Self-esteem and optimism in men and women infected with HIV

Modeling the Impact of Race, Socioeconomic Status, Discrimination and Cognitive Appraisal on Mental Health Concerns Among Heavy Drinking HIV+ Cisgender MSM

Prior research has attributed mental health disparities between marginalized and non-marginalized populations to socioeconomic differences (i.e., education, income, employment), stigma (e.g., HIV-related discrimination), and cognitive appraisal (i.e., optimism, hostility, satisfaction with life), but the relations among these variables have not been examined concomitantly. The current study utilized structural equation modeling to examine how race and socioeconomic status impact mental health outcomes through increased exposure to stigma and more negative cognitive appraisals. Data came from a randomized controlled trial of motivational interviewing to address heavy drinking in cisgender men with HIV who have sex with men (n = 180). We found that self-reported discrimination experiences related to race/ethnicity, sexual orientation, and HIV status significantly mediated the relation between socioeconomic status and mental health concerns, whereas cognitive appraisal did not. These findings suggest that, among heavy drinking men with HIV who have sex with men, having low socioeconomic resources may increase exposure to discrimination which, in turn, may worsen mental health. Interventions that address social determinants, like socioeconomic disadvantage, and that enhance coping resources related to stigma, may have positive effects on mental health.ClinicalTrials.gov Identifier NCT01328743. Date of Registration 09/09/2019.

Clinician Optimism: Development and Psychometric Analysis of a Scale for Mental Health Clinicians

Clinician optimism is an important factor in achieving treatment outcomes in counselling contexts. Currently, there are no measures of mental health clinician optimism which report substantial psychometric validation. This study sought to assesses the validity and reliability of the Therapeutic Optimism Scale (TOS). 223 mental health clinicians working in a range of clinical settings were administered the TOS and convergent and discriminate validity were established. Test–retest reliability was established over a period of 1 month. The TOS was found to achieve acceptable reliability (Cronbach's α = .68) and yielded consistent scores over a one month period (r = .68, p < .01). Factor analyses revealed a 3-factor solution reflecting (1) General Treatment Outcome Expectancy, (2) Personal Treatment Outcome Expectancy, and (3) Pessimism. These findings support the utility of the TOS for research purposes, but further revision is recommended to enhance the reliability of the scale.

Translation of a comprehensive health behavior intervention for women living with HIV: the SMART/EST Women's Program

Translation of behavioral interventions into community settings for people living with HIV/AIDS can decrease the risk of comorbid conditions. This study was designed to determine whether a multiple health behavior intervention for women with HIV/AIDS could be effectively translated into community health centers (CHCs), delivered by CHC primary care staff. Health Resources and Services Administration-supported CHCs in Miami, FL, and the New York metropolitan area participated. Six health behavior domains were assessed at baseline, 6 months, and 12 months post-intervention: nutrition, physical activity, sexual risk behavior, alcohol use, drug use, and tobacco use. Behavioral outcomes were compared between research staff-led and CHC staff-led intervention groups. Research staff and CHC staff outcomes were similar for the majority of outcomes. Results indicate that complex, multicomponent behavioral interventions can be translated into community-based settings with existing CHC staff and can produce clinical effects similar to those achieved by research staff.

Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women

Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions.

Use of a brief version of the self-compassion inventory with an international sample of people with HIV/AIDS

The objective of this study was to extend the psychometric evaluation of a brief version of the Self-Compassion Scale (SCS). A secondary analysis of data from an international sample of 1967 English-speaking persons living with HIV disease was used to examine the factor structure, and reliability of the 12-item Brief Version Self-Compassion Inventory (BVSCI). A Maximum Likelihood factor analysis and Oblimin with Kaiser Normalization confirmed a two-factor solution, accounting for 42.58% of the variance. The BVSCI supported acceptable internal consistencies, with 0.714 for the total scale and 0.822 for Factor I and 0.774 for Factor II. Factor I (lower self-compassion) demonstrated strongly positive correlations with measures of anxiety and depression, while Factor II (high self-compassion) was inversely correlated with the measures. No significant differences were found in the BVSCI scores for gender, age, or having children. Levels of self-compassion were significantly higher in persons with HIV disease and other physical and psychological health conditions. The scale shows promise for the assessment of self-compassion in persons with HIV without taxing participants, and may prove essential in investigating future research aimed at examining correlates of self-compassion, as well as providing data for tailoring self-compassion interventions for persons with HIV.

Effect of breast augmentation mammoplasty on self-esteem and sexuality: a quantitative analysis

Although not extensively researched, psychologic factors have attributed to the growing number of performed breast augmentation procedures. The reported a 293% increase in the cases of cosmetic surgery since 1997. The percent increase in breast augmentation procedures performed in 2003 was up 12 (280 procedures up to 401). As the number of women seeking breast augmentation surgery continues to rise, an increasing number of healthcare professionals are likely to be confronted with questions, concerns, and complications that often accompany the procedure. Consequently, it is important that healthcare providers comprehend the degree to which self-esteem and/or sexuality may affect their patients' outcomes. Healthcare professionals must ascertain specific nursing skills and attitudes while caring for the cosmetic surgical patient. Therefore, the purpose of this research is to gain an understanding of the changes that occur in the levels of self-esteem and sexuality following the breast augmentation. Test of the study hypotheses 1 through 4 failed to be rejected, thereby supporting significant positive relationships between the variables. Statistical analysis of Hypothesis 5 found positive significance between breast augmentation, self-esteem, and the demographic variables-educational level and history of previous cosmetic surgery.

Bearing witness to suffering in AIDS: the testing of a substantive theory

AIDS volunteerism, as a response by those affected by loss associated with HIV/AIDS, has been described as an act of bearing witness. The theory "bearing witness to suffering in HIV/AIDS," proposes that AIDS volunteerism assists individuals affected by loss to increase their levels of hope, self-esteem, social support, and develop a sense of purpose in life (PIL). The purpose of this descriptive research was to determine if AIDS volunteerism, hope, self-esteem, and social support were predictive of PIL among individuals affected by loss from HIV/AIDS. Path analysis was used to analyze data. Hope, social support, and self-esteem were found to have significant positive effects on PIL and accounted for 66% of the total variance. The results from this study will be used to further develop the theory of bearing witness; this theory may be useful to develop and test interventions to relieve the suffering experienced by individuals affected by HIV/AIDS.

Health disparities among vulnerable populations: evolution of knowledge over five decades in Nursing Research publications

BACKGROUND

Considerable attention has been focused recently on conducting research on the health disparities experienced by some Americans as the result of poverty, ethnicity, and/or marginalized social status. Nursing research has a major role to play in developing this body of knowledge.

PURPOSE

The purpose of this paper is to review the contributions that Nursing Research made through its publications over the last five decades in developing the body of tested knowledge about health disparities in vulnerable groups and to analyze the progress made.

METHODS

Criteria for reviewing the literature were established. All Nursing Research publications between 1952 and 2000 were searched manually, indexes of each year's bound volumes were reviewed, and computer searches were conducted. Included in the review were research reports, research briefs, and methodology articles.

RESULTS

Seventy-nine papers were found that met basic criteria for inclusion. The number of relevant publications increased each decade, with a sizable increase in numbers since 1990, and may be related to the social, political, and economic climate of each decade. The research questions asked and the methods used became more complex over time.

CONCLUSIONS

Nursing Research has made a significant contribution in disseminating the body of tested knowledge related to the health disparities experienced by vulnerable populations and the methodologies associated with vulnerable populations research. Areas for future research are community-based studies, intervention studies that provide tangible resources, and methodologic approaches that involve participants in the research process.