集体心理干预对癌症患者应对方式影响的研究

为了探索集体心理干预对癌症患者应对方式的影响,本研究在90名癌症患者中随机选取46人进行干预研究。为考察干预效果,在干预后分别以医学应对方式问卷各维度因子的前测得分为协变量,以医学应对方式问卷各维度因子的后测得分为因变量,进行2(分组:实验组、对照组)×2(性别:男、女)×3(年龄:低龄组、中龄组、高龄组)的三因素协方差分析。结果表明,经过集体心理干预的实验组在应对方式各分量表上的得分要显著高于对照组,集体心理干预在性别和年龄上不存在显著差异。研究结果表明集体心理干预能够有效地改善癌症患者的应对方式。     

A Social Ecological Model of Syndemic Risk affecting Women with and At-Risk for HIV in Impoverished Urban Communities

Syndemic risk is an ecological construct, defined by co‐occurring interdependent socio‐environmental, interpersonal and intrapersonal determinants. We posited syndemic risk to be a function of violence, substance use, perceived financial hardship, emotional distress and self‐worth among women with and at‐risk for HIV in an impoverished urban community. In order to better understand these interrelationships, we developed and validated a system dynamics (SD) model based upon peer‐reviewed literature; secondary data analyses of a cohort dataset including women living with and at‐risk of HIV in Bronx, NY (N = 620); and input from a Bronx‐based community advisory board. Simulated model output revealed divergent levels and patterns of syndemic risk over time across different sample profiles. Outputs generated new insights about how to effectively explore multicomponent multi‐level programs in order to strategically develop more effective services for this population. Specifically, the model indicated that effective multi‐level interventions might bolster women’s resilience by increasing self‐worth, which may result in decreased perceived financial hardship and risk of violence. Overall, our stakeholder‐informed model depicts how self‐worth may be a major driver of vulnerability and a meaningful addition to syndemic theory affecting this population.     

Healing Without Waging War: Beyond Military Metaphors in Medicine and HIV Cure Research

Military metaphors are pervasive in biomedicine, including HIV research. Rooted in the mind set that regards pathogens as enemies to be defeated, terms such as “shock and kill” have become widely accepted idioms within HIV cure research. Such language and symbolism must be critically examined as they may be especially problematic when used to express scientific ideas within emerging health-related fields. In this article, philosophical analysis and an interdisciplinary literature review utilizing key texts from sociology, anthropology, history, and Chinese and African studies were conducted to investigate the current proliferation of military metaphors. We found the use of these metaphors to be ironic, unfortunate, and unnecessary. To overcome military metaphors we propose to (1) give them less aggressive meanings, and/or (2) replace them with more peaceful metaphors. Building on previous authors' work, we argue for the increased use of “journey” (and related) metaphors as meaningful, cross-culturally appropriate alternatives to military metaphors.     

The Role of the Black Church in HIV Prevention: Exploring Barriers and Best Practices

Black people have the highest rate of HIV/AIDS infection in the USA, and they are less likely to access quality physical and mental healthcare. To address these disparities as outlined in the National HIV/AIDS Strategy, there is a need for culturally congruent, innovative approaches to HIV/AIDS prevention. The first multi‐denominational national study of Black faith leaders was conducted utilizing focus groups that were held in 11 US cities. The 265 participants were faith leaders who reported involvement in such prevention practices as sponsoring HIV/AIDS workshops, integrating HIV/AIDS messaging in the worship service, hosting HIV/AIDS screenings, distributing written materials about HIV/AIDS through the bulletin or flyers, pastoral counselling, advocating for policies that provide quality healthcare to the community and disseminating HIV/AIDS prevention messages through new media such as the Church website. These findings, including attention to barriers to engagement, provide insight into innovative practices that can be integrated into faith‐based HIV/AIDS prevention programming. Copyright © 2016 John Wiley & Sons, Ltd.     

The Association Between Age and Ethics-Related Issues in Using Social Media for HIV Prevention in Peru

Little research has focused on the ethical issues around using social media for HIV prevention in low- and middle-income countries, such as Peru. This study surveyed participants from the HOPE social media HIV intervention in Peru to assess their experiences and perceptions of ethical issues in the study and the impact of age on their experiences and perceptions. This study found that, compared to younger participants, older participants were more likely to express higher levels of understanding of the consent form and trust that other participants were real. Older participants also reported being less likely to benefit from learning about their HIV status. Findings suggest that age plays a role in participants’ experiences in a social-media-based HIV intervention.     

Health outcomes resulting from the quality of emotional expression in HIV/AIDS patients

IntroductionStudies on emotional expression and its impact upon health have mainly focused on quantitative aspects of interactions rather than on their quality.ObjectiveThe present study aimed to examine the interpersonal quality of interactions in the social sharing of emotions (SSE) in people living with HIV/AIDS (PLWHA), and its impact on patients’ physical and psychological well-being.MethodOne hundred and one PLWHA answered a questionnaire (Likert scale items) which assessed the following: shame, guilt, perceived stigma, perceived physical health, perceived mental health, SSE and the interpersonal quality of SSE (IQSSE). The main hypotheses were compiled into a theoretical model which was tested by a series of structural equation modeling (SEM) analyses.ResultsThe final solution resulted into a well-fit model which showed that: shame predicted IQSSE, perceived stigma mediated the relationship between IQSSE and guilt, and perceived mental health mediated the relationship between IQSSE and perceived physical health.ConclusionThese results corroborate previous findings which demonstrate that IQSSE is independent from quantitative aspects of SSE and that the way the SSE takes place is crucial to the benefits it induces.     

Optimizing preoperative expectations in cardiac surgery patients is moderated by level of disability: the successful development of a brief psychological intervention

Patients’ expectations have shown to be a major psychological predictor of health outcome in cardiac surgery patients. However, it is unclear whether patients’ expectations can be optimized prior to surgery. This study evaluates the development of a brief psychological intervention focusing on the optimization of expectations and its effect on change in patients’ expectations prior to cardiac surgery. Ninety patients scheduled for coronary artery bypass graft were randomly assigned to (1) standard medical care, (2) additional expectation manipulation intervention (EMI), and (3) additional attention control group. Therapists’ fidelity to intervention manuals and patients satisfaction with the intervention were assessed for both active intervention conditions. Patients’ expectations about post-surgical disability, treatment control, personal control, and disease duration were assessed before and after the psychological intervention. Demographical, medical, and psychosocial characteristics and disability were assessed at baseline. Treatment fidelity and patient satisfaction was very high in both intervention conditions. Only patients receiving EMI developed higher personal control expectations and longer (more realistic) expectations of disease duration. The effect of intervention group on patients’ disability expectations and patients’ personal control expectations was moderated by patient’s level of disability. EMI patients with low to moderate disability developed positive expectations whereas patients with high disability did not. This study shows the successful development of a short psychological intervention that was able to modify patients’ expectations, especially in those with low to moderate disability. Given the robust association of expectations and surgery outcome, such an intervention might offer the opportunity to enhance patients’ health following cardiac surgery.     

Apathy is associated with lower mental and physical quality of life in persons infected with HIV

HIV infection is associated with lower health-related quality of life (HRQoL), which is influenced by immunovirological factors, negative affect, neurocognitive impairment, and functional dependence. Although apathy is a common neuropsychiatric sequela of HIV infection, emerging findings regarding its unique role in lower HRQoL have been mixed. The present study was guided by Wilson and Cleary's (1995), model in examining the association between apathy and physical and mental HRQoL in 80 HIV+ individuals who completed a neuromedical examination, neuropsychological assessment, structured psychiatric interview, and a series of questionnaires including the SF-36. Apathy was measured using a composite of the apathy subscale of the Frontal Systems Behavioral Scale and the vigor-activation subscale of the Profile of Mood States. Independent of major depressive disorder, neurocognitive impairment, functional status, and current CD4 count, apathy was strongly associated with HRQoL. Specifically, apathy and CD4 count were significant predictors of physical HRQoL, whereas apathy and depression were the only predictors of mental HRQoL. All told, these findings suggest that apathy plays a unique role in HRQoL and support the importance of assessing and managing apathy in an effort to maximize health outcomes among individuals with HIV disease.