Psychological morbidity and psychosocial variables associated with life-threatening illness: A comparative study of patients with HIV infection or cancer

Ineffective coping (00069): A Walker and Avant conceptual analysis

PURPOSE

To analyze the diagnostic concept of "ineffective coping" (00069) proposed by NANDA-I, using Walker and Avant's framework.

DATA SOURCES

The theoretical framework of Walker and Avant was used for the concept analysis. A search was performed in the Virtual Health Library portal using the keywords "ineffective coping" and "enfrentamento ineficaz."

DATA SYNTHESIS

According to the literature, ineffective coping is defined as an adoption of inadequate psychosocial and behavioral strategies in response to a set of contextual stressors that negatively affect well-being and lifestyle.

CONCLUSIONS

The concept created for ineffective coping has the potential to address the psychosocial elements associated with life experiences in the face of coping mechanisms.

IMPLICATIONS FOR NURSING PRACTICE

This analysis may contribute to the improvement of nursing care for patients experiencing difficult situations in their lives, as well as the challenges of nursing interventions that promote positive adaptation.

A preliminary study of spiritual self-schema (3-S+) therapy for reducing impulsivity in HIV-positive drug users

The purpose of this study was twofold. First, pretreatment correlations are presented among impulsivity, intoxicant use, HIV risk behavior, spirituality, and motivation in a sample of 38 HIV-positive drug users. Second, treatment outcomes are presented from a preliminary study of spiritual self-schema (3-S(+)) therapy - a manual-guided psychotherapy integrating cognitive and Buddhist psychologies - for increasing motivation for abstinence, HIV prevention, and medication adherence. Impulsivity was negatively correlated with spiritual practices and motivation for recovery, and was positively related to intoxicant use and HIV risk behavior. Relative to a standard care comparison condition, patients completing 3-S(+) therapy reported greater decreases in impulsivity and intoxicant use, and greater increases in spiritual practices and motivation for abstinence, HIV prevention, and medication adherence.

The deterioration and mobilization effects of trauma on social support: childhood maltreatment and adulthood military violence in a Palestinian community sample

OBJECTIVES

To show that exposure to childhood maltreatment deteriorates, whereas exposure to adulthood military violence mobilizes social support; second, to show that associations between traumatic events and mental health problems are mediated through social support and, subsequently, adulthood military violence is associated with low level and childhood maltreatment with high level of mental health symptoms; third, to explore whether the moderating (protecting) effect of sufficient and satisfactory social support would differ among victims of childhood maltreatment and adulthood military violence.

METHOD

The participants were a random-sample of Palestinian men and women (n=585) of 16-60 years of age. Exposure to military violence in adulthood was assessed by the Harvard Trauma Questionnaire (HTQ_I), and to childhood maltreatment by a 13-item questionnaire developed for the study. A Social Network Schedule was applied to assess the function, source, and satisfaction with social support, and the Revised SCL90-R Symptoms Checklist to assess mental health symptoms.

RESULTS

Findings supported our hypothesis that exposure to childhood maltreatment was associated with low levels of social support, whereas exposure to adulthood military violence was associated with high levels of social support. Contrary to our second hypothesis, both childhood maltreatment and adulthood military violence were associated with high levels of mental health symptoms. Finally, high level and satisfactory social support moderated the association between exposure to military violence in adulthood and mental health symptoms, but not between childhood maltreatment and mental health symptoms.

CONCLUSION

The findings emphasize that the nature of trauma, that is, whether familial or political, determines the availability of protective resources versus vulnerability, which should be considered when tailoring interventions to trauma victims.

INTERDEPENDENCE OF STRESS PROCESSES AMONG AFRICAN AMERICAN FAMILY MEMBERS: INFLUENCE OF HIV SEROSTATUS AND A NEW INFANT

This study makes a theoretical contribution to stress process research by using a systemic approach to contextualize individual outcomes within the framework of other family members' experience. Utilizing a mixed model approach, indicators of the stress process of urban low-income HIV(+) African American recent mothers were found to affect the psychological distress and perceived adequacy of coping of multiple other family members. These relationships were found to be strongest proximal to birth and to be exacerbated by HIV infection. Social support to the mother was found to have differential effects depending on whether it was from the immediate family or outside sources. HIV infection of the recent mother was found to affect family members both through relationships of the mother's stress process and through their own coping responses.

How injection drug users coped with testing HIV-seropositive: implications for subsequent health-related behaviors

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.

Coping styles and psychosocial-related variables in HIV-infected patients

The study examined the relationship between coping and psychosocial variables (psychological stress symptoms, locus of control, emotional repression, and social support) among 108 human immunodeficiency virus (HIV)-infected patients. The authors administered several tests, including one that measures fighting spirit and degree of hopelessness, to assess each patient's individual coping style. The patients who were adjusting well to their HIV-positive status tended to have a higher level of fighting spirit and lower degree of hopelessness than those patients who were not adjusting well to their HIV-positive status. A coping style based on incapacity to face and confront HIV infection was associated with symptoms of psychological stress, repression of anger, external locus of control, and low social support in the latter group. These patients showed symptoms indicating maladjustment to HIV infection (43% of the sample) and differed from the "noncases" (the well-adjusted patients) in that the former group reported inadequate coping responses (lower fighting spirit and higher hopelessness, fatalistic attitude, and anxious preoccupation) and poorer social support, and had a greater tendency to repress anger and express sadness. The data support the hypothesis that coping with HIV infection is a complex phenomenon involving multiple and interacting variables. Interventions aimed at improving the coping style for many HIV patients are needed.