Depression,anxiety and social support in rheumatoid arthritic women without and with a spouse

Abstract

A comparison was made of income and physical, social and psychological aspects of health between 22 female patients who had never married, 127 patients living with a spouse and 53 patients who were widowed or divorced. No significant differences were found between never married patients and patients living with a spouse. The widowed or divorced patients however had a lower income, reported less potential support, more depression and anxiety than the patients who were never married and those living with a spouse. The relationship of social support to depression and anxiety was investigated in spouseless patients (n=75) and in those living with a spouse (n=127). In both groups of patients, less potential support was found to be related to more anxiety. In addition, pain was found to contribute significantly to depression and to anxiety only in the patients living with a spouse. With regard to the latter, it is suggested that the debilitating influence of pain on the relationship with the partner might have been the mediating factor.     

Stress,coping, and depressive symptomatology in Latina and Anglo aids caregivers

In a survey of 432 AIDS caregivers, we examined differences in the stress and coping process and predictors of depressive symptomatology by ethnicity and gender. Our sample included 192 Anglo gay and bisexual male partners, 86 Anglo women, and 154 Latina family caregivers. We examined differences in primary and secondary stressors as predictors of depression; differences in sociodemographic and background factors, and differences in the predictive value and mediating influences of factors that may attenuate the relationship between stress and depression. Results indicate substantial differences in predictors and mediators of depression across groups. While all groups evidenced moderate levels of depression, background factors influenced depression mostly for Latinas. Depression in gay and bisexual partners was more influenced by primary objective stressors such as assisting with activities of daily living (ADLs). Service acquisition appears to be shaped by access, knowledge, and cultural acceptance. Based on our findings, we suggest that service provision for caregivers must also vary and be attuned to cultural and gender differences that may influence perception of stress and depression for caregivers.     

Coping with HIV as a chronic illness: A longitudinal analysis of illness appraisals

Illness appraisals are central to understanding how individuals cope with chronic illness. An interpretive phenomenological approach to the analysis of two years of bimonthly stressful event narratives in a sample of 57 HIV?+?gay men revealed five groups that differed on how they appraised HIV and one group of individuals who changed from one type of appraisal to another over the course of the 2-year study. The ways of appraising HIV revealed in this analysis have implications for interventions and for the study of coping with HIV as a chronic illness. The repeated assessment of specific HIV-associated stressful events and a qualitative analytic approach allowed for a more in-depth understanding of the meaning of HIV for the participants. This study suggests that coping interventions may be more powerful if they are tailored to individual appraisals of HIV because different forms of coping are likely to be differentially effective depending on the meaning of HIV in the individual's life.     

Cross-sectional and Longitudinal associations in coping strategies and physical health outcomes among HIV-Positive youth

This study assessed whether coping styles had an influence on physical health outcomes either concurrently or longitudinally in a sample of HIV-positive youth. Coping styles were characterized as positive, passive, depressive withdrawal, and escapist. A cross-sectional latent variable analysis (N = 279) assessed associations among environmental stress, self-esteem, social support, coping styles, AIDS symptoms, and CD4 count. A more restricted longitudinal analysis (N = 174) tested associations among earlier environmental stress, self-esteem, coping styles, and AIDS symptoms at follow-up. CD4 count was not associated with coping styles in the cross-sectional analysis. Concurrent AIDS symptoms were significantly predicted by depressive withdrawal and environmental stress. A passive coping style modestly predicted more AIDS symptoms longitudinally. Correlates of perceived health and well-being of persons with HIV/AIDS are important to investigate in addition to more objective measures such as CD4 count that may not be amenable to change through coping style interventions alone.     

Structural Ecosystems Therapy for HIV+ African‐American Women and Drug Abuse Relapse

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ). This report examines the effect of Structural Ecosystems Therapy (SET) for (n=143) HIV+ African‐American women on rate of relapse to substance use relative to both a person‐centered approach (PCA) to therapy and a community control (CC) group. A prior report has shown SET to decrease psychological distress and family hassles relative to these 2 comparison groups. In new analyses, SET and CC had a significant protective effect against relapse as compared with PCA. There is evidence that SET's protective effect on relapse was related to reductions in family hassles, whereas there was not a direct impact of change in psychological distress on rates of relapse. Lower retention in PCA, perhaps caused by the lack of a directive component to PCA, may have put these women at greater risk for relapse. Whereas SET did not specifically address substance abuse, SET indirectly protected at‐risk women from relapse through reductions in family hassles.     

如何成为一名优秀的骨科医生

目前,由于医疗模式的转变,除了对患者本身疾病的治疗外,患者的满意程度和生命质量也成为衡量治愈率高低的一个标准。因此,加强医护人员培养教育,提升医疗服务质量任重而道远。这篇文章探讨了成为一名优秀的临床医护人员所应具备的品质和能力特征。     

Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives

HIV treatment adherence interventions increasingly rely on peer facilitators to promote treatment adherence and improve patient retention, yet little is known about how participants perceive the role performed by peer facilitators. The present study examined participant perceptions in terms of the social support from peer facilitators in a hospital‐based intervention in Chicago. Content analysis was conducted with reference to four types of social support (instrumental, informational, emotional and affiliational) on exit interviews with 11 participants enrolled in the intervention that targeted African‐American patients living with HIV/AIDS. We examined how the type of social support perceived by participants was related to their self‐reported behaviours in three domains: adherence, sexual safety and general coping. Our analysis revealed that most participants perceived informational and emotional support from their peer facilitators, followed by instrumental support. Affiliational support was the least frequently perceived type of social support. We found that perceived informational support from peer facilitators with regard to adherence had greater impact and credibility amongst participants than the same type of support from medical providers. Informational support was cited most frequently with regard to influencing adherence and sexual safety behaviours, whereas perceived emotional support was cited primarily with helping participants cope with HIV. Copyright © 2015 John Wiley & Sons, Ltd.     

Using the Theory of Gender and Power to Examine Experiences of Partner Violence,Sexual Negotiation,and Risk of HIV/AIDS Among Economically Disadvantaged Women in Southern India

This article uses the Theory of Gender and Power to examine women's vulnerability to HIV/AIDS in order to: understand the vulnerability of female sex workers/poor women due to poverty and lack of educational resources; explore women's vulnerability in the context of client/partner violence, alcohol use, male partner's high-risk behaviors, and women's lack of control in their intimate relationships; and explore the role of traditional heterosexual gender norms in the outcomes of sexual negotiation. Ethnographic data were collected from 32 women and 38 men in India as part of an ongoing National Institute of Mental Health study. Results highlighted women's vulnerability to HIV/AIDS stemming from partner violence, alcohol use, poverty, dangers of sex work environments, and tacit acceptance of cultural/gender norms.     

The Role of Male Sexual Partners in HIV Infection Among Male-to-Female Transgendered Individuals

SUMMARY

Male-to-female transgendered persons (MtF) in San Francisco have very high HIV prevalence and incidence. To explore possible sources for these high rates of HIV infection, a rapid needs assessment was conducted using two methods: (1) an interviewer-administered, mostly closed-ended survey with the male partners of MtF persons, and (2) focus groups with MtF persons. Five main themes were evident from the findings: (1) male partners of MtF persons are of all ages, races, sexual orientations, and socioeconomic backgrounds; (2) high-risk sex occurs between MtF persons and their male sexual partners, despite a high level of concern about HIV among both the male and MtF study participants; (3) drug use appears to play a role in unsafe sex between MtF and their male partners; (4) male partners of MtF persons may represent a possible bridge for HIV transmission among different populations, given that they reported sex with male and female partners, as well as transgendered partners; and (5) men engaging in receptive anal sex with MtF partners probably occurs more frequently than reported by the male participants, given the comments of MtF study participants. The results indicate a need for creative, community-based HIV prevention strategies that target the male partners of MtF transgendered persons.     

Gender as an Obstacle in HIV/AIDS Prevention: Considerations for the Development of HIV/AIDS Prevention Efforts for Male-to-Female Transgenders

SUMMARY

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention intervention efforts targeting male-to-female (MTF) transgender people.

This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area.

Quantitative analysis demonstrated that this sample is composed of young, unemployed, and undereducated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the “feminine.” Their discourse underlines their need to reinforce their identity by the construction of a female self which undermines their possibilities for negotiating safer sex, as happens to most females in Latino societies.

Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities.