K, Wright J, Berkley-Patton J. Do coping styles mediate the relationship between substance use and educational attainment and antiretroviral adherence? AIDS Behav 2012; 16:2319-29. [PMID: 22673969 DOI: 10.1007/s10461-012-0222-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
There is a substantial body of literature that demonstrates that substance use and lower educational attainment are associated with poorer antiretroviral (ART) adherence, however, the nature of these relationships are not well understood. The purpose of this study was to explore whether coping styles mediate the relationship between substance use and educational attainment and ART adherence in order to better understand how these variables relate to adherence. The sample consisted of 192 HIV-positive patients (mean age = 41 years; 75.5 % male, 46.9 % heterosexual; 52.6 % with a high school/GED education or less) who were on ART. Path analysis revealed that active and avoidant coping significantly mediated the relationship between drug use and ART adherence. No form of coping was found to mediate the relationship between either binge drinking or educational attainment and adherence. Findings suggest that a focus on coping skills should be included in any multimodal intervention to increase ART adherence among HIV-positive drug using patients.
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Affiliation(s)
- David A Martinez
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St., Room 138, Kansas City, MO, 64110, USA.
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9
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Chipimo PJ, Tuba M, Fylkesnes K. Conceptual models for mental distress among HIV-infected and uninfected individuals: a contribution to clinical practice and research in primary-health-care centers in Zambia. BMC Health Serv Res 2011; 11:7. [PMID: 21219644 PMCID: PMC3024218 DOI: 10.1186/1472-6963-11-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Accepted: 01/10/2011] [Indexed: 11/11/2022] Open
Abstract
Background Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms. Methods Qualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies. Results Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection. Conclusions Patient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals.
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Affiliation(s)
- Peter J Chipimo
- University of Zambia, School of Medicine, Department of Community Medicine, Box 50110, Lusaka, Zambia.
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10
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Kuntsche S, Knibbe RA, Gmel G. A step beyond--the relevance of depressed mood and mastery in the interplay between the number of social roles and alcohol use. Addict Behav 2010; 35:1013-20. [PMID: 20643507 DOI: 10.1016/j.addbeh.2010.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 05/20/2010] [Accepted: 06/14/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The present study examines whether depressed mood and external control mediate or moderate the relationship between the number of social roles and alcohol use. PARTICIPANTS The analysis was based on a national representative sample of 25- to 45-year-old male and female drinkers in Switzerland. METHOD The influence of depressed mood and external control on the relationship between the number of social roles (parenthood, partnership, employment) and alcohol use was examined in linear structural equation models (mediation) and in multiple regressions (moderation) stratified by gender. All analyses were adjusted for age and education level. RESULTS Holding more roles was associated with lower alcohol use, lower external control and lower depressed mood. The study did not find evidence of depressed mood or external control mediating the social roles-alcohol relationship. A moderation effect was identified among women only, whereby a protective effect of having more roles could not be found among those who scored high on external control. In general, a stronger link was observed between roles and alcohol use, while depressed mood and external control acted independently on drinking. With the exception of women with high external control, the study found no link between a higher number of social roles and greater alcohol use. CONCLUSION Our results indicate that drinking behaviours are more strongly linked to external control and depressed mood than they are to the number of social roles. The study also demonstrates that in any effective alcohol prevention policy, societal actions that enable individuals to combine more social roles play a central role.
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Panagopoulou E, Kersbergen B, Maes S. The Effects of Emotional (Non-)Expression in (Chronic) Disease: A Meta-Analytic Review. Psychol Health 2010. [DOI: 10.1080/08870440290025759] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ndlovu U, Ion A, Carvalhal A. "My children and my home": the most recent and challenging stressors of HIV-positive women. Arch Womens Ment Health 2010; 13:215-22. [PMID: 20182756 DOI: 10.1007/s00737-010-0148-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 01/08/2010] [Indexed: 11/24/2022]
Abstract
Because of negative health consequences and differences in exposure and vulnerability to stressful encounters, it is important to examine and understand the stressful experiences faced by women living with HIV. The goal of this study was to examine the most recent and challenging stressors faced and coping strategies adopted by a sample of women living with HIV. Using mixed methodology, narratives of six women's most recent and stressful experience and answers to the Ways of Coping questionnaire were collected and analysed. Two main themes arose from the stressor narratives: child-related concerns and housing issues. To address these stressors, each woman used a variety of coping strategies, the most common being seeking social support even when stressors were analysed separately according to their main themes. Implications of these findings within service provision are discussed.
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Affiliation(s)
- Uitsile Ndlovu
- The Ontario HIV Treatment Network, 600-1300 Yonge Street, Toronto, ON M4T 1X3, Canada.
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O'Brien KK, Davis AM, Strike C, Young NL, Bayoumi AM. Putting episodic disability into context: a qualitative study exploring factors that influence disability experienced by adults living with HIV/AIDS. J Int AIDS Soc 2009. [PMID: 19900284 PMCID: PMC2788343 DOI: 10.1186/1758-2652-12-30] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background An increasing number of individuals may be living with the health-related consequences of HIV and its associated treatments, a concept we term disability. However, the context in which disability is experienced from the HIV perspective is not well understood. The purpose of this paper is to describe the contextual factors that influence the experiences of disability from the perspective of adults living with HIV. Methods We conducted four focus groups and 15 face-to-face interviews with 38 men and women living with HIV. We asked participants to describe their health-related challenges, the physical, social and psychological areas of their life affected, and the impact of these challenges on their overall health. We also conducted two validity check focus groups with seven returning participants. We analyzed data using grounded theory techniques to develop a conceptual framework of disability for adults living with HIV, called the Episodic Disability Framework. Results Contextual factors that influenced disability were integral to participants' experiences and emerged as a key component of the framework. Extrinsic contextual factors included social support (support from friends, family, partners, pets and community, support from health care services and personnel, and programme and policy support) and stigma. Intrinsic contextual factors included living strategies (seeking social interaction with others, maintaining a sense of control over life and the illness, "blocking HIV out of the mind", and adopting attitudes and beliefs to help manage living with HIV) and personal attributes (gender and aging). These factors may exacerbate or alleviate dimensions of HIV disability. Conclusion This framework is the first to consider the contextual factors that influence experiences of disability from the perspective of adults living with HIV. Extrinsic factors (level of social support and stigma) and intrinsic factors (living strategies and personal attributes) may exacerbate or alleviate episodes of HIV-related disability. These factors offer a broader understanding of the disability experience and may suggest ways to prevent or reduce disability for adults living with HIV.
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Affiliation(s)
- Kelly K O'Brien
- Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Ontario, Canada.
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15
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O'Brien KK, Davis AM, Strike C, Young NL, Bayoumi AM. Putting episodic disability into context: a qualitative study exploring factors that influence disability experienced by adults living with HIV/AIDS. J Int AIDS Soc 2009; 12:5. [PMID: 19900284 DOI: 10.1186/1758-2652-2-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Accepted: 11/09/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An increasing number of individuals may be living with the health-related consequences of HIV and its associated treatments, a concept we term disability. However, the context in which disability is experienced from the HIV perspective is not well understood. The purpose of this paper is to describe the contextual factors that influence the experiences of disability from the perspective of adults living with HIV. METHODS We conducted four focus groups and 15 face-to-face interviews with 38 men and women living with HIV. We asked participants to describe their health-related challenges, the physical, social and psychological areas of their life affected, and the impact of these challenges on their overall health. We also conducted two validity check focus groups with seven returning participants. We analyzed data using grounded theory techniques to develop a conceptual framework of disability for adults living with HIV, called the Episodic Disability Framework. RESULTS Contextual factors that influenced disability were integral to participants' experiences and emerged as a key component of the framework. Extrinsic contextual factors included social support (support from friends, family, partners, pets and community, support from health care services and personnel, and programme and policy support) and stigma. Intrinsic contextual factors included living strategies (seeking social interaction with others, maintaining a sense of control over life and the illness, "blocking HIV out of the mind", and adopting attitudes and beliefs to help manage living with HIV) and personal attributes (gender and aging). These factors may exacerbate or alleviate dimensions of HIV disability. CONCLUSION This framework is the first to consider the contextual factors that influence experiences of disability from the perspective of adults living with HIV. Extrinsic factors (level of social support and stigma) and intrinsic factors (living strategies and personal attributes) may exacerbate or alleviate episodes of HIV-related disability. These factors offer a broader understanding of the disability experience and may suggest ways to prevent or reduce disability for adults living with HIV.
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Affiliation(s)
- Kelly K O'Brien
- Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Ontario, Canada.
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Bormann JE, Aschbacher K, Wetherell JL, Roesch S, Redwine L. Effects of faith/assurance on cortisol levels are enhanced by a spiritual mantram intervention in adults with HIV: a randomized trial. J Psychosom Res 2009; 66:161-71. [PMID: 19154859 PMCID: PMC2760973 DOI: 10.1016/j.jpsychores.2008.09.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Revised: 09/16/2008] [Accepted: 09/25/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Previous research among HIV-infected individuals suggests that spiritual well-being is inversely related to psychological distress and rates of disease progression. Use of a mantram, a spiritual word or phrase repeated frequently and silently throughout the day, has been associated with decreased psychological distress and increased spiritual well-being. This study compared the effects of 2 interventions-a spiritually-based mantram intervention versus an attention-matched control group-on faith/assurance and average salivary cortisol levels among HIV-infected individuals. METHODS Using a randomized design, HIV-infected adults were assigned to the intervention (n = 36) or control condition (n = 35). Faith scores and saliva (collected at 7 a.m., 11 a.m., 4 p.m., and 9 p.m.) were assessed at preintervention, postintervention, and 5-week follow-up. Path analyses tested competing models that specify both concurrent and sequential relationships between faith and average daily cortisol levels while comparing groups. RESULTS Faith levels increased among mantram participants from pre- to postintervention. Greater faith at preintervention was significantly associated with lower average cortisol at postintervention in the mantram group but not in the controls. The associations between faith at postintervention and cortisol levels at 5-week follow-up were significant among both groups but weaker than the pre- to postintervention association identified in the mantram group. CONCLUSIONS These results suggest the presence of lagged or antecedent consequent relationships between faith and cortisol, which may be enhanced by mantram use. Decreased cortisol could potentially benefit immune functioning among HIV-infected individuals.
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Affiliation(s)
- Jill E Bormann
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA.
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Hansen NB, Tarakeshwar N, Ghebremichael M, Zhang H, Kochman A, Sikkema KJ. Longitudinal effects of coping on outcome in a randomized controlled trial of a group intervention for HIV-positive adults with AIDS-related bereavement. DEATH STUDIES 2006; 30:609-36. [PMID: 16865824 DOI: 10.1080/07481180600776002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This study examined the longitudinal effects of coping on outcome one year following completion of a randomized, controlled trial of a group coping intervention for AIDS-related bereavement. Bereaved HIV-positive participants (N = 267) were administered measures of grief, psychiatric distress, quality of life, and coping at baseline, post-intervention, and at 4-, 8-, and 12-month follow-ups. Coping strategies directly impacted all outcome variables for both study conditions. Additionally, the coping intervention moderated the relationship between avoidant coping and the longitudinal course of grief and psychiatric distress, resulting in greater reductions in grief and distress for intervention participants after accounting for avoidant coping strategies.
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Affiliation(s)
- Nathan B Hansen
- The Consultation Center, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA.
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Abstract
AIM The aim of this paper was to discuss a substantive theory on the dynamics of hope in adults living with the human immunodeficiency virus/acquired immune deficiency syndrome. BACKGROUND Existing literature describes how the dynamics of hope have profound connections with human essence and life, wellbeing and health, suffering and illness, and nursing care, in general as well as in the context of human immunodeficiency virus/acquired immune deficiency syndrome. METHOD The data consisted of five original articles describing the dynamics of hope in people living with human immunodeficiency virus/acquired immune deficiency syndrome and their significant others in Finland. Meta-synthesis was adapted to synthesize the original studies into a substantive theory. FINDINGS The core category that emerged was the dynamically alternating balance between interconnected hope, despair and hopelessness based on folding (closing down of) and unfolding (opening up of) possibilities with regard to the dynamics of hope in dealing with the changing self and life with human immunodeficiency virus/acquired immune deficiency syndrome. The dynamics of hope include the subprocesses of hope, despair and hopelessness. CONCLUSION The dynamics of hope in adults living with human immunodeficiency virus/acquired immune deficiency syndrome is an important phenomenon in nursing practice and nursing science. In taking care of people living with acquired immune deficiency syndrome, factors contributing to folding possibilities should be minimized, if possible, and factors contributing to unfolding possibilities should be nourished. The present study adds to the knowledge-base of nursing science about the dynamics of hope in people living with acquired immune deficiency syndrome. Future research should focus on testing this theory in people living with acquired immune deficiency syndrome.
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Affiliation(s)
- Jari Kylma
- Department of Nursing Science, University of Kuopio, Kuopio, Finland.
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Rogers ME, Hansen NB, Levy BR, Tate DC, Sikkema KJ. Optimism and Coping with Loss in Bereaved Hiv–Infected Men and Women. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2005. [DOI: 10.1521/jscp.24.3.341.65619] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Williams P, Narciso L, Browne G, Roberts J, Weir R, Gafni A. The prevalence, correlates, and costs of depression in people living with HIV/AIDS in Ontario: implications for service directions. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2005; 17:119-30. [PMID: 15899750 DOI: 10.1521/aeap.17.3.119.62903] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
As new technologies extend the lives of people living with HIV/AIDS (PHA), the need increases for services that optimize their quality-of-life cost effectively. This study of PHAs (n = 297) in Ontario, Canada, examined the prevalence of depression, and its association with quality-of-life, coping strategies, social support, and use of health and social services. Results showed that depression was widespread (54.2%) and largely unrelated to demographic characteristics, but associated with diminished health status, health-related quality-of-life, and coping strategies. Depressed PHAs used significantly more crisis health care and related services, and community-based HIV/AIDS service organizations (ASOs). Findings suggest quality-of-life of PHAs may be improved by expanding the capacity of ASO workers to recognize and address depression, including helping depressed PHA access appropriate medication and sustain medication regimes.
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21
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Grassi L, Buda P, Cavana L, Annunziata MA, Torta R, Varetto A. Styles of coping with cancer: The Italian version of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale. Psychooncology 2005; 14:115-24. [PMID: 15386782 DOI: 10.1002/pon.826] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Mental adjustment to cancer has been explored in a large body of the literature by using the Mental Adjustment to Cancer (MAC) scale. Problems in the factor structure of the scale and the need for refining the instrument have determined the development of the Mini-MAC. The aim of this study was to validate, according to a test-oriented approach, the Italian version of the Mini-MAC. Four hundred and thirty cancer patients in five centres in Northern Italy completed the Mini-MAC and the Brief Symptom Inventory (BSI). A subgroup of 153 patients filled out the instruments again within 3 months of the first assessment. The five original subscales (Fighting Spirit, Hopeless, Fatalism, Anxious Preoccupation and Cognitive Avoidance) showed acceptable levels of reliability (Cronbach alpha coefficients ranging from 0.55 to 0.80) although alphas were lower for the scales Fighting Spirit and Fatalism. Factor analysis (Varimax rotation) identified the same five factors with minor variations from the original version. Again, alpha coefficients were less robust for the factors Fighting Sprit and Fatalism. Hopeless and Anxious Preoccupation were significantly related to all the BSI psychological stress symptoms, including the Global Stress Index (GSI). Test-retest reliability showed no differences in the sub-scales scores between assessments.
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Affiliation(s)
- Luigi Grassi
- Psycho-Oncology Service, Section of Psychiatry, University of Ferrara, Ferrara, Italy.
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22
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Abstract
An increasing proportion of newly diagnosed AIDS cases is being reported among African American urban women. Recent research regarding the psychosocial and behavioral impact of a mother's HIV status on her uninfected children as well as a growing body of clinical evidence suggest that these children are extremely vulnerable and at risk for problems in psychosocial adjustment. The present paper reports the results of research designed to examine the pathways by which a mother's HIV-positive status affects the psychosocial adjustment of her uninfected school-age child. The principal predictor variables of the model are family sociodemographic characteristics, social support available to mother and child, HIV-related symptom distress in the mother, coping strategies of both mother and child, emotional distress of the mother, and quality of the parent-child relationship. The dependent variable is the psychosocial adjustment of the child. Data were collected on 147 mother-child dyads using standardized questionnaires and personal interviews. Eighty-six percent of the mothers were African American and over 96% were on public assistance. Structural equation modeling was used to test the proposed model of mother-child coping and adjustment. After adding three paths, the model had a good fit to the data (comparative fit index=0.94; root mean square estimate of error=0.06). Five model constructs accounted for 36% of the variance in child adjustment. The constructs in order of importance were maternal HIV-associated stressors, maternal emotional distress, child social support, child coping, and quality of parent-child relationship.
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Affiliation(s)
- Edythe S Hough
- Wayne State University College of Nursing, 5557 Cass Avenue, 48202, Detroit, MI, USA.
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Vosvick M, Koopman C, Gore-Felton C, Thoresen C, Krumboltz J, Spiegel D. Relationship of functional quality of life to strategies for coping with the stress of living with HIV/AIDS. PSYCHOSOMATICS 2003; 44:51-8. [PMID: 12515838 DOI: 10.1176/appi.psy.44.1.51] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors examined factors associated with four dimensions of functional quality of life (physical functioning, energy/fatigue, social functioning, and role functioning) in 142 men and women living with HIV/AIDS. Participants completed the Brief COPE inventory and the Medical Outcomes Study Health Survey, with HIV-relevant items added. Greater use of maladaptive coping strategies was associated with lower levels of energy and social functioning. Pain severe enough to interfere with daily living tasks was associated with a lower level of functional quality of life on all four quality of life dimensions. Interventions aimed at developing adaptive coping strategies and improving pain management may improve functional aspects of quality of life in persons living with HIV/AIDS.
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Affiliation(s)
- Mark Vosvick
- Department of Psychology, University of North Texas, Denton, TX 76203-1280, USA.
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Penedo FJ, Gonzalez JS, Davis C, Dahn J, Antoni MH, Ironson G, Malow R, Schneiderman N. Coping and psychological distress among symptomatic HIV+ men who have sex with men. Ann Behav Med 2003; 25:203-13. [PMID: 12763715 DOI: 10.1207/s15324796abm2503_06] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
This study evaluated relations among indicators of latent coping factors and psychological distress while incorporating measures of life stress and HIV illness related factors simultaneously among 211 symptomatic, HIV+ men who have sex with men (MSM). Participants were all assessed at a single time point. A structural equations model with latent factors for approach-oriented coping, avoidant-oriented coping, and psychological distress showed adequate fit. Furthermore, significant associations were identified among latent factors for approach-oriented coping, avoidance coping, and psychological distress; specifically, greater use of approach-oriented coping strategies and less use of avoidant-oriented coping were associated with lower levels of psychological distress. The model was revised to incorporate variables significantly associated with psychological distress (i.e., personal loss-total events, personal loss-controllability, and HIV-related symptoms). Relations among the coping and psychological distress latent factors remained significant. The results suggest that HIV+ MSM who do not have the coping skills or resources necessary to use adequate coping strategies to face the chronic burdens associated with HIV illness are likely to experience higher levels of psychological distress, independent of life stress and ongoing HIV-related symptoms.
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Affiliation(s)
- Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL 33134, USA.
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Ball J, Tannenbaum L, Armistead L, Maguen S. Coping and HIV infection in African-American women. Women Health 2002; 35:17-36. [PMID: 11942467 DOI: 10.1300/j013v35n01_02] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
HIV is impacting African-American women at alarming rates. Many of these women are poor and socially disadvantaged, resulting in a combination of stressors that impacts the quality of their lives. This study investigated whether coping style (i.e., problem-focused, emotion-focused) varies as a function of HIV status or stage of HIV-related illness. Secondly, we examined whether the use of a particular style is associated with three areas of functioning among HIV-infected women: general psychological distress, depressive symptomatology, and physical symptomatology. Ninety-nine HIV-infected women and 143 noninfected women completed measures assessing coping styles and functioning. No significant differences emerged in coping styles between the HIV-infected and noninfected women or for the groups when symptomatic women were examined separate from asymptomatic women. Greater emotion-focused coping was associated with less general psychological distress and depression specifically. Problem-focused coping interacted with illness stage to predict all areas of functioning. By identifying effective coping strategies among African-American women with HIV, mental health professionals can design empirical interventions that can help improve quality of life for these women.
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Affiliation(s)
- Joanna Ball
- Department of Psychology, Georgia State University, Atlanta 30303, USA
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26
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Depressive symptomatology in relation to emotional control and chronic pain in persons who are HIV positive. Rehabil Psychol 2002. [DOI: 10.1037/0090-5550.47.4.402] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Molassiotis A, Callaghan P, Twinn SF, Lam SW. Correlates of quality of life in symptomatic HIV patients living in Hong Kong. AIDS Care 2001; 13:319-34. [PMID: 11397334 DOI: 10.1080/09540120120043973] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This cross-sectional study assessed quality of life (QOL), coping styles, mood and uncertainty in illness in a non-random sample of 46 (out of 91 eligible) symptomatic HIV patients living in Hong Kong. QOL was moderate and the main concerns were related to the environmental aspects of QOL, spirituality and social relationships. Considerable mood disturbance was demonstrated in the sample, especially with regards to depression, fatigue and tension/anxiety. High levels of uncertainty in illness were also reported. A median split of the uncertainty score demonstrated that high uncertainty was related to lower levels of overall QOL (p = 0.04), higher psychological dysfunction (p = 0.05), worse adjustment with the environment (p < 0.001) and higher mood disturbance (p = 0.008). The sample predominantly used internal coping, which also correlated well with higher QOL scores. Through regression analysis it was shown that QOL could be predicted with the combined effects of uncertainty in illness and fatigue (adjusted R2 = 0.51, p < 0.001). Findings indicate that efforts should be directed towards improving QOL issues in the Chinese HIV patients and interventions could be introduced to alleviate those factors that were found to affect QOL. It is suggested that such interventions may include group or individual psychological therapies, management of fatigue and teaching patients more effective coping techniques.
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Affiliation(s)
- A Molassiotis
- Department of Nursing, Chinese University of Hong Kong, Hong Kong.
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28
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Avants SK, Warburton LA, Margolin A. How injection drug users coped with testing HIV-seropositive: implications for subsequent health-related behaviors. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2001; 13:207-218. [PMID: 11459357 DOI: 10.1521/aeap.13.3.207.19742] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
At entry into methadone maintenance treatment, 94 HIV-positive injection drug users (IDUs) completed the Coping Reponses Inventory, which asked them to "describe your feelings and experiences when you first learned you were HIV positive." Controlling for time since HIV testing, a reliance on avoidance coping following HIV testing was correlated with high levels of recent HIV risk behavior and poor health at entry into the study. The use of any coping strategy, particularly approach strategies, was related to medication adherence. Hierarchical regression analysis showed that avoidance coping accounted for a significant proportion of the variance in recent HIV risk behavior over and above that accounted for by the other variables. Other independent predictors of continued risk behavior were poor health, lack of social support, and low levels of HIV/AIDS knowledge. The need for interventions to help injection drug users (IDUs) cope subsequent to testing HIV seropositive is discussed.
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Affiliation(s)
- S K Avants
- Yale University School of Medicine, Division of Substance Abuse, New Haven, CT 06519, USA.
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29
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Grassi L, Mondardini D, Pavanati M, Sighinolfi L, Serra A, Ghinelli F. Suicide probability and psychological morbidity secondary to HIV infection: a control study of HIV-seropositive, hepatitis C virus (HCV)-seropositive and HIV/HCV-seronegative injecting drug users. J Affect Disord 2001; 64:195-202. [PMID: 11313086 DOI: 10.1016/s0165-0327(00)00244-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide ideation and psychological morbidity among HIV-positive patients has been the object of intense research. No study has investigated this area among injecting drug users (IDUs) infected with HIV and those infected with the hepatitis C virus (HCV), which has the same patterns of transmission of the HIV and may favour HIV replication and, possibly, HIV disease progression. METHODS In order to examine the prevalence and characteristics of suicide ideation and psychological morbidity associated with HIV and HCV infection in IDUs, a sample of HIV+ (n=81), HIV-/HCV+ (n=62) and HIV-/HCV- (n=152) subjects completed the Suicide Probability Scale (SPS), The Brief Symptom Inventory (BSI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS No difference was found between the groups as far as the mean scores on SPS and the risk of suicide (no-low risk category: 70.7% HIV+, 56.09% HCV+, 65.6% HIV-/HCV-). Estimated psychological morbidity (BSI) (26.9% HIV+, 27.1% HCV+, 25.4% of HIV-/HCV-) and BSI and HADS scores were comparable across the groups. CONCLUSIONS Suicide ideation, psychological morbidity and anxiety and depression symptoms seemed not to be directly influenced by HIV-serostatus. Careful assessment of psychological symptoms and suicide ideas among IDUs, as a vulnerable segment of population at risk of HIV and HCV infections, needs to be routinely carried out in clinical settings.
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Affiliation(s)
- L Grassi
- Department of Medical Sciences of Communication and Behavior, Section of Psychiatry, the Consultation-Liaison Psychiatric Service and Psychiatric Unit, University of Ferrara, C.so Giovecca 203, 44100, Ferrara, Italy.
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Chen ML, Deng SL, Chang HK. A comparison of the health locus of control and perceived social support between cancer and AIDS patients. Scand J Caring Sci 2001. [DOI: 10.1046/j.1471-6712.2001.1510092.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kelly B, Raphael B, Burrows G, Judd F, Kernutt G, Burnett P, Perdices M, Dunne M. Measuring psychological adjustment to HIV infection. Int J Psychiatry Med 2001; 30:41-59. [PMID: 10900560 DOI: 10.2190/fk4e-b9vj-k4ug-0h0r] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIMS A modified version of the Mental Adjustment to Cancer Scale (The Mental Adjustment to HIV Scale--MAHIVS) was used to evaluate patterns of psychological adjustment in response to HIV infection. METHODS A sample of 164 HIV positive homosexual/bisexual men were recruited across three Australian centers (79 asymptomatic (CDC II/III) and 85 symptomatic HIV infection (CDC IV)). Factor analysis of the MAHIVS was conducted and the predictive validity of the MAHIVS was investigated using the General Health Questionnaire, while The Diagnostic Interview Schedule was used to assess current and lifetime psychiatric disorder. Other measures of adjustment/coping were used to investigate the construct validity of the MAHIVS (neuroticism, locus of control, defense style). RESULTS Factor analysis of the MAHIVS detected four factors: Hopelessness, Fighting Spirit/Self Efficacy, Personal Control, and Minimization. Hopelessness and Fighting Spirit factors exhibited acceptable levels of internal consistency and validity, with significant correlations detected with psychological symptoms and significant association with other measures of psychological adjustment and personality. Fighting Spirit emerged as a potential indicator of psychological resilience, whereas Hopelessness was significantly associated with psychological symptoms and current major depression (but not past depression). CONCLUSIONS The findings indicate the validity of the MAHIVS and support the presence of common themes in the psychological adaptation to life-threatening illness that can be detected across disease categories and groups.
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Affiliation(s)
- B Kelly
- University of Queensland, Brisbane, Australia
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Kraus MR, Schäfer A, Csef H, Scheurlen M, Faller H. Emotional state, coping styles, and somatic variables in patients with chronic hepatitis C. PSYCHOSOMATICS 2000; 41:377-84. [PMID: 11015623 DOI: 10.1176/appi.psy.41.5.377] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The authors in a cross-sectional study examined 113 patients with chronic hepatitis C (CHC) without widely progressed or decompensated liver disease. The patients were investigated for emotional state (depression, anxiety, coping styles) and somatic/sociodemographic variables. A high percentage of patients had positive scores for depression (22.4%) and anxiety (15.2%). Mode of acquisition (e.g., former drug abuse) and histological grade of liver damage had no significant influence on emotional state or coping strategies. Older patients (> or = 50 years) were significantly more depressed (P = 0.024). Patients with a recently diagnosed CHC (> 4 weeks, < 6 months) had significantly lower scores for depression (P = 0.003) and anxiety (P = 0.001) than the subgroup with a time interval since initial diagnosis of more than 5 years. Recently diagnosed CHC patients also showed the highest levels of problem-solving behavior. Patients who were advised not to undergo an interferon therapy were significantly more depressed (P = 0.001) and anxious (P = 0.028). Older patients with CHC and patients with a long period since CHC diagnosis or who were advised not to undergo interferon therapy should be carefully and regularly assessed for depression, anxiety, and inappropriate coping styles.
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Affiliation(s)
- M R Kraus
- Medizinische Poliklinik, University of Würzburg, Germany.
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