Predictors of quality of life enjoyment and satisfaction in individuals living with HIV and AIDS in a resource-constrained setting in South Africa

The burden of HIV disease is concentrated in sub-Saharan Africa, particularly in South Africa (SA). Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of the study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) among individuals infected with HIV. A battery of questionnaires, which included the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), were administered to 121 participants. Data was analysed using SPSS. Of the total sample (n = 121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25–49 years old experienced psychological distress. Those who were not on antiretroviral treatment (ART) were significantly affected (66%). Psychological distress was significantly prevalent among HIV positive individuals and also the strongest predictor of Q-LES among these individuals.     

Psychological and social consequences of HIV exposure: Homosexuals in southern california

Abstract

The purpose of this study was to identify the psychological and social consequences experienced by apparently healthy homosexual men who learn that they have positive results on the HIV antibody test, but who have not yet developed AIDS or ARC. Employing a census survey of the male membership of three homophile organizations in a Southern California county (n=1905), 30 HIV positives and 55 negatives completed a biographical questionnaire, the IPAT Anxiety Scale Questionnaire, the IPAT Depression Scale, and the Coping Strategies Inventory. Results indicate that HIV positives show considerable disorganization after hearing test results, have clinically high levels of anxiety (n=10), and clinically high levels of depression (n=14) when compared to the normative samples. Positives also reported pervasive changes in their sexual activity (n=30), and experienced negative consequences in social (n=15) and occupational functioning (n=10). Twelve subjects reported suicidal ideation after they heard the results of their testing, with one subject reporting a suicide attempt. The methodological limitations of the study were examined, with an emphasis on the limitations of the survey method. Speculations to account for the reported behaviors were discussed.     

Psychological interventions for carers of people with dementia: A systematic review of quantitative and qualitative evidence

Rationale: Carers of people with dementia experience significant levels of stress in their everyday role. The National Dementia Strategy in England identifies the key role that carers play in supporting people with dementia living at home, often to the detriment of their social, emotional and physical health. Aims: To add to the substantive knowledge‐base by combining search criteria used by Pinquart and Sörensen (2006) and Gallagher‐Thompson and Coon (2007) to update the literature on psychological interventions for carers of people with dementia published between 2005 and 2011. Method: Following the study inclusion criteria, comprehensive searches were conducted using the electronic databases Medline, PsycINFO, ERIC, and PubMed. Twenty studies were identified, graded and synthesised into the reported systematic review with both quantitative and qualitative studies included to maximise practice application. Results: Consistent with previous findings, three categories of psychological intervention were identified: (i) psychoeducational‐skill building (n=8); (ii) psychotherapy‐counselling (n=1); (iii) multicomponent (n=6). Our review also identified a fourth intervention category, (iv) technology‐based (n=5). The majority of studies in the updated review examine the constructs of depression, burden, social support and well‐being. The development of focused interventions for carers, whether individually tailored interventions or group interventions around a common issue, was significant for developing practice. Future studies across all categories should continue to embed supervision arrangements within their psychological intervention protocols.     

Positive Psychology Factors as Predictors of Latina/o College Students’ Psychological Grit

Latina/o college students (N = 130) provided perceptions of psychological grit, presence of meaning in life, search for meaning in life, hope, life satisfaction, and mindfulness. Hope and mindfulness were significant predictors of psychological grit. A discussion regarding the importance of these findings and implications for counselors are presented. Un grupo de estudiantes universitarios latinos (N = 130) aportó sus percepciones de perseverancia psicológica, presencia de sentido en la vida, búsqueda de sentido en la vida, esperanza, satisfacción vital y atención plena. Se presenta una discusión sobre la importancia de estos hallazgos y sus implicaciones para los consejeros.     

The effect of contemplation and meditation on ‘great compassion’ on the psychological well-being of adolescents

This study aimed to evaluate the effect of contemplation and meditation (CM) training, with a focus on developing great compassion, on the psychological well-being (PWB) of adolescents. Participants (N = 51, mean age = 15.8) were randomly allocated to either CM training (n = 26) or a comparison group (n = 25). Both groups completed measures of PWB before and after the intervention. Adolescents who received CM training showed statistically significant increases in environmental mastery and personal growth, as well as decreased negative affect compared to the comparison group. Girls in the experimental group also showed a significant decrease in negative affect compared with boys in the experimental group. Both the experimental and comparison groups demonstrated increased life satisfaction, environmental mastery, self-acceptance, autonomy, and purpose in life. There were no changes in positive affect and positive relations with others for both groups.     

the relationship between pain and coping styles among hiv-positive men and women

Abstract

Pain in HIV/AIDS patients is associated with compromised quality of life and emotional adjustment. Although previous findings support a relationship between coping styles and subjective pain for various groups of chronically-ill persons, little research has examined the associations between coping and pain in HIV-positive or AIDS patients. The purpose of this study was to explore the relationship between pain and coping styles among 105 HIV-positive participants (32 women and 73 men) in a randomized clinical trial designed to examine the effect of group psychotherapy on quality of life and health behavior. Participants completed the Brief COPE, the pain scale from the Medical Outcomes Study-HIV, and a demographic and medical questionnaire. Multiple regression analysis, with pain as the dependent variable, showed that participants who reported coping through denial reported greater pain severity (p < 0.0001). These results suggest that denial as a coping strategy appears to be signficantly associated with pain for persons with HIV/AIDS. However, further research is necessary to determine the causal relationship between pain and coping through denial. These findings also point to the possibility of psychological intervention in order to modify maladaptive coping styles and to ameliorate pain in this population.     

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?

People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n?=?63, 31.3%, women, n?=?138, 68.7%, mean age?=?40.1, SD?=?10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.

     

Does a self management intervention lower distress in woman diagnosed with breast cancer?1

Psychological distress is particularly common with any cancer diagnosis. This paper examined the psychological distress in a cohort of women newly diagnosed with breast cancer and postulates on the underlying theory. A longitudinal study of a cohort of women (n = 147) diagnosed with breast cancer (within the past 1 year), was conducted at University Malaya Medical Centre, Kuala Lumpur. Data were collected at baseline and at post 4‐week intervention. Analysis of variance was conducted to examine for any significant differences in the change‐scores between the experimental group (n = 69) and the control group (n = 78). Using the change scores, analyses of variance showed significant differences between groups for stress, F(1, 140) = 13.68, p < .0001, anxiety F(1, 140) = 8.44, p < .004, and depression, F(1, 140) = 11.57, p < .0001. Levels of stress, anxiety and depression generally decreased significantly in the experimental groups, p < .05, but either maintained or increased in the control group. This study indicates that the level of psychological distress of women with breast cancer can be ameliorated with a 4‐week self‐management intervention. Lower stress levels were also found in women who reported engagement in higher physical activity than women with low physical activity.     

Unrealistic optimism and genetic risk

The study examined whether life stress moderated the effects of a physical activity intervention. Women (n = 184) and 154 men (61% non-Hispanic white, average age 24 years) from an urban university participated. Data were analyzed separately for men and women using a 2 × 2 ANCOVA adjusting for baseline physical activity (intervention vs. control × high life stress vs. low stress) with total physical activity at one-year and two-year assessments as dependent variables. No significant main effect for stress or condition was found. The interaction was significant (p = 0.015) for men at one-year, indicating that men in the intervention group with high stress were more active than low stress intervention men. Instruction received in the intervention group on the stress-relieving properties of physical activity may have helped men with high stress to adopt or maintain physical activity.     

Examining the Clinical Efficacy of Core Transformation: A Randomized Clinical Trial

This randomized clinical trial with a sample of adults (N = 129) from India explored the effects of a single core‐transformation session on symptom experience and psychological growth. The results over the total 8‐week study period indicated significant, moderate overall effect sizes (ds = 0.63 and 0.52) for symptom experience, emotional stability, affect balance, global well‐being, and purpose in life. Implications for research and clinical practice are discussed.     

Cost-effectiveness of online positive psychology: Randomized controlled trial

As yet, no evidence is available about the cost-effectiveness of positive psychological interventions. When offered via the Internet, these interventions may be particularly cost-effective, because they are highly scalable and do not rely on scant resources such as therapists’ time. Alongside a randomized controlled trial of an online positive psychological intervention, a health-economic evaluation was conducted. Mild to moderately depressed adults seeking self-help and recruited in the general population were randomly assigned to the intervention group (n?=?143) and a waitlisted usual care group (n?=?141). Improved clinical outcomes were achieved in the intervention group (at least for depression) at higher costs. When outliers (the top 2.5%, n?=?5 in intervention group, n?=?2 in control group) were removed, cost-effectiveness was increased considerably. For positive psychology, economic evaluations may be a means to nudge policy decision-makers towards placing positive psychological interventions on the health agenda.     

The Beliefs About Medication Scale: Development, Reliability, and Validity

The purpose of the study was to develop and evaluate a psychometrically sound health belief measure, the Beliefs About Medication Scale (BAMS) that can be used with adolescent chronic illness populations whose prescribed treatment includes oral medication. One hundred and thirty-three adolescents (age 11–18 years) with asthma (n = 60), HIV (n = 31), or inflammatory bowel disease (n = 42) completed the BAMS and, along with their parent, a self-report medication interview. A confirmatory factor analysis supported the hypothesized subscales of Perceived Threat, Positive Outcome Expectancy, Negative Outcome Expectancy, and Intent to Adhere to treatment. The subscales evidenced good internal consistency and 3-week test-retest reliability. Univariate and multivariate analyses demonstrated that the health belief constructs accounted for 22% of the variance in medication adherence beyond demographic and illness characteristics. The study provides preliminary evidence of the reliability and validity of a theoretically based measure of health beliefs for adolescents. The BAMS may be a useful tool to evaluate the psychological barriers to adherence that place teenagers at risk for nonadherence.     

Processes in acceptance and commitment therapy and the rehabilitation of chronic fatigue

Acceptance and commitment therapy (ACT) has never been tested for patients with chronic fatigue. We aimed to test if a 3.5‐week ACT rehabilitation program for patients with chronic fatigue improved quality of life (QoL), fatigue, and psychological flexibility. Further, to test if improvements in QoL and fatigue were associated with improvement in psychological flexibility, and if psychological flexibility explained variance above and beyond maladaptive cognitions typically targeted in CBT for fatigue. Patients (n = 140) who had been on sick leave > 8 weeks due to chronic fatigue received a 3.5‐week non‐controlled inpatient rehabilitation program based on ACT. A physician and a psychologist examined the patients, assessing medication use and SCID‐I diagnoses. Patients completed questionnaires about somatic complaints, psychological complaints, and maladaptive cognitions before and after treatment. At post‐treatment, patients reported improved QoL (p < 0.001; g = 1.07) and less fatigue (p < 0.001; g = 1.08), but not increased psychological flexibility (p = 0.6). Changes in psychological flexibility was associated with improved QoL, but not fatigue, in hierarchical regression analyses. When adjusting for other cognitions, changes in fear‐avoidance cognitions and all‐or‐nothing thoughts, but not psychological flexibility, were associated with improved QoL and fatigue. The ACT‐based treatment improved QoL and reduced fatigue for patients with chronic fatigue with large effect sizes. Improvement was associated with a reduction in fear‐avoidance cognitions and all‐or‐nothing thoughts, but not psychological flexibility.     

Evaluation of a Brief Mindfulness Program for People with Multiple Sclerosis Delivered in the Community Over Five Years

This study evaluated the effectiveness, change mechanisms, and sustainability of a brief mindfulness intervention for people with multiple sclerosis (PwMS) delivered in the community through a frontline service over five years. Participants were 126 PwMS. A single intervention condition design was used with pre-intervention, post-intervention and 2-month follow-up assessments. The primary outcome was distress. Secondary outcomes were perceived stress, quality of life (QoL) and fatigue, and the proposed change mechanisms: mindfulness, self-compassion, psychological inflexibility. Intention-to-treat analyses showed the primary outcome, distress (Cohen’s d = .25), and all secondary outcomes improved: perceived stress (d = .38), mental health QoL (d = .39), physical health QoL (d = .47), fatigue (d = .30), mindfulness (d = .29), self-compassion (d = .37), psychological flexibility (d = .44). Distress, stress and perceived stress continued to improve post-intervention to follow-up. Mindfulness emerged as a temporal mediator of perceived stress (BCa 95% CI). Self-compassion mediated concurrent improvements in distress, perceived stress, fatigue and physical health QoL, while greater psychological flexibility mediated concurrent reductions in distress (BCa 95% CI). Mindfulness home practice was unrelated to improvements on all outcomes except a marginal association with mindfulness. Of the socio-demographic and illness factors, lower disease severity predicted improvements in physical health QoL (p = .046). Improvements in outcomes were supported by qualitative feedback and participant satisfaction ratings. Twenty-one groups were offered with good participant engagement and wide geographical reach, suggesting sustained feasibility of the Mindfulness for MS program over five years. Findings support the delivery of the Mindfulness for MS program through a community-based service in partnership with a local university.

     

Validating Measures of Psychological Well-being by Contrasting Samples Employed in Hazardous and Less Hazardous Work

The study investigated whether differences between contrasting groups reflect significant differences in psychological well-being scores. Membership of hazardous vs. less hazardous occupations in the same profession served as proxy measures of well-being. Antonovsky's Sense of Coherence (SOC), Block & Kremen's Ego-resiliency, and Goldberg's Emotional Stability scales were validated. Study 1 compared mine rescue team members and ordinary miners (n = 34, 41) and Study 2 police special task force members and regular officers (n = 43, 41). In Study 1, SOC and job satisfaction predicted group membership. In Study 2, satisfaction with life and extraversion scales predicted group membership, as did SOC in a secondary analysis. The SOC scale could predict psychological well-being in hazardous work settings.     

Beyond Smiling: The Evaluation of a Positive Psychological Intervention Aimed at Student Happiness

The aim of this study was to develop and evaluate a positive psychological intervention (PPI) aimed at increasing happiness of students in a tertiary educational institution. A convenience sample (n = 20) was drawn from the entire population of academic third year students in the field of Industrial/Organisational psychology (n = 109). The majority of the participants were Sesotho speaking (45%), black (95%), female (90%), and 21 years of age (45%). A single group pre-, post-, and post-post-test design was used. The PPI stretched across eight months and was presented in two phases: (a) a three day self-development workshop and (b) six sessions of individual coaching. The intervention focused on facilitating development on two levels, namely a psychological (engagement, meaning, person-environment fit, autonomy, competence, relatedness and authenticity), and emotional (pleasure, affect balance and life satisfaction) level. Data were collected using the Satisfaction with Life Scale, Positive and Negative Affect Scale, Orientations to Happiness Questionnaire, Basic Psychological Needs Scale, the Authentic Self Inventory and Person-Environment Fit scale. The results indicated that the overall happiness of a student increased through developing individuals on both an emotional and psychological level. The PPI affected all the aspects conceptualised in this study, except for two components of authenticity. Therefore, a multi-dimensional approach towards PPIs aimed at happiness of students in a tertiary educational environment may contribute to happy students.     

Effects of Neuro-Linguistic Psychotherapy on psychological difficulties and perceived quality of life

Aims: The purpose of this study was to examine the effects of Neuro-Linguistic Psychotherapy on psychological difficulties and perceived quality of life of clients who came for psychotherapy during free practice. Method: A total of 106 psychotherapy clients were randomly assigned to a therapy group or a control group. The outcome was assessed by the Structured Clinical Interview for DSM-IV Personality Disorders (SCID II) with respect to clinical symptoms and by the Croatian Scale of Quality of Life (KVZ) with respect to Quality of Life. The therapy group received the measures at pre-, post- and five-months follow-up occasions, whereas the control group received them initially and after a period of three months. Results: In the therapy group, as compared to the control group, there was a significant decrease of clinical symptoms and increase in the quality of life. With respect to clinical symptoms, effect sizes were 0.65 at post-measurement and 1.09 at follow-up, indicating a substantial reduction of symptom strain, which is comparable to the well established effects of Cognitive Behavior Therapy. We also found a significant increase in perceived quality of life after therapy, as compared to the wait-list control group, with effect sizes between 0.51 and 0.73. Therapeutic improvements were still present five months after the end of therapy, showing further development in the same direction. Conclusions: Neuro-linguistic psychotherapy is an efficient intervention, which is on a par with other, well-established psychotherapeutic techniques.     

Correlates of Dispositional and State Flow in Tennis Competition

The purpose of this study was to investigate the relationship between psychological correlates and flow in tennis competition. Using a cross-sectional design, the sample of 261 junior tennis athletes showed moderate-to-strong correlations between flow (dispositional and state) and confidence (r _disp = .59; r _state = .35), imagery use (r _disp = .58; r _state = .32), and action control (r _disp = .41; r _state = .40), whereas absorption was orthogonal to flow. Commonality analysis revealed that imagery and confidence accounted for 34.2% of the variance in dispositional flow. The results are discussed for the development of intervention studies in order to enhance flow in competition.