Benefits of Family and Social Relationships for Thai Parents Living with HIV

Family and social relationships are important structural supports in Thailand that are likely to influence the health and mental health of persons living with HIV (PLH). Structural equation modeling examined these relationships among 409 PLH in two communities in Thailand. Latent variables were constructed for most outcomes and mediators, with adherence to antiretroviral (ARV) therapy, depression, and disclosure represented by single-item indicators. All models controlled for gender, age, and education. Disclosure was significantly and positively associated with ARV adherence, and to both family functioning and social support. Family functioning and social support were significantly related to the PLH’s self-perceptions of health and mental health, as well as being significantly correlated with each other. Better family functioning was significantly associated with better quality of life, better perceived health, fewer symptoms of depression, and greater ARV adherence. Social support was significantly associated with better quality of life and fewer depressive symptoms. These results highlight the important role that an organized and structured family life and social support network can play in encouraging better health outcomes among PLH.     

The role of personality, coping style and social support in health-related quality of life in HIV infection

Objective: To determine the role of health status, personality and coping style, on self-report health-related quality of life (QoL). Methods: Participants were HIV seropositive individuals at all disease stages from three samples (a) gay/bisexual men from the UK, (b) injecting drug users from the UK, (c) injecting drug users from Italy. All participants completed questionnaires evaluating QoL, personality, coping style and social support. Explicit models of the relationships between the measured variables based on a review of the literature were tested using structural equation modelling. Results: Health status was modestly associated with the physical but not the psychological aspects of QoL ( = 0.44). Neuroticism was strongly associated with psychological QoL ( = –0.73) but only weakly with physical QoL ( = –0.21). The samples did not differ in either the pattern or the magnitude of these relationships. Mediating factors such as coping style, social support and other personality variables had only a weak influence on the role of Neuroticism. Conclusions: Neuroticism had a strong influence on health-related QoL that was independent of health status. Neuroticism was more strongly associated with the psychological aspects of QoL than health status. Coping styles and the other psychological variables assessed had only a weak mediating influence on this relationship.     

Quality of life among women living with HIV: the importance violence, social support, and self care behaviors

This paper describes the relationship between psychosocial factors and health related quality of life among 287 HIV-positive women using items from the Medical Outcomes Study HIV Health Survey to measure physical functioning, mental health and overall quality of life. Multivariate models tested the relative importance of sociodemographic characteristics, HIV-related factors and psychosocial variables in explaining these quality of life outcomes. A history of child sexual abuse and adult abuse, social support and health promoting self-care behaviors were the psychosocial factors studied. Women in the sample were on average 33 years old and had known they were HIV-positive for 41 months; 39% had been hospitalized at least once due to their HIV; 83% had children; 19% had a main sex partner who was also HIV-positive. More than one-half of the women (55%) had a history of injection drug use and 63% reported having been physically or sexually assaulted at least once as an adult. A history of childhood sexual abuse. reported by 41% of the sample, was significantly related to mental health after controlling for sociodemographic and HIV-related characteristics. Women with larger social support networks reported better mental health and overall quality of life. Women who practiced more self-care behaviors (healthy diet and vitamins, adequate sleep and exercise, and stress management) reported better physical and mental health and overall quality of life. The high prevalence of physical abuse and child sexual abuse reported by this sample underscores the importance of screening for domestic violence when providing services to HIV-positive women. That such potentially modifiable factors as social support and self care behaviors are strongly associated with health-related quality of life suggests a new opportunity to improve the lives of women living with HIV.     

Psychological Correlates of Quality of Life in Atrial Fibrillation

Objective: Atrial fibrillation (AF) is associated with significant health-related quality of life (QoL) impairments. Markers of heart disease severity have explained little variance in QoL and it is unclear what other factors will better account for the observed differences in adjustment. We examined whether specific personality traits and illness management styles would help explain the severity of QoL impairments reported in this population.Methods: Patients with AF (N = 93) completed validated questionnaires measuring disease burden (dependent variables: physical and mental QoL, symptom severity, psychological distress), personality (independent variables: anxiety sensitivity, optimism), and illness management style (mediating variable: symptom preoccupation). Hypothesized relationships were evaluated using mediation models.Results: Anxiety sensitivity was associated with poorer physical and mental QoL, greater symptom severity, and higher distress. Optimism was correlated with better mental QoL and lower distress, but unrelated to physical QoL and symptom severity. Symptom preoccupation significantly mediated the relationships between anxiety sensitivity and each of the QoL measures, as well as the relationships between optimism and mental well-being.Conclusions: Personality traits and illness management styles are important to consider when assessing the impact of AF on QoL. The data support a cognitive-behavioral model that explains the direct and indirect relationships between psychological predictors and multiple indices of QoL.     

Social Support,Medication Compliance and HIV/AIDS

ABSTRACT

Social work practitioners and researchers have greatly understudied the idea of how social support correlates with combination therapy medication compliance, in people living with HIV disease. Meanwhile, such data could help health social workers better assist HIV-infected people who want to cope well, live long, and avoid drug resistance. Therefore, this article presents findings from a three-stage empirical secondary data analysis that examined seven specific types of social support, psychological history and stage of illness variables, and sociodemographics and their connection to medication compliance ratings. A sub-sample of 179 HIV-infected clinical trial study participants enrolled in a federally funded combination therapy treatment study and a nested compliance study were analyzed. Analysis of 14 bivariate hypotheses and 20 predictor variables at the multivariate level revealed that having emotional support and being employed seemed to be predictive of being a “Good Complier.” Also, having higher levels of HIV symptoms appeared to be associated with being a “Poor Complier.”     

安徽省艾滋病抗病毒治疗病人生活质量与社会支持典型相关分析

目的了解接受抗病毒治疗的艾滋病病人的生活质量和社会支持现况及其相关性。方法采用简明健康调查量表（the MOS item short from health survey,SF-36）和社会支持评定量表（social science research solutions,SSRS）对选定人群进行生活质量和社会支持的调查及典型相关分析。结果抗病毒治疗艾滋病病人生活质量和社会支持得分均低于一般人群（均有P〈0.05）。病人社会支持与生活质量之间存在典型相关关系（F=7.48,P〈0.001）。反映生活质量的第一典型变量V1主要由心理健康和情绪角色限制决定;反映社会支持的第一典型变量W1主要由主观支持和对支持的利用度决定。结论抗病毒治疗艾滋病病人生活质量差,社会支持水平低。病人获得的主观支持越多或对支持的利用度越高,则其心理健康状况越好;越少或越低,则由情感问题所造成的职能限制越大。     

Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: A Nordic multicentre study

Background: Few studies have investigated differences between subjective and externally assessed quality of life in individuals with a severe mental illness. In a sample of 387 patients with schizophrenia living in the community the present study investigated the association between subjective and interviewer-rated quality of life, clinical and sociodemographic factors related to the two assessments, and if discrepancies in the assessments were related to any clinical or social features of the patients. Method: The study was a Nordic multicentre study with a cross-sectional design. Instruments used were the Lancashire Quality of Life Profile, the Brief Psychiatric Rating Scale, the Interview Schedule for Social Interaction, Camberwell Assessment of Needs and General Assessment of Functioning. Results: The correlation between subjective and interviewer-rated quality of life was moderate (ICC=0.33). More severe affective symptoms, fewer emotional relations and a lower monthly income were related to poorer subjectively rated quality of life but in a stepwise multiple regression analysis accounted for only 14.1 of the variance. Poorer interviewer-rated quality of life was mainly related to a more severe psychopathology but also to a lower monthly income, fewer emotional relations and not being employed. Together these factors accounted for 45.5 of the variance. A greater discrepancy between the subjective and the interviewer rating was found in patients with less affective symptoms, unemployment, and a better social network. Conclusion: Only a moderate correlation between subjective and interviewer-assessed global quality of life was found, implying that the sources of assessment differed, as was also shown in subsequent regression models. It is concluded that both perspectives on the patient’s quality of life may be valuable for treatment planning, especially in cases where differences in quality of life assessment related to the patient’s psychopathology may be expected.     

Indicators of psychological well‐being in a sample of employed women: An exploratory study

Studies indicate that women experience higher rates of mental illness than do men. The basis of this difference in mental health status is unclear. The purpose of this study was to clarify whether self‐reports about the method, safety, and reliability of fertility regulation, the presence of menstrual symptoms, and specific social factors influence employed women's psychological well‐being (PWB). A cross‐sectional correlational approach to survey data was used. Data were collected through a structured questionnaire that included the General Well‐Being Schedule and the Moos Menstrual Distress Questionnaire. The sample (n = 633) consisted of healthy women between the ages of 21 and 44 years. Through multiple correlation/regression and chi‐square analysis techniques, relationships between and among the independent variables (menstrual symptoms, fertility regulation, and social factors), and the dependent variable PWB were examined. Results indicated that variations in PWB were related to safety and reliability of birth control method (p < .001), usualness of menstrual symptoms (p < .01), number of children (p < .025), effect of menstrual cycle on relationships (p < .05), and effect of the menstrual cycle on life in general (p < .05). The relationship between children in residence and PWB were nonsignificant, as was usualness of symptoms and birth control method. These results identify factors that have the potential to explain variations in women's mental health and can be viewed as progress toward explaining gender differences in mental health.     

合肥市蜀山区艾滋病患者生活质量与社会支持相关性分析

目的了解艾滋病患者生活质量及社会支持现状,并探讨其相关性。方法采用SF-36生活质量和社会支持评定量表问卷,整群抽取合肥市蜀山区25例接受免费抗病毒治疗的患者进行问卷调查。结果艾滋病患者在SF-36生活质量各领域得分均低于常模,与健康人群在躯体功能(PF)、总体健康(GH)、社会功能(SF)以及精神健康(MH)等领域差异有统计学意义(P0.05);社会支持总分29.04±6.96,与常模比较差异有统计学意义(t=3.97,P0.05),其中客观支持得分5.24±2.52,主观支持17.80±3.91,对支持的利用度6.00±2.33。情感职能与社会支持总分以及躯体功能与支持利用度呈明显正相关。结论艾滋病患者的生活质量受到人口学特征、疾病及相关因素、社会心理和社会支持等因素的影响,改善社会支持是提高他们生活质量的重要途径。     

Quality of Life and its Determinants in People Living with Human Immunodeficiency Virus Infection in Puducherry, India

Context:

With anti-retroviral therapy (ART) for human immunodeficiency virus infection (HIV) coming into picture, quality of life (QOL) has gained importance. Knowledge on the factors affecting QOL would be helpful in making important policy decisions and health care interventions.

Aims:

The aim of this study is to assess the quality of life of people living with HIV (PLWH) and to identify the factors influencing their QOL.

Materials and Methods:

The study was done among 200 PLWH attending a tertiary care hospital, and three Non Governmental Organizations at Puducherry, India, from November 2005 to May 2007. QOL was assessed using HIV specific World Health Organization Quality Of Life scale (WHOQOL-HIV) – BREF questionnaire which has six domains (physical, psychological, level of independence, social relationships, environment and spirituality/religiousness/personal belief). Social support and stigma were measured using “Multidimensional Scale of Perceived Social Support” and “HIV Stigma Scale,” respectively, using Likert Scale. Factors influencing QOL were identified using backward stepwise multiple linear regression with the six domain scores as the dependent variables.

Results:

Male: Female ratio was 1:1 and 58% were in early stage of the disease (stage I/II). Psychological and SRPB (Spirituality Religiousness and Personal Beliefs) domains were the most affected domains. All the regression models were statistically significant (P<0.05). The determination coefficient was highest for the social relationship domain (57%) followed by the psychological domain (51%). Disease stage and perceived social support significantly influenced all the domains of WHOQOL. Younger age, female gender, rural background, shorter duration of HIV, non-intake of ART and greater HIV related stigma were the high risk factors of poor QOL.

Conclusion:

Interventions such as ART, family, vocational and peer counseling would address these modifiable factors influencing QOL, thereby improving the QOL of PLWH.     

Sociodemographic,Psychological and Health-Related Factors Associated with Poor Mental Health in Spanish Women and Men in Midlife

ABSTRACT

Background: The purpose of this work was to examine the sociodemographic, psychological, and health-related factors (considered jointly) associated with poor mental health in midlife and to analyze whether risk and protective factors differed in men and women.

Methods: A cross-sectional study was conducted with a middle-class sample of 252 women and 189 men between 45 and 65 years of age from Spanish rural areas. Mental health status was measured with the 12-Item General Health Questionnaire (GHQ-12; Goldberg & Williams, 1988). Multiple logistic regression models were used to calculate odds ratios with confidence intervals of 95%, adjusting for confounding variables.

Results: The percentage of women (14.3%) with poor mental health was twice that of the men (7.4%). In women, the following variables were significantly and positively related to poor mental health: consumption of psychoactive drugs, physiological and cognitive anxiety; self-esteem and family satisfaction were protective factors. For men, physical complaints and cognitive anxiety were significant risk factors, and job satisfaction was a protective factor.

Conclusions: In general, the psychological variables were more clearly related to poor mental health. Women had a more unfavorable profile, and the variables related to poor mental health differed for men and women, perhaps due to social roles associated with gender. To facilitate diagnosis and take preventive measures, men's and women's risk factors for poor mental health should be differentiated.     

Subjective well-being, sociodemographic factors, mental and physical health of rural residents

Objective: To ascertain the relationship between subjective well‐being and sociodemographic factors, mental and physical health of a sample of rural residents. Design: Cross‐sectional survey with stratified random sampling of persons based on the 2000 State Electoral Role. Questionnaire was forwarded to 23 000 residents throughout a rural area. Setting: Households within Gippsland. Participants: Five thousand three hundred and ninety‐one adults aged 18 years and above. Main outcome measures: Residents completed a self‐reported questionnaire assessing life satisfaction/subjective well‐being, psychological distress, sociodemographic factors, physical and mental health problems. Results: Completed survey indicated that participants with lower levels of psychological distress, physical disability and mental disability had higher odds of being satisfied with their life. Participants with severe mental disability had the lowest odds of being satisfied with life. On average, participants were satisfied with their life (mean score of 21, SD = 5.9), are within the normal range of the Kessler‐10 (mean score = 16.31, SD = 5.85), had no mental disability (mean score = 51.8, SD = 7.36) on the mental component of the Short Form‐12 Health Survey, but are mildly physically disabled (mean score = 48.9, SD = 7.74). Conclusions: The results of this study indicate that sociodemographic factors, psychological distress, physical health and mental health contribute to subjective well‐being. Compared with other age groups, those aged 66 years and above had the highest level of life satisfaction. Those living with partner/spouse without children, with no mental or physical disability and no psychological distress had highest level of life satisfaction. Women also had higher levels of life satisfaction compared with men.     

个体心理干预对艾滋病病毒感染者抗病毒治疗的影响

目的 通过对艾滋病病毒感染者开展心理干预,了解心理健康水平中介因素对抗病毒治疗接受性和服药依从性的影响。方法 以认知疗法和支持性心理疗法为理论基础,由省级心理学专业团队设计了个体心理干预方案,结合日常随访工作,培训合格的随访医生实施个体干预。通过对600例艾滋病病毒感染者的干预对照研究,比较干预前后感染者各项指标变化情况。结果 干预后,干预组的抗病毒治疗比例(χ²=16.546,P<0.001)和在治依从性良好比例(χ²=12.693,P<0.001)均显著高于对照组;与对照组相比,干预组的艾滋病压力评分(t=-38.507,P<0.001)、焦虑评分(t=-36.907,P<0.001)、抑郁评分(t=-36.567,P<0.001)、消极应对评分(t=-12.497,P<0.001)显著下降;社会支持评分(t=33.172,P<0.001)、积极应对评分(t=8.332,P<0.001)显著上升。结论 个体心理干预可有效提高艾滋病病毒感染者心理健康水平,心理健康水平的提高对抗病毒治疗的接受性...     

Physical and mental component summaries score of the SF-36 in coronary patients

Background: The aim of the study was to determine the clinical and sociodemographic factors related to the physical and mental components of the health-related quality of life (HRQL) in coronary patients. Methods: We studied 132 patients diagnosed with Acute Myocardial Infarction (AMI) and unstable angina admitted to a cardiology unit over a period of 18 months. The HRQL was assessed with the Short Form 36 Health Questionnaire (SF-36) and the presence of possible mental disorders was measured using the General Health Questionnaire (GHQ-28). In order to study the variables related to both physical and mental summary components of the SF-36, two multiple linear regression models were constructed with the physical (PCS) and the mental component summary (MCS) as outcome variables. Results: The GHQ-28 score 6 was the variable most associated with the lowest PCS in the patients studied. Moreover in the patients with a personal history of coronary heart disease (CHD), age tended to increase the PCS of the HRQL, whereas in those with no such history, age diminished the PCS score. For the MCS, not being married, being of female sex, having GHQ-28 scores 6 and being of younger age were the four variables most related to the lowest MCS score in the patients studied. Conclusion: Age, sex, marital status, personal history of CHD and the presence of a possible mental disorder were the factors most related to HRQL in the coronary patients studied. Focusing medical attention on these groups could contribute to improving their quality of life.     

Depressed Mood and Social Support as Predictors of Quality of Life in Women Receiving Home Health Care

We examined relationships among depressed mood, social support and quality of life in 58 medically ill low-income women 40 years and older receiving home health care. Analyses showed a negative relation ship between depressed mood and quality of life (p’s ≤ 0.05). Positive relationships were found between number of people avail able for support and two of three quality of life domains as well as sat is faction with support and all three domains (p’s ≤ 0.05). Results also provided preliminary support that belonging to a church is related to emotional well-being (p = 0.039) and among those belonging to a church, recent increased activity was related to social/family well-being (p = 0.004). Mediational analyses revealed a cycle of depressed mood, dissatisfaction with social support, and loss of social support providers underlying the poor quality of life of many participants. This high lights the need to address the relation ship between depression and social support when treating patients with chronic illness.     

Social support,medication compliance and HIV/AIDS

Social work practitioners and researchers have greatly understudied the idea of how social support correlates with combination therapy medication compliance, in people living with HIV disease. Meanwhile, such data could help health social workers better assist HIV-infected people who want to cope well, live long, and avoid drug resistance. Therefore, this article presents findings from a three-stage empirical secondary data analysis that examined seven specific types of social support, psychological history and stage of illness variables, and sociodemographics and their connection to medication compliance ratings. A sub-sample of 179 HIV-infected clinical trial study participants enrolled in a federally funded combination therapy treatment study and a nested compliance study were analyzed. Analysis of 14 bivariate hypotheses and 20 predictor variables at the multivariate level revealed that having emotional support and being employed seemed to be predictive of being a "Good Complier." Also, having higher levels of HIV symptoms appeared to be associated with being a "Poor Complier."     

Quality of life of Turkish type 2 diabetics in Germany and Turkey – a comparison between Hamburg and Istanbul

Objectives. The analyses address the following research questions: (1) Do Turkish diabetics in Germany and Turkey differ in terms of quality of life? (2) If yes, can these differences (in part) be explained by social factors (age, gender, education, household size), functional limitations and availability of support? (3) Are social factors, functional limitations and availability of support differently associated with quality of life among Turkish diabetics in Germany and Turkey?

Design. For this comparative cross-sectional study, 111 patients with type 2 diabetes were personally interviewed in Istanbul (Turkey) and 294 Turkish patients in Hamburg (Germany). For quality of life measurement we have used the Turkish version of the WHOQOL-Bref-26. Sociodemographics included age, sex, education and household-size. Health related functional limitations were assessed on the basis of an index of (instrumental) activities of daily living including the availability of help. Statistical analyses were conducted on group comparisons with Chi-square- and T-tests as well as linear regressions.

Results. There are no significant differences between Turkish diabetics in Germany and Turkey in the physical and the psychological dimensions of the WHOQOL-Bref. However, in the WHOQOL-domains ‘social QoL’ and ‘environmental QoL’ Turkish diabetics living in Hamburg have a significantly better quality of life than their counterparts in Istanbul. These differences cannot be explained by individual sociodemographic factors, functional limitations and availability of support. Furthermore, we found much stronger positive associations between education and quality of life in Istanbul than in Hamburg.

Conclusion. Beyond strong similarities between the two samples in sociodemographics, physical and mental health the social and environmental quality of life was significantly assessed better by the Turkish diabetics living in Hamburg. This is most likely an effect of public investment in social security, infrastructure and health care which is also influencing the decision as to where to spend life in retirement.     

脑瘫儿童父母生存质量的影响因素分析

目的分析影响脑瘫儿童父母生存质量的相关因素,为医务人员对患儿父母进行心理干预提供理论依据。方法采用自制调查问卷、社会支持评定量表、WHO生存质量测定量表简表(WHOQOL-BREF)等量表对随机分层抽取的50名1⁷岁脑瘫患儿父母进行调查,结果采用多重线性回归的逐步回归法进行统计分析。结果患儿病情越重,父母年龄越大,患儿父母生理领域生存质量越低;患儿社会支持程度越高,患儿父母心理领域、社会关系领域生存质量越高;患儿父母文化程度越高,社会支持程度越大,患儿父母环境领域及总的生存质量越高。结论患儿病情程度、父母年龄、父母文化程度、所获社会支持程度等因素影响着脑瘫儿童父母的生存质量。     

A five-year prospective study of quality of life after colorectal cancer

Purpose

Long-term (??5?years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5?years to describe changes over time and antecedents of long-term outcomes.

Method

A prospective survey of a population-based sample of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5?months post-diagnosis as predictors of QOL and psychological distress 5?years post-diagnosis.

Results

QOL improved over time (P?P?>?0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, being single, low social support, low optimism, and a more negative cancer threat appraisal. Being women, having a pet, having a private health insurance, and receiving both surgery and adjuvant treatment were protective.

Conclusion

Consistent with response shift theory, the antecedents of QOL after colorectal cancer are multifactorial and include predisposing socio-demographic, medical, and psychological variables. Psychosocial interventions that target both social support and threat appraisal may be effective for this patient group. Additional stepped-up support may be needed for people from a poorer social environment who have multiple risk factors for poorer adjustment. Health system effects require further investigation.