Spirituality and Dignity of Thai Adolescents Living with HIV

Asking the Experts: Using Cognitive Interview Techniques to Explore the Face Validity of the Mental Wellness Measure for Adolescents Living with HIV

There has been an increased focus on the mental health of adolescents living with HIV (ALHIV), because evidence shows that poor mental health outcomes are associated with lower rates of adherence and retention in HIV care. However, the research to date has predominantly focused on addressing mental health problems and reducing symptoms of mental illness rather than strengthening mental wellness [positive mental health]. Consequently, little is known about the critical mental wellness indicators that should be targeted in services for ALHIV. There is a need for valid and appropriate measures of mental wellness to drive research and provide evidence on the mental wellness needs of ALHIV that would inform service delivery as well as the monitoring and evaluation of treatment outcomes. To this end, we developed the Mental Wellness Measure for Adolescents Living with HIV (MWM-ALHIV) for ALHIV in the South African context. In this paper, we report on the findings from a cognitive interview study with nine ALHIV aged 15-19 years receiving treatment at a public healthcare facility in the Cape Metropole, South Africa. Through interviews, participants identified key issues related to the wording, relevance and understanding of the items and provided suggestions to improve the instrument's overall face validity.

Discourses of Mental Wellness Among Adolescents Living with HIV in Cape Town, South Africa

Background

Adolescence is a unique period of development where individuals transition from childhood to adulthood, and where they are at heightened risk for developing mental health problems and engaging in risky behaviours. In addition, adolescents living with HIV (ALHIV) must learn to cope with challenges related to the biological impact of a chronic condition, adhering to lifelong treatment, and managing HIV-related psychological and social challenges. Mental wellness as a precursor to mental wellbeing, is vital to facilitate persistent adherence and engagement in care for optimal treatment outcomes for ALHIV. However, little is known about how ALHIV understand and talk about mental wellness in the context being on HIV treatment.

Methods

We conducted a photovoice study with 12 groups, consisting of 43 ALHIV, aged 15–19 years, and receiving HIV treatment at three public primary health care facilities in the Western Cape Metropole in South Africa.

Results

Through discourse analysis, we identified six themes that depicted mental wellness concepts that were prominent in their experiences, namely, connectedness, spirituality and mindfulness, social coherence and awareness, self-esteem, self-acceptance, and sense of coherence. In addition, the adolescents gave accounts of six mental wellness behaviours namely, self-efficacy, coping, resilience, life purpose, engagement in enjoyable life activities and physical functioning.

Discussion

These concepts and behaviours are similar to those identified in targeted interventions aimed at ALHIV. These mental wellness concepts and behaviours are critical to improving health outcomes for ALHIV and should be targeted in the delivery of youth friendly services and integrated HIV care in public healthcare facilities in South Africa and the sub-Saharan African continent.

Spirituality and Spiritual Care among Ethnic Chinese Residing in England: Implications for Nursing

(1) Background: There is a lack of understanding of how spirituality is understood among ethnic Chinese living outside of China. The aim of this investigation was to gain insight into the meaning of spirituality and spiritual care among ethnic Chinese residing in England. (2) Methods: This study employed a grounded theory method. (3) Results: A core category called “seeking a meaningful life” emerged, comprising six categories: “motivation”, “support”, “maintaining standard values”, “achieving a meaningful life”, “relationships” and “perceptions of spirituality”. The core category included a three-stage process influenced by two factors: relationships with others and perceptions of spirituality. In motivated or supported situations of suffering and illness, ethnic Chinese usually follow principles of their Chinese tradition in seeking meaning for a satisfied spiritual life. This process is impacted by their relationships with others and view of spirituality. (4) Conclusions: Participants’ understanding of spirituality and spiritual care was related to seeking meaning and purpose in life. Nurses could incorporate the newly developed life meaning processes into their practice. This could be achieved by culturally explaining suffering and focusing on the significance of physical illness for Chinese people. This would ensure their spiritual care practice delivers culturally competent care for ethnic Chinese. Educators could also incorporate this process within their teaching materials so that this aspect of spiritual care is addressed for this specific group.