Depression, social support, and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India
Depression, social support, and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India
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DOI：
10.1080/09540121.2018.1563281
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发表时间：
2019-05-04
影响因子：
1.7
通讯作者：
Nyamathi, Adeline M.
中科院分区：
文献类型：
--
作者：
Garfin, Dana Rose;Shin, Sanghyuk S.;Nyamathi, Adeline M.
生活质量（QOL）与艾滋病毒/艾滋病人群的更好结局相关。我们在印度600名女性艾滋病毒/艾滋病感染者（WLH/A）[平均年龄= 34.31，SD = 6.97]中探索了生活质量随时间改善的预测因素，这些女性参加了护士领导的阿莎（认可的社会健康活动家）干预。经过培训的当地访谈者确定了基线和六个月随访（干预后）的自我报告数据。潜在类别分析（LCA）确定星座的反应心理社会指标（抑郁症，社会支持，内化的耻辱和耻辱的恐惧），随着时间的推移，他们与生活质量的关系进行了检查。我们确定了三个类：第1类：最高社会资源/最低抑郁;第2类：一些社会资源/最高抑郁;第3类：最低社会资源/更高抑郁。在基线时，3级报告的QOL最低（M = 0.25，SD = 0.26）; 1级报告的QOL最高（M = 0.37，SD = 0.33）。2类的生活质量没有从3类的生活质量不同，可能是由于高抑郁症的有效影响。在6个月的随访中，所有组都报告了生活质量的改善;类别成员资格不再预测变异性（2级与1级对比=-0.05，95%CI =-0.14，0.04; 3级与1级对比= 0.01，95%CI =-0.03，0.05; 3级与2级对比= 0.07，95%CI =-0.02，0.16）。心理社会指标是生活质量的重要预测因子; Asha支持的方法可能具有广泛的适用性，以提高印度WLH/A的生活质量。
Quality of life (QOL) is associated with better outcomes in HIV/AIDS populations. We explored predictors of improved QOL over time in 600 Women Living with HIV/AIDS (WLH/A) in India [mean age = 34.31, SD = 6.97], enrolled in a nurse-led-Asha (Accredited Social Health Activist) intervention. Trained local interviewers ascertained self-report data at baseline and six-month follow-up (post-intervention). Latent Class Analysis (LCA) identified constellations of responses on psychosocial indicators (depression, social support, internalized stigma and stigma fears); their relationship with QOL over time was examined. We identified three classes: Class 1) Highest Social Resources/Lowest Depression; Class 2) Some Social Resources/Highest Depression; and Class 3) Lowest Social Resources/Higher Depression. At baseline, Class 3 reported the lowest QOL (M = 0.25, SD = 0.26); Class 1 reported the highest (M = 0.37, SD = 0.33). Class 2's QOL did not differ from Class 3's QOL, likely due to the potent effects of high depression. At six-month follow-up, all groups reported improved QOL; class membership no longer predicted variability (contrast between Class 2 and 1 = -0.05, 95% CI = -0.14, 0.04; contrast between Class 3 and 1 = 0.01, 95% CI = -0.03, 0.05; contrast between Class 3 and 2 = 0.07, 95% CI = -0.02, 0.16). Psychosocial indicators are important predictors of QOL; an Asha-supported approach may have broad applicability to improve QOL in WLH/A in India.