"Cooling of the mind": Assessing the relevance of mindfulness training among people living with HIV using alcohol and other substances in South Africa.
"Cooling of the mind": Assessing the relevance of mindfulness training among people living with HIV using alcohol and other substances in South Africa.
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DOI：
10.1016/j.socscimed.2020.113424
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Andersen LS
中科院分区：
文献类型：
--
作者：
Magidson JF;Satinsky EN;Luberto CM;Myers B;Funes CJ;Vanderkruik R;Andersen LS
“想得太多”是一种在撒哈拉以南非洲地区发现的痛苦文化习语，包括艾滋病毒感染者（PLWH），这与抑郁症，药物使用和艾滋病毒药物不依从性有关。尽管正念训练与解决思考过多，改善艾滋病毒相关结果和减少药物使用的相关性，但为适应这种情况和更广泛的服务不足人群而进行的正念训练的努力有限。我们在这方面探讨了：（a）在与坚持和物质使用作斗争的PLWH中思考过多的经历;（B）正念训练对解决思考过多的适当性;（c）实施正念训练的潜在障碍和促进因素。我们对开普敦郊区的两家诊所的患者（n = 19）和医疗服务提供者（n = 11）进行了半结构化采访。在ADAPT-ITT模型的指导下，我们纳入了体验式正念练习，参与者分享了他们对当地语言（isiXhosa）干预的观察和描述。参与者发现正念相关，文化突出，适合重新集中注意力。研究结果提供了参与者提供的独特语言，以在未来定制正念训练（例如，“听你的静脉”，“冷却的头脑”）。与会者确定了潜在的实施障碍，包括缺乏隐私，以及指导未来调整的促进因素。需要更多的研究来适应和增加全球资源有限环境中的正念训练，同时保持治疗的完整性和保真度。
“Thinking too much” is a cultural idiom of distress identified across sub-Saharan Africa, including among people living with HIV (PLWH), which is associated with depression, substance use, and HIV medication nonadherence. Despite the relevance of mindfulness training to address thinking too much, improve HIV-related outcomes, and reduce substance use, efforts to adapt mindfulness training for this context and underserved populations more broadly have been limited. We explored in this context: (a) the experience of thinking too much among PLWH struggling with adherence and substance use; (b) the appropriateness of mindfulness training to address thinking too much; and (c) potential barriers and facilitators to implementing mindfulness training. We conducted semi-structured interviews with patients (n = 19) and providers (n = 11) at two clinics in a peri-urban area of Cape Town. Guided by the ADAPT-ITT model, we included an experiential mindfulness practice and participants shared their observations and descriptions of the intervention in the local language (isiXhosa). Participants found mindfulness relevant, culturally salient, and appropriate for refocusing the mind. Findings provide unique language offered by participants to tailor mindfulness training in the future (e.g., “hearing your veins,” “cooling of the mind”). Participants identified potential implementation barriers, including lack of privacy, and facilitators to guide future adaptations. More research is needed to adapt and increase access to mindfulness training in resource-limited settings globally, while also maintaining treatment integrity and fidelity.
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DOI：
10.1111/tmi.12502
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期刊：
Tropical medicine & international health : TM & IH
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