1
|
Martínez N, Connelly CD, Pérez A, Calero P. Self-care: A concept analysis. Int J Nurs Sci 2021; 8:418-425. [PMID: 34631992 PMCID: PMC8488814 DOI: 10.1016/j.ijnss.2021.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives There is extensive literature from various disciplines on self-care, an important aspect of nursing intervention via evaluation and education, but its meaning remains unprecise due to the difficulty integrating the diverse definitions developed over time across disciplines. Therefore, it is vital to clarify the meaning of self-care and formulate the defining attributes, antecedents, and consequences to self-care. Methods Walker and Avant’s concept analysis approach was used to analyze the concept of self-care. A search of the literature was completed using the databases CINAHL, PubMed, and EBSCOhost for years 1975–2020; literature search included peer-review articles, full-text publications, and available in English. A total of 31 articles were reviewed, and saturation was reached. Results An extensive review of the literature revealed salient characteristics that reflected the most frequently used terms associated with the concept. Guided by Walker and Avant’s method, three defining attributes emerged as common themes: awareness, self-control, and self-reliance. Conclusions A clarified definition was identified: the ability to care for oneself through awareness, self-control, and self-reliance in order to achieve, maintain, or promote optimal health and well-being.
Collapse
Affiliation(s)
- Nicole Martínez
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Cynthia D Connelly
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Alexa Pérez
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Patricia Calero
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| |
Collapse
|
2
|
Symptom Profile and Technology Use of Persons Living With HIV Who Access Services at a Community-Based Organization in the Deep South. J Assoc Nurses AIDS Care 2020; 31:42-50. [PMID: 30908348 DOI: 10.1097/jnc.0000000000000078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Currently, the Southern United States has the highest rates of new HIV diagnoses with the largest percentage of people living with HIV (PLWH), and the most Americans dying from the disease. Given the increase of the HIV epidemic in the Deep South and the availability of evidence-based self-management tools for PLWH, we conducted an in-person survey in Birmingham, Alabama, to understand the symptom profile and the use of technology by PLWH. Muscle aches or joint pain was the most frequently (67%) reported symptom followed by fatigue, sleep difficulties, neuropathy, and depressive symptoms. We also assessed mobile technology use and ownership and found that 83.7% of persons own a smartphone, with most of these (79.9%) being Android users. Given these findings, there is strong scientific premise to support the feasibility of a mobile-delivered symptom self-management tool in the Deep South for improving health outcomes for PLWH.
Collapse
|
3
|
Meunier S, Roberge C, Coulombe S, Houle J. Feeling better at work! Mental health self-management strategies for workers with depressive and anxiety symptoms. J Affect Disord 2019; 254:7-14. [PMID: 31082629 DOI: 10.1016/j.jad.2019.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/05/2019] [Accepted: 05/06/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to identify self-management strategies that can be used in a workplace setting by workers living with depression and anxiety. METHODS A two-round Delphi study was conducted among three panels of experts: (1) employees living with anxiety or depression (n = 31); (2) managers of employees living with anxiety or depression (n = 12); and (3) researchers with expertise in workplace mental health (n = 15). Participants had to indicate whether each of 60 self-management strategies was applicable at work, and how useful each was for managing their symptoms while working. They could also reformulate or add strategies that were then evaluated in the second round. RESULTS A total of 60 existing and new self-management strategies were retained following the two rounds. Most useful strategies refer to the ability to set boundaries, maintain work-life balance, identify sources of stress and create positive relationships with supervisor and colleagues. Panels differed in their assessment of the usefulness of strategies focusing on employees' empowerment. LIMITATIONS Most participants were from Canada, limiting the generalizability of the results. CONCLUSION The self-management strategies identified in this study should be included in programs focusing on mental health at work and disseminated to employees living with depression and anxiety. Managers should take employee's perspective into account when searching for solutions to help them. Future research should use an inductive approach to identify strategies that are specifically related to the workplace setting. Quantitative studies are also needed to evaluate the effect of such strategies on work functioning.
Collapse
Affiliation(s)
- Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, P.O. Box 8888, Station Centre-ville, Montréal H3C 3P8, QC, Canada.
| | - Camille Roberge
- Department of Psychology, Université du Québec à Montréal, P.O. Box 8888, Station Centre-ville, Montréal H3C 3P8, QC, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, P.O. Box 8888, Station Centre-ville, Montréal H3C 3P8, QC, Canada
| |
Collapse
|
4
|
Thapa R, Yang Y, Bekemeier B. Menopausal symptoms and associated factors in women living with HIV in Cambodia. J Women Aging 2019; 32:517-536. [PMID: 30957680 DOI: 10.1080/08952841.2019.1593773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study investigated the prevalence and severity of menopausal symptoms and associated factors among women living with HIV in Cambodia. Menopause Rating Scale (MRS) assessed the menopausal symptoms, and SPSS Version 20.0 analyzed the data. The three most dominant symptoms, which were also rated the top three "severe" symptoms, were psychological: physical and mental exhaustion (91.5%), irritability (84.1%), and depressive mood (83.6%). The highest incidence was among the perimenopausal women. Severity of symptoms was associated with personal income, abortion, and intake of calcium supplements. Health-care professionals need to provide appropriate individualized interventions to maintain the social, emotional, and overall well-being of menopausal women living with HIV.
Collapse
Affiliation(s)
- Roshna Thapa
- School of Nursing, Chonbuk National University , Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Youngran Yang
- School of Nursing, Research Institute of Nursing Science, Chonbuk National University , Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Betty Bekemeier
- School of Nursing, University of Washington , Seattle, Washington, USA
| |
Collapse
|
5
|
Iribarren S, Siegel K, Hirshfield S, Olender S, Voss J, Krongold J, Luft H, Schnall R. Self-Management Strategies for Coping with Adverse Symptoms in Persons Living with HIV with HIV Associated Non-AIDS Conditions. AIDS Behav 2018; 22:297-307. [PMID: 28488165 DOI: 10.1007/s10461-017-1786-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
People living with HIV (PLWH) are living longer, but many are now affected by HIV-associated non-AIDS (HANA) conditions and their associated adverse symptoms. An online survey was conducted with 769 PLWH with HANA conditions in the US. Information was elicited on symptoms experienced, self-management strategies employed, and the helpfulness of these strategies. Open ended responses were collected for self-management strategies. A qualitative data analytic approach was used to organize the 4036 self-management strategies into thematic categories, with eight main categories emerging, including: taking medication, modifying activity, altering diet, seeking help, waiting, substance use, managing thoughts and attitudes, and altering the physical environment. Of the self-management strategy subcategories, social support was the most helpful self-management strategy with waiting/doing nothing being the least helpful approach. Findings can be used to inform the development of self-management interventions and to support health care professionals in recommending symptom self-management strategies to their patients.
Collapse
|
6
|
Schnall R, Liu J, Iribarren S. Information sources of self-care strategies for persons living with HIV. Int J Med Inform 2017; 111:1-6. [PMID: 29425620 DOI: 10.1016/j.ijmedinf.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 11/27/2017] [Accepted: 12/05/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES A number of studies have been conducted to identify the self-care strategies that are used by persons living with chronic illnesses to manage their symptoms, but little work has been done to identify the primary information source for these self-care strategies. METHODS We conducted an anonymous online survey with 1373 persons living with HIV to identify the self-care strategies they use to manage 28 commonly experienced symptoms. Following their report of their symptoms and self-care strategies, we asked an open-ended question to identify where the participant obtained the information. We applied iterative content analysis of the narrative data and multi-nominal regression to identify which demographic factors were significantly related to each information source category. RESULTS Respondents reported a total of 8539 information sources for their self-care strategies categorized as follows: Common sense/Self-experience, Healthcare professional, Internet, Literature, Multiple Sources, Social Support, and TV ads. CONCLUSIONS We found that respondents with no college education were significantly more likely to report the use of the Internet as the information source for their self-care strategies. On the other hand, males as compared to females were significantly less likely to use the Internet and significantly more likely to use TV ads.
Collapse
Affiliation(s)
- Rebecca Schnall
- Columbia University School of Nursing, New York, NY, United States.
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, United States
| | - Sarah Iribarren
- University of Washington School of Nursing, Seattle, WA, United States
| |
Collapse
|
7
|
Algoodkar S, Kidangazhiathmana A, Rejani PP, Shaji KS. Prevalence and Factors associated with Depression among Clinically Stable People Living with HIV/AIDS on Antiretroviral Therapy. Indian J Psychol Med 2017; 39:789-793. [PMID: 29284813 PMCID: PMC5733430 DOI: 10.4103/ijpsym.ijpsym_364_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Individuals with HIV/AIDS are prone for psychiatric/psychological morbidities. Many studies have reported significantly higher prevalence of depression in people living with HIV/AIDS (PLWHA's) when compared to general population. However, there are only very few studies looking at the prevalence of depression in patients on antiretroviral therapy (ART). OBJECTIVES To estimate the prevalance and factors associated with depression among clinically stable PLWHAs. MATERIALS AND METHODS We used a cross-sectional study design to estimate the prevalence of depression and factors associated with it among clinically stable PLWHAs with CD4 cell count >400 cells/mm3 and on ART for >2 years. We assessed 100 PLWHAs and diagnosed depression using ICD-10 diagnostic criteria. RESULTS The prevalence of depression was 30% in this sample. Female gender, lack of family support, and HIV-positive status of the spouse were associated with depression in this study. Multiple logistic regression analysis showed lack of family support significantly associated with depression. High prevalence of depression and its association with stressful life circumstances even in individuals stable on ART points toward need for psychosocial interventions to improve metal health and well-being of these patients.
Collapse
Affiliation(s)
- Sharanabasappa Algoodkar
- Department of Psychiatry, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
| | | | - P. P. Rejani
- Department of Community Medicine, Government Medical College, Thrissur, Kerala, India
| | - K. S. Shaji
- Department of Psychiatry, Government Medical College, Thrissur, Kerala, India
| |
Collapse
|
8
|
Abstract
Affect is an important indicator of quality of life; unfortunately, many people with Human Immunodeficiency Virus (HIV) disease are vulnerable to depression and negative affect. In a secondary data analysis, 50 HIV-positive and 50 HIV-negative adults between 30 and 65 years old completed several affective measures and rated their emotional health. The HIV-positive adults reported more negative affect than the HIV-negative adults. Older age, loneliness, and HIV stigma were associated with such negative affect.
Collapse
Affiliation(s)
- David E Vance
- University of Alabama at Birmingham, 1530 3rd Ave. South, Birmingham, AL 35294-2100, USA.
| |
Collapse
|
9
|
Spirituality Self-Care Practices as a Mediator between Quality of Life and Depression. RELIGIONS 2016. [DOI: 10.3390/rel7050054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
10
|
Villaggi B, Provencher H, Coulombe S, Meunier S, Radziszewski S, Hudon C, Roberge P, Provencher MD, Houle J. Self-Management Strategies in Recovery From Mood and Anxiety Disorders. Glob Qual Nurs Res 2015; 2:2333393615606092. [PMID: 28462317 PMCID: PMC5342854 DOI: 10.1177/2333393615606092] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 12/13/2022] Open
Abstract
Mood and anxiety disorders are the most prevalent mental disorders. People with such disorders implement self-management strategies to reduce or prevent their symptoms and to optimize their health and well-being. Even though self-management strategies are known to be essential to recovery, few researchers have examined them. The aim of this study is to explore strategies used by people recovering from depressive, anxiety, and bipolar disorders by asking 50 of them to describe their own strategies. Strategies were classified according to dimensions of recovery: social, existential, functional, physical, and clinical. Within these themes, 60 distinct strategies were found to be used synergistically to promote personal recovery as well as symptom reduction. Findings highlight the diversity of strategies used by people, whether they have depressive, anxiety, or bipolar disorders. This study underscores the importance of supporting self-management in a way that respects individual experience.
Collapse
Affiliation(s)
| | | | - Simon Coulombe
- Université du Québec à Montréal, Montréal, Québec, Canada
| | - Sophie Meunier
- Université du Québec à Montréal, Montréal, Québec, Canada
| | | | | | | | | | - Janie Houle
- Université du Québec à Montréal, Montréal, Québec, Canada
| |
Collapse
|
11
|
Lanier L, DeMarco R. A synthesis of the theory of silencing the self and the social ecological model: understanding gender, race, and depression in African American women living with HIV infection. AIDS Patient Care STDS 2015; 29:142-9. [PMID: 25614997 DOI: 10.1089/apc.2014.0116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The challenges that face African American women living with HIV are immense. African American women continue to be disproportionately infected and affected by this chronic and life-threatening infection in a complex context of individual experience, interactions with the environment, formal and informal support systems, and cultural belief systems. This article identifies the Theory of Silencing the Self (STS) and a widely known model, the Social Ecological Model (SEM), as a synthesized explanatory framework in helping nurses understand how to address research questions and clinical care that is congruent with the experience of African American women living with HIV infection. In synthesizing the components of these two frameworks, an explanation of the relationship between disempowerment and depression in this population will be uncovered as a key component to making relationships at the individual, family, and community level better. Helping African American women living with HIV infection to explore and address how choosing to be silent across their life systems will advance healthcare adherence as we currently know it to improved self-management of a chronic, gender-specific, culturally-bound experience of depression.
Collapse
Affiliation(s)
- Latrona Lanier
- Department of Nursing, Darton State College, Albany, Georgia
| | - Rosanna DeMarco
- Department of Nursing, College of Nursing and Health Sciences, University Massachusetts Boston, Boston, Massachusetts
| |
Collapse
|
12
|
Marie Modeste RR, Majeke SJ. Sources and types of information on self-care symptom management strategies for HIV and AIDS. Curationis 2014; 37:127. [PMID: 24833168 DOI: 10.4102/curationis.v37i1.127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 11/22/2013] [Accepted: 11/23/2013] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND It has been reported that South Africa has the highest number of people living with HIV worldwide, with more women being infected than men. Women living with HIV have been documented as experiencing various symptoms related to HIV and use various strategies to manage these symptoms. OBJECTIVE The objective of this study was to explore the sources and types of information regarding self-care symptom management strategies received by women living with HIV. METHOD The study was conducted at an HIV clinic in an urban area of KwaZulu-Natal. Individual in-depth interviews were completed with 11 women who were living with HIV,exploring the sources of information received on how they manage the HIV- (and/or AIDS-) related symptoms they experienced as well as the types of information received. The collecteddata were analysed using qualitative content analysis. RESULTS The participants identified various sources, which mainly included groups of people who provided them with information on how to manage their HIV-related symptoms, namely healthcare providers, their personal networks and the community. The different sources offered different types of information, including the use of medication, complementary treatments and self-comforting activities. CONCLUSION The study highlights that participants used multiple sources to get information about how to manage the experienced symptoms related to HIV, namely, healthcare providers, family and friends as well as themselves. It is to be noted that each source provided a preferred type of information.
Collapse
Affiliation(s)
- Regis R Marie Modeste
- School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape.
| | | |
Collapse
|
13
|
Mukolo A, Torres I, Bechtel RM, Sidat M, Vergara AE. Consensus on context-specific strategies for reducing the stigma of human immunodeficiency virus/acquired immunodeficiency syndrome in Zambézia Province, Mozambique. SAHARA J 2014; 10:119-30. [PMID: 24527744 PMCID: PMC4039134 DOI: 10.1080/17290376.2014.885847] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Stigma has been implicated in poor outcomes of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) care. Reducing stigma is important for HIV prevention and long-term treatment success. Although stigma reduction interventions are conducted in Mozambique, little is known about the current nature of stigma and the efficacy and effectiveness of stigma reduction initiatives. We describe action research to generate consensus on critical characteristics of HIV stigma and anti-stigma interventions in Zambézia Province, Mozambique. Qualitative data gathering methods, including indepth key-informant interviews, community interviews and consensus group sessions, were utilized. Delphi methods and the strategic options development analysis technique were used to synthesize qualitative data. Key findings are that stigma enacted by the general public might be declining in tandem with the HIV/AIDS epidemic in Mozambique, but there is likely excessive residual fear of HIV disease and community attitudes that sustain high levels of perceived stigma. HIV-positive women accessing maternal and child health services appear to shoulder a disproportionate burden of stigma. Unintentional biases among healthcare providers are currently the critical frontier of stigmatization, but there are few interventions designed to address them. Culturally sensitive psychotherapies are needed to address psychological distress associated with internalized stigma and these interventions should complement current supports for voluntary counseling and testing. While advantageous for defining stakeholder priorities for stigma reduction efforts, confirmatory quantitative studies of these consensus positions are needed before the launch of specific interventions.
Collapse
Affiliation(s)
- Abraham Mukolo
- a MSc, MPH, PhD, Clinical Assistant Professor, is affiliated to the Vanderbilt Institute for Global Health , Vanderbilt University , Nashville , TN , USA
| | | | | | | | | |
Collapse
|
14
|
Schnall R, Wantland D, Velez O, Cato K, Jia H. Feasibility testing of a web-based symptom self-management system for persons living with HIV. J Assoc Nurses AIDS Care 2014; 25:364-71. [PMID: 24434198 DOI: 10.1016/j.jana.2013.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 09/10/2013] [Indexed: 01/10/2023]
Abstract
The purpose of this study was to explore the feasibility of using a Web-based tool to provide tailored symptom management strategies for persons living with HIV (PLWH) and to estimate the effect size of the tool for future studies. Testing the components of the Web-based system was done by incorporating a repeated-measures design measuring the outcomes of symptom frequency and intensity, use of symptom management strategies, and engagement with health care providers. We recruited 42 PLWH; participants were enrolled in the study for 12 weeks and were asked to use the system and complete the questionnaires every 2 weeks. Our results showed that participants who used the strategies were more likely to have a decrease in symptom frequency and intensity. Findings from this feasibility study provide preliminary evidence for the use of a Web-based HIV symptom management tool with self-management strategies for individuals living with HIV infection.
Collapse
|
15
|
Lorenc A, Robinson N. A review of the use of complementary and alternative medicine and HIV: issues for patient care. AIDS Patient Care STDS 2013; 27:503-10. [PMID: 23991688 DOI: 10.1089/apc.2013.0175] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV/AIDS is a chronic illness, with a range of physical symptoms and psychosocial issues. The complex health and social issues associated with living with HIV mean that people living with HIV/AIDS (PLWHA) have historically often turned to complementary and alternative medicine (CAM). This article provides an overview of the literature on HIV and CAM. Databases were searched using keywords for CAM and HIV from inception to December 2012. Articles in English and in Western countries were included; letters, commentaries, news articles, articles on specific therapies and basic science studies were excluded. Of the 282 articles identified, 94 were included. Over half reported prevalence and determinants of CAM use. Lifetime use of CAM by PLWHA ranged from 30% to 90%, with national studies suggesting CAM is used by around 55% of PLWHA, practitioner-based CAM by 15%. Vitamins, herbs, and supplements were most common, followed by prayer, meditation, and spiritual approaches. CAM use was predicted by length of time since HIV diagnosis, and a greater number of medications/symptoms, with CAM often used to address limitations or problems with antiretroviral therapy. CAM users rarely rejected conventional medicine, but a number of CAM can have potentially serious side effects or interactions with ART. CAM was used as a self-management approach, providing PLWHA with an active role in their healthcare and sense of control. Clinicians, particularly nurses, should consider discussing CAM with patients as part of patient-centered care, to encourage valuable self-management and ensure patient safety.
Collapse
Affiliation(s)
- Ava Lorenc
- London South Bank University, London, United Kingdom
| | | |
Collapse
|
16
|
Predictors of late presentation for HIV diagnosis: a literature review and suggested way forward. AIDS Behav 2013; 17:5-30. [PMID: 22218723 DOI: 10.1007/s10461-011-0097-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Early commencement of antiretroviral treatment can be beneficial and economical in the long run. Despite global advances in access to care, a significant proportion of adults presenting at HIV/AIDS care facilities present with advanced HIV disease. Understanding factors associated with late presentation for HIV/AIDS services is critical to the development of effective programs and treatment strategies. Literature on factors associated with late presentation for an HIV diagnosis is reviewed. Highlighted is the current emphasis on socio-demographic factors, the limited exploration of psychosocial correlates, and inconsistencies in the definition of late presentation that make it difficult to compare findings across different studies. Perspectives based on experiences from resource limited settings are underreported. Greater exploration of psychosocial predictors of late HIV diagnosis is advocated for, to guide future intervention research and to inform public policy and practice targeted at 'difficult to reach' populations.
Collapse
|
17
|
Mailhot T, Cossette S, Alderson M. Une analyse évolutionniste du concept d'autosoins. Rech Soins Infirm 2013. [DOI: 10.3917/rsi.112.0094] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
18
|
Mukolo A, Wallston KA. The relationship between positive psychological attributes and psychological well-being in persons with HIV/AIDS. AIDS Behav 2012; 16:2374-81. [PMID: 21858673 DOI: 10.1007/s10461-011-0029-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The relationship between personal psychological attributes and psychological well-being was assessed among adults with HIV/AIDS. The predictive power of sense of coherence, dispositional optimism and perceived competence (PC) on positive affect (PA), negative affect (NA) and relative mood (PA-NA) were assessed using hierarchical linear regression analysis of two data collections, 2 months apart, from 124 HIV-infected participants. In cross-sectional models all of the baseline psychological attributes accounted for a significant amount of variance in the well-being measures. In longitudinal analyses, changes in PA were predicted by PC and dispositional optimism but not by sense of coherence. The positive psychological attributes did not predict changes in NA. Sense of coherence, dispositional optimism and PC, individually and in composite form, significantly correlate with psychological well-being among HIV infected persons. However, change in psychological well-being might be best predicted by PC.
Collapse
Affiliation(s)
- Abraham Mukolo
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA
| | | |
Collapse
|
19
|
Eller LS, Kirksey KM, Nicholas PK, Corless IB, Holzemer WL, Wantland DJ, Willard SS, Robinson L, Hamilton MJ, Sefcik EF, Moezzi S, Mendez MR, Rosa M, Human S. A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms. AIDS Care 2012; 25:391-9. [PMID: 22880943 DOI: 10.1080/09540121.2012.712662] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Abstract Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ (2) 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice.
Collapse
Affiliation(s)
- Lucille S Eller
- College of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Self-care management and risk factors for depressive symptoms among elderly outpatients in Taiwan. Int Psychogeriatr 2012; 24:278-87. [PMID: 21880176 DOI: 10.1017/s1041610211001645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Early detection and appropriate treatment interventions for depressive symptoms in the elderly are important issues for healthcare systems. However, few studies to date have focused on understanding self-care strategies to manage depressive symptoms among elderly people worldwide. The purpose of this study was to explore self-care management strategies and risk factors for depressive symptoms among elderly outpatients in Taiwan. METHODS A convenience sample of elderly persons (≥65 years old; N = 1054) was recruited from outpatient clinics of two hospitals in northern Taiwan. RESULTS In our sample, the prevalence of depressive tendency was 16.3%. The majority of participants (70.1%) managed depressive symptoms with self-care strategies. The strategy most often used to relieve depressive symptoms was "take a walk." The main information source for self-care strategies was self-learning. Depressive tendency in this sample was shown by logistic regression analysis to be significantly predicted by gender, marital status, perceived income adequacy, perceived health condition, stroke, and cancer. CONCLUSION Elderly people need to be made more aware of strategies to self-manage depressive symptoms. Healthcare providers can decrease/prevent the first risk factor for depressive symptoms (poor perceived health status) by improving elders' perceived health and promoting their actual health. The second risk factor (poor perceived income adequacy) can be decreased/prevented by carefully assessing patients' financial situation during clinic visits and providing suitable referral for further assistance.
Collapse
|
21
|
Menopause-associated metabolic manifestations and symptomatology in HIV infection: a brief review with research implications. J Assoc Nurses AIDS Care 2011; 23:195-203. [PMID: 21924646 DOI: 10.1016/j.jana.2011.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 06/29/2011] [Indexed: 02/02/2023]
Abstract
Many women living with HIV in the United States have entered or will soon enter menopause. Clinical changes including increased visceral fat, reduced muscle mass, and changes in lipids and bone density are seen across the menopause transition among non-infected women. HIV and antiretroviral therapy use have been associated with similar manifestations, including reduced bone density, and changes in lipid metabolism and body composition. Menopause is also associated with changes in mood, quality of life, and vasomotor symptoms. Similar psychological indices are common among women with HIV, and may worsen during menopause transition. Research investigating the presence and acuity of metabolic, psychological, and vasomotor symptoms among perimenopausal women with HIV is limited. An important, yet unknown consideration for researchers and clinicians is how metabolic and psychological co-morbidities associated with HIV will influence changes associated with menopause in this population. Further research is needed to provide answers to these important questions.
Collapse
|
22
|
Scoping the field: identifying key research priorities in HIV and rehabilitation. AIDS Behav 2010; 14:448-58. [PMID: 19277858 DOI: 10.1007/s10461-009-9528-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 01/27/2009] [Indexed: 10/21/2022]
Abstract
The purpose of this project was to identify key research priorities related to HIV and rehabilitation. We conducted a scoping study which included a literature review of published and grey literature, followed by focus group and interview consultations with 28 participants including people living with HIV, researchers, educators, clinicians, and policy makers with expertise in HIV and rehabilitation. Qualitative content analysis was used to identify emergent themes related to research priorities in HIV and rehabilitation. The resulting Framework of HIV and Rehabilitation Research provided an outline for approaching research in the field. The framework included three overlapping research priorities: (a) living with HIV across the lifespan, (b) disability, and (c) rehabilitation that should be viewed through environmental and/or personal contextual lenses, using different methodological approaches. Six key research priorities from this framework were identified through additional consultation with new and returning participants including: (1) disability and episodic disability, (2) concurrent health conditions aging with HIV, (3) HIV and the brain, (4) labour force and income support, (5) access to and effectiveness of rehabilitation, and (6) development and evaluation of outcome measurement tools. These priorities inform a future plan for HIV and rehabilitation research that will increase our knowledge to enhance practice, programming and policy for people living with HIV.
Collapse
|
23
|
Tufts KA, Wessell J, Kearney T. Self-care behaviors of African American women living with HIV: a qualitative perspective. J Assoc Nurses AIDS Care 2009; 21:36-52. [PMID: 19819168 DOI: 10.1016/j.jana.2009.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 07/08/2009] [Indexed: 11/24/2022]
Abstract
Significant numbers of African American (AA) women have been diagnosed with HIV over the past decade. HIV may be viewed as a chronic condition that can be actively managed through the use of self-care behaviors, yet little is known about how these women define self-care (SC) for themselves, and still less is known about what facilitates and hinders SC behaviors among these women. This article highlights the results of a qualitative research study undertaken with AA women living with HIV in a metropolitan city in the southeastern United States. The objective of this study was to systematically collect data about the SC experiences of these women. Focus group methodology was used. Content analysis of the data was conducted. Two primary domains emerged: do what the doctor says and living healthy. SC activities included seeking social support, managing disclosure, engaging in pampering, taking part in religious customs, and maintaining recovery.
Collapse
|
24
|
Swendeman D, Ingram BL, Rotheram-Borus MJ. Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care 2009; 21:1321-34. [PMID: 20024709 PMCID: PMC2881847 DOI: 10.1080/09540120902803158] [Citation(s) in RCA: 190] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HIV/AIDS is widely recognized as a chronic illness within HIV care, but is often excluded from chronic disease lists outside the field. Similar to other chronic diseases, HIV requires lifetime changes in physical health, psychological functioning, social relations, and adoption of disease-specific regimens. The shift from acute to chronic illness requires a self-management model in which patients assume an active and informed role in healthcare decision making to change behaviors and social relations to optimize health and proactively address predictable challenges of chronic diseases generally and HIV specifically. This article reviews literature on chronic disease self-management to identify factors common across chronic diseases, highlight HIV-specific challenges, and review recent developments in self-management interventions for people living with HIV (PLH) and other chronic diseases. An integrated framework of common elements or tasks in chronic disease self-management is presented that outlines 14 elements in three broad categories: physical health; psychological functioning; and social relationships. Common elements for physical health include: a framework for understanding illness and wellness; health promoting behaviors; treatment adherence; self-monitoring of physical status; accessing appropriate treatment and services; and preventing transmission. Elements related to psychological functioning include: self-efficacy and empowerment; cognitive skills; reducing negative emotional states; and managing identity shifts. Social relationship elements include: collaborative relationships with healthcare providers; social support; disclosure and stigma management; and positive social and family relationships. There is a global need to scale up chronic disease self-management services, including for HIV, but there are significant challenges related to healthcare system and provider capacities, and stigma is a significant barrier to HIV-identified service utilization. Recognizing that self-management of HIV has more in common with all chronic diseases than differences suggests that the design and delivery of HIV support services can be incorporated into combined or integrated prevention and wellness services.
Collapse
Affiliation(s)
- Dallas Swendeman
- Global Center for Children and Families, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
| | | | | |
Collapse
|
25
|
Psychological well-being among individuals aging with HIV: the value of social relationships. J Acquir Immune Defic Syndr 2009; 51:91-8. [PMID: 19282781 DOI: 10.1097/qai.0b013e318199069b] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Utilizing a heterogenous sample of adults diagnosed with HIV infection, the current study sought to explore associations among age, various dimensions of social support, and psychological and functional well-being. METHODS Cross-sectional data capturing subjective and instrumental support, social interaction, behavioral health service utilization, and psychological well-being (ie, positive affect and depressive symptomatology), and physical functioning, were collected from 109 men and women living with HIV. To explore age group differences, participants were stratified by age (<54 vs. 55+ years). RESULTS Despite endorsing greater medical comorbidity, older adults reported significantly lower depressive symptomatology and greater positive affect and were less likely to report seeing a behavioral health specialist than their younger counterparts. No age group differences emerged for instrumental support or amount of social interaction. However, older adults reported higher subjective support, which in turn was associated with lower depressive symptomatology, greater positive affect, and nonutilization of behavioral health services. CONCLUSIONS More attention should be paid to the social environment of individuals diagnosed with HIV as the quality of social relationships may be particularly important for successful psychological adaptation to HIV.
Collapse
|
26
|
Symptoms experienced by HIV-infected Individuals on antiretroviral therapy in KwaZulu-Natal, South Africa. Appl Nurs Res 2009; 24:1-9. [PMID: 20974052 DOI: 10.1016/j.apnr.2009.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 12/15/2008] [Accepted: 01/03/2009] [Indexed: 10/20/2022]
Abstract
Symptom management in HIV/AIDS is a critical issue that influences the quality of life of those living with the disease. Although the goals of treating the numbers living with HIV/AIDS have not yet been achieved, availability of antiretroviral therapies (ARVs) has been expanded to many clinical settings in KwaZulu-Natal, the epicenter of HIV infection in South Africa. The South African Department of Health (2007) estimates indicate that 5.54 million South Africans are living with HIV/AIDS, whereas UNAIDS (2007) estimates suggest that 18.8% of the population in South Africa is affected. Because the symptom experience may influence adherence to ARVs and quality of life, this study focused on the prevalence of symptoms reported by patients (N = 149) diagnosed with HIV/AIDS and adherence to medications and appointments. Self-report data were obtained from this community-based sample of HIV-infected patients who received care in outpatient clinics in Durban, KwaZulu-Natal, South Africa. With an average of three side effects, the most frequently reported by the study participants were fatigue/tiredness (41%), rashes (40%), headaches (32%), insomnia (31%), sadness (24%), disturbing dreams (23%), numbness (22%), pain (22%), and self-appearance (20%). On a scale of 1 to 10 (10 being worst possible), those with symptoms reported an average intensity of 4.2 (SD = 2.0), and the degree to which symptoms affected activity levels was 3.2 (SD = 2.2). Although intensity of symptoms and effects on activity levels were strongly correlated (r = .78, p < .001), there were no significant relationships between adherence and the intensity of symptoms or the relationship of symptoms with activity levels. Logistic regression analyses indicate that the presence of a greater number of symptoms was not associated with greater adherence (odds ratio = 2.27, 95% confidence interval = 0.60-8.70, ns). However, those who reported higher adherence were 1.5 times more likely to report greater physical health than low adherers (p = .04). High adherers were also 1.6 times more likely to report greater psychological health than low adherers (p = .03). This suggests that further study is needed to investigate adherence motivations for those living with HIV/AIDS in South Africa because adherence seems not to be linked to the frequency of symptoms or limitations on activity related to symptoms.
Collapse
|
27
|
Willard S, Holzemer WL, Wantland DJ, Cuca YP, Kirksey KM, Portillo CJ, Corless IB, Rivero-Méndez M, Rosa ME, Nicholas PK, Hamilton MJ, Sefcik E, Kemppainen J, Canaval G, Robinson L, Moezzi S, Human S, Arudo J, Eller LS, Bunch E, Dole PJ, Coleman C, Nokes K, Reynolds NR, Tsai YF, Maryland M, Voss J, Lindgren T. Does "asymptomatic" mean without symptoms for those living with HIV infection? AIDS Care 2009; 21:322-8. [PMID: 19280409 PMCID: PMC3630501 DOI: 10.1080/09540120802183511] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Throughout the history of the HIV epidemic, HIV-positive patients with relatively high CD4 counts and no clinical features of opportunistic infections have been classified as "asymptomatic" by definition and treatment guidelines. This classification, however, does not take into consideration the array of symptoms that an HIV-positive person can experience long before progressing to AIDS. This short report describes two international multi-site studies conducted in 2003-2005 and 2005-2007. The results from the studies show that HIV-positive people may experience symptoms throughout the trajectory of their disease, regardless of CD4 count or classification. Providers should discuss symptoms and symptom management with their clients at all stages of the disease.
Collapse
Affiliation(s)
- Suzanne Willard
- Assistant Professor, Drexel University, College of Nursing and Health Professions, Elizabeth Glaser Pediatric AIDS Foundation, 1140 Connecticut Avenue, NW, Suite 200, Washington, DC 20036, T: 202 448-8491
| | - William L. Holzemer
- Professor and Associate Dean, UCSF School of Nursing, 2 Koret Way, Box 0608, San Francisco, CA 94143-0608, T: 415-476-2763, F: 415-476-6042
| | - Dean J. Wantland
- Assistant Adjunct Professor, UCSF School of Nursing, 2 Koret Way, Box 0608, San Francisco, CA 94143-0608, T: 415-613-4107, F: 415-476-6042
| | - Yvette P. Cuca
- Project Director, UCSF School of Nursing, 2 Koret Way, Box 0608, San Francisco, CA 94143-0608, T: 415-502-8081, F: 415-476-6042
| | - Kenn M. Kirksey
- Director of Nursing Research, SETON Family of Hospitals, 1601 Rio Grande, Suite 300, Austin, Texas 78701, T: 512-324-8988
| | - Carmen J. Portillo
- Professor, UCSF School of Nursing, 2 Koret Way, Box 0608, San Francisco, CA 94143-0608, T: 415-476-1630, F: 415-476-6042
| | - Inge B. Corless
- MGH Institute of Health Professions, CNY 36 1 Ave, Boston, MA 02129, T: 617-726-8018, F: 617-724-6321
| | - Marta Rivero-Méndez
- Professor, University of Puerto Rico, Medical Sciences Campus, School of Nursing, P.O. Box 365067, San Juan, Puerto Rico 00936-5067, T: 787-758-2525, x2114, F: 787-281-0721
| | - María E. Rosa
- Dean and Professor, Universidad del Turabo, School of Health Sciences, PO Box 3030, Gurabo, PR 00778, T: 787-743-7979 x 4017/4462, F: 787-704-2703
| | - Patrice K. Nicholas
- Director of Global Health and Academic Partnerships, Professor, MGH Institute of Health Professions, Brigham and Women’s Hospital, One Brigham Circle 4th Floor, Boston, MA 02115, T: 617-525-7790
| | - Mary Jane Hamilton
- Dean & Professor, Texas A&M University - Corpus Christi, College of Nursing & Health Science, 6300 Ocean Drive, Corpus Christi, TX 78412, T: 361-825-2649, F: 361-825-2484
| | - Elizabeth Sefcik
- Professor, Texas A&M University - Corpus Christi, 6300 Ocean Drive, Corpus Christi, TX 78412, T: 361-825-5857
| | - Jeanne Kemppainen
- Associate Professor, School of Nursing, The University of North Carolina at Wilmington, 1080 St. Joseph St., 3B, Carolina Beach, NC 28428, T: 910-962-3202, H: 910-458-3788
| | - Gladys Canaval
- Universidad del Valle, A.A. 25360 Cali, Valle, Colombia, T: 57-2-3391437 ext 110, F: 57-2-5581938
| | - Linda Robinson
- Associate Professor, University of San Diego, Hahn School of Nursing, 5998 Alcala Park, San Diego, CA, T: 619-260-4571, F: 619-260-6814
| | - Shahnaz Moezzi
- Assistant Professor, University of Utah, College of Nursing, 1340 Michigan Ave., Salt Lake City, UT 84105, T: 801-587-9128, F: 801-581-4642
| | - Sarie Human
- University of South Africa, Department of Health Studies, PO Box 392, Unisarand, UNISA, Pretoria, 0003, South Africa, T: 27-12-429-6290, F: 27-12-429-6688
| | - John Arudo
- Regional Research Co-ordinator, Aga Khan University Advanced Nursing Programme, PO Box 39340-00623, Nairobi, Kenya, T: 254-20-374-74-83, F: 254-20-374-7004
| | - Lucille Sanzero Eller
- Associate Professor, Rutgers, the State University of New Jersey, 180 University Ave., Suite 102, Newark, NJ 07102, T: 973-353-5326 x503, F: 973-353-1277
| | - Eli Bunch
- Professor, University of Oslo, Institute of Nursing Science, POB 1153, Blindern, 0318, Oslo Norway, T: 47-22-85-05-60, F: 47-22-85-05-70
| | - Pamela J. Dole
- Village Diagnostic and Treatment Center, 121A W 20 Street, New York, NY 10011, T: 212-337-9290, F: 212-337-9254
| | - Christopher Coleman
- University of Pennsylvania, School of Nursing, Philadelphia, PA 19104-6096, T: 215-898-0760, F: 215-573-7496
| | - Kathleen Nokes
- Professor, Hunter College, CUNY, Hunter-Bellevue School of Nursing, 425 East 25 St., Box 874, New York, NY 10010, T: 212-481-7594, F: 212-481-4427
| | - Nancy R. Reynolds
- Yale University, School of Nursing, P.O. Box 9740, 100 Church Street South, Suite 200, New Haven, CT 06536-0740, T: 203-737-2313, F: 203-785-6455
| | - Yun-Fang Tsai
- Professor, School of Nursing, Chang Gung University, 259 Wen Hua 1 Road, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC, T: 011-886-3-3283016 ext 5958, F: 011-886-3-211868
| | - Mary Maryland
- University of Illinois at Chicago, College of Medicine, Hematology Oncology, 820 S. Wood St., Suite 172 (M/C 712), Chicago, Illinois 60612, T: 312-413-2042, F: 312-996-5984
| | - Joachim Voss
- Assistant Professor, University of Washington, School of Nursing, Dept. of Biobehavioral Nursing and Health Systems, UW Box 357266, Room T 624B, Seattle, WA 98195, T: 206-616-7819, F: 206-543-4771
| | - Teri Lindgren
- Project Director, UCSF School of Nursing, 2 Koret Way, Box 0606, San Francisco, CA 94143-0606, T: 415-504-7892
| |
Collapse
|
28
|
Fillipas S, Bowtell-Harris CA, Oldmeadow LB, Cicuttini F, Holland AE, Cherry CL. Physical activity uptake in patients with HIV: who does how much? Int J STD AIDS 2008; 19:514-8. [PMID: 18663035 DOI: 10.1258/ijsa.2007.007237] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Regular physical activity is recommended for patients with human immunodeficiency virus (HIV) to help manage their disease. However, to date, little is known about levels of uptake of this advice. This study describes daily physical activity in HIV antibody-positive patients attending a public hospital infectious diseases clinic, compares them with those of patients attending the clinic for general infectious diseases and investigates compliance with the recommendations of the Centres for Disease Control and Prevention and American College of Sports Medicine physical activity guidelines. During April 2006, 261 patients completed the International Physical Activity Questionnaire short form. One hundred and ninety-one reported being HIV antibody-positive. Results showed that 1:4 HIV antibody-positive and 1:3 HIV antibody-negative respondents failed to meet the recommended guidelines. These findings are of concern, given the evidence-based benefits of regular physical activity. Further work is needed to identify barriers to participation and interventions that can improve uptake.
Collapse
Affiliation(s)
- S Fillipas
- Physiotherapy Department, The Alfred, Prahran, Vic, Australia.
| | | | | | | | | | | |
Collapse
|
29
|
Bradbury-Jones C, Tranter S. Inconsistent use of the critical incident technique in nursing research. J Adv Nurs 2008; 64:399-407. [PMID: 18764849 DOI: 10.1111/j.1365-2648.2008.04811.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a critique of the use of critical incident technique in nursing and a demonstration of how its development has resulted in inconsistency and confusion. BACKGROUND Critical incident technique is used globally by nurse researchers to explore a plethora of nursing issues. Its main strengths are flexibility and adaptability, but its popularity has resulted in ambiguity and confusion. DATA SOURCES A search of the CINAHL database for the period 1956-2007 was performed using the search terms critical incident technique and nursing. Together with hand searching, this produced a total of 59 papers. The papers were analysed according to country of origin, research topic, sample size, data collection method, inclusion/exclusion criteria, data analysis and terminology. We then categorized the results of this analysis depending on similarities and differences in the papers. DISCUSSION We focus on two areas: methodology and terminology. From a methodological perspective critical incident technique has become inconsistent and in relation to terminology, the diverse language associated with the technique has created confusion. Moreover, issues of rigour may be compromised as a result of this inconsistency. A great deal of inconsistency has been created by nurse researchers' attempts to advance critical incident technique. This has led to confusion, which is not helpful for advancing nursing knowledge. CONCLUSION While embracing the continued development of critical incident technique, we advocate a standardized approach to its use. Unless nurse researchers are alert to the methodological and terminological inconsistencies in use of the critical incident technique, it risks becoming an interminable quagmire through which navigation will be impossible.
Collapse
|
30
|
Holzemer WL. University of California, San Francisco International Nursing Network for HIV/AIDS Research. Int Nurs Rev 2007; 54:234-42. [PMID: 17685906 DOI: 10.1111/j.1466-7657.2007.00571.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The University of California, San Francisco International Nursing Network for HIV/AIDS Research (the Network) is an international group of nurse scientists dedicated to research and education for the purpose of improving HIV/AIDS nursing care around the world. This article describes the evolution of the Network, as well as its structure, achievements and challenges. BACKGROUND Although HIV/AIDS has been around for over 25 years, millions of people are still affected by the disease every year. Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that in 2005, there were 38.6 million people living with HIV around the world. In many parts of the developed and developing world, nurses are the primary caregivers for people living with HIV/AIDS, and they need up-to-date information about the daily management of the disease. The Network was established to respond to the need of HIV/AIDS nurses for relevant information to inform clinical care. The Network's main activity is a series of international multi-site collaborative research studies. Past studies have addressed issues such as medication adherence, symptom management and self-care for people living with HIV/AIDS. The Network also hosts semi-annual meetings as well as a biannual international nursing science conference. CONCLUSION The Network's flexible structure has proven to be one of its greatest assets, as well as a challenge. Although the Network faces challenges, it has proven to be a useful framework for conducting international collaborative activities related to HIV/AIDS and nursing science.
Collapse
Affiliation(s)
- W L Holzemer
- UCSF School of Nursing, Department of Community Health Systems, San Francisco, CA 94143-0608, USA.
| |
Collapse
|
31
|
Voss JG, Sukati NA, Seboni NM, Makoae LN, Moleko M, Human S, Molosiwa K, Holzemer WL. Symptom Burden of Fatigue in Men and Women Living With HIV/AIDS in Southern Africa. J Assoc Nurses AIDS Care 2007; 18:22-31. [PMID: 17662921 DOI: 10.1016/j.jana.2007.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Indexed: 11/26/2022]
Abstract
HIV-related fatigue is a debilitating and disabling symptom that persists for months and years. In 743 HIV/AIDS patients from Southern Africa, the authors found ratings of HIV-related fatigue to be highly prevalent. The authors conducted a secondary data analysis within the theoretical context of the University of California, San Francisco Symptom Management Model. The analysis focused on 538 patients who reported fatigue to investigate correlates and predictors of fatigue severity in relationship to demographic and HIV/AIDS illness indicators, as well as HIV-specific physical and psychological symptoms. A hierarchical regression model explored the contributions of those five blocks on fatigue severity. Of the 47% of the total variance in fatigue severity, a combination of variables within the health and illness block (6%), the physical symptoms block (7%) and the psychological symptom block (2%) contributed significantly to the increase in fatigue severity scores. Fatigue severity in Southern Africa was moderate, and the factors contributing to the perceived fatigue were most likely related to symptoms of acute HIV disease (such as fever and gastrointestinal problems). In conclusion, fatigue severity is less impacted by demographic or environmental variables but much more by co-occurring symptoms and HIV disease severity. The results of this study imply the need for more research to understand if improvements in water quality and access to food would prevent infection and diarrhea and whether sufficient access to antiretroviral treatments to manage the HIV infection would improve fatigue and co-occurring symptom profiles.
Collapse
|
32
|
Israelski DM, Prentiss DE, Lubega S, Balmas G, Garcia P, Muhammad M, Cummings S, Koopman C. Psychiatric co-morbidity in vulnerable populations receiving primary care for HIV/AIDS. AIDS Care 2007; 19:220-5. [PMID: 17364402 DOI: 10.1080/09540120600774230] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Considerable evidence suggests that people with HIV disease are significantly more distressed than the general population, yet psychiatric disorders are commonly under-detected in HIV care settings. This study examines the prevalence of three stress-related psychiatric diagnoses--depression, posttraumatic stress disorder (PTSD), and acute stress disorder (ASD), among a vulnerable population of HIV-infected patients. Among approximately 350 patients attending two county-based HIV primary care clinics, 210 participants were screened for diagnostic symptom criteria for depression, PTSD, and ASD. Standardized screening measures used to assess for these disorders included the Beck Depression Inventory, the Posttraumatic Stress Checklist, and the Stanford Acute Stress Questionnaire. High percentages of HIV-infected patients met screening criteria for depression (38 per cent), PTSD (34 per cent), and ASD (43 per cent). Thirty eight percent screened positively for two or more disorders. Women were more likely to meet symptom criteria for ASD than men (55 per cent vs. 38 per cent, OR=1.94, CI95 per cent=1.1-3.5). ASD was detected more commonly among African-American and white participants (51 per cent and 50 per cent respectively), compared with other ethnic groups. Latinos were least likely to express symptoms of ASD (OR=0.52, CI95 per cent=0.29-0.96). Of the 118 patients with at least one of these disorders, 51 (43 per cent) reported receiving no concurrent mental health treatment. Patients with HIV/AIDS who receive public healthcare are likely to have high rates of acute and posttraumatic stress disorders and depression. These data suggest that current clinical practices could be improved with the use of appropriate tools and procedures to screen and diagnose mental health disorders in populations with HIV/AIDS.
Collapse
Affiliation(s)
- D M Israelski
- Stanford University School of Medicine, San Mateo, CA, USA
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Abel E, Hopson L, Delville C. Health promotion for women with human immunodeficiency virus or acquired immunodeficiency syndrome. ACTA ACUST UNITED AC 2006; 18:534-43. [PMID: 17064331 DOI: 10.1111/j.1745-7599.2006.00169.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this pilot study was twofold: first, to modify Stuifbergen's health promotion intervention initially developed for women with multiple sclerosis for use among women with human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS) and to evaluate the feasibility of the newly modified health promotion intervention named "Put Health Into Living" (PHIL). The pilot study was completed in two phases. DATA SOURCES In phase I, data were derived from a literature review, a focus group of women with HIV/AIDS (n= 7), a panel of experts who reviewed the intervention for content, and three female community workers who evaluated the intervention for the context of living with HIV/AIDS, cultural relevancy, and literacy. During phase II, a pretest/posttest one-group design was used to determine the feasibility of the study methods, content, and format of the health promotion intervention among 10 women with HIV/AIDS. CONCLUSIONS The pilot study demonstrated the importance of a health promotion intervention for a vulnerable population. Participants verbalized the benefits of attending a health promotion program to gain knowledge and skills to promote their health. One woman said, "I have been positive for 20 years now and no one has talked to me just about my overall health." Participants indicated the PHIL intervention offered a supportive group environment, an overall health focus, and an acceptable format. IMPLICATIONS FOR PRACTICE Health promotion is a desirable goal for persons living with a chronic disease, and the PHIL intervention has the potential to benefit persons living with HIV/AIDS if subsequent evidence is found in further testing of the intervention.
Collapse
Affiliation(s)
- Elizabeth Abel
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA.
| | | | | |
Collapse
|
34
|
Abstract
Although depressive symptoms are common in people living with HIV/AIDS, their reported prevalence varies greatly across HIV-positive populations, ranging from 21% to 97%. Comparing these rates is complicated by the varied conceptualization of depression as a major depressive disorder (clinical depression) or depressive symptoms, and by the use of multiple methods of measurement. Knowledge of predictors of depressive symptoms can assist health care providers in the identification of those who are most at risk. Appropriate diagnosis, treatment, and referral are critical, because depressive symptoms have been associated with poorer disease outcomes. Additionally, self-management symptoms can be used to supplement more traditional treatment methods.
Collapse
Affiliation(s)
- Lucille Sanzero Eller
- College of Nursing, Rutgers-The State University of New Jersey, 180 University Avenue, Newark, NJ 07102, USA.
| |
Collapse
|
35
|
Tsai YF. Self-care management and risk factors for depressive symptoms among elderly nursing home residents in Taiwan. J Pain Symptom Manage 2006; 32:140-7. [PMID: 16877181 DOI: 10.1016/j.jpainsymman.2006.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2006] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to explore self-care management strategies and risk factors for depressive symptoms among elderly residents of nursing homes in Taiwan. Stratified random sampling was used to recruit participants (n = 220). In these elderly nursing home residents, the prevalence of depressive tendency was 55.0%. Although only 42% of participants used self-care strategies to manage depressive symptoms, the most frequently used strategy was "take a walk." Self-learning was the main information source for self-care strategies. Logistic regression analysis indicated that satisfaction with living situation and perceived health status significantly predicted depressive symptoms. Since elders tended to engage in activities and interact with others to manage their depressive symptoms, health care providers in nursing homes should consider improving access to activities and interpersonal contacts for elderly residents. Elders' awareness of strategies to self-manage depressive symptoms also needs to be increased. The risk factors for depressive symptoms may be addressed by providing a pleasant and comfortable living environment, discouraging poor perceived health status, and promoting the health of elderly residents of nursing homes in Taiwan.
Collapse
Affiliation(s)
- Yun-Fang Tsai
- School of Nursing, Chang Gung University, Tao-Yuan, Taiwan, Republic of China.
| |
Collapse
|