Psychosocial Assessments for HIV plus African Adolescents: Establishing Construct Validity and Exploring Under-Appreciated Correlates of Adherence
Psychosocial Assessments for HIV plus African Adolescents: Establishing Construct Validity and Exploring Under-Appreciated Correlates of Adherence
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DOI：
10.1371/journal.pone.0109302
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发表时间：
2014-10-03
期刊：
影响因子：
3.7
通讯作者：
Glanz, Karen
中科院分区：
文献类型：
--
作者：
Lowenthal, Elizabeth D.;Marukutira, Tafireyi C.;Glanz, Karen
研究目的：心理社会因素，如预期结果，感知的耻辱，社会情感支持，考虑未来的后果，心理抗拒可能会影响青少年坚持抗逆转录病毒治疗。缺乏文化适应和有效的工具来衡量非洲青少年的这些因素。我们的目的是确定文化的具体因素的重要性，建立当地的结构validity in Botswana.Methods：使用34 HIV+青少年的深入访谈，我们探讨了如何在这种文化背景下的心理社会因素被认为上面列出。我们评估了六个尺度，已在其他情况下验证。我们还探讨了其他因素，青少年认为重要的艾滋病毒药物治疗的依从性。分析进行了分析框架的方法，使用NVivo9 software.Results：虽然一些西方衍生的评估工具的结构效度得到证实，其他工具在这种文化背景下，他们的结构代表性差。工具选择来评估艾滋病毒相关的预期结果和感知的耻辱是很好的理解和相关的青少年。来自青少年的反馈表明，工具来衡量所有其他结构需要重大修改，以获得在博茨瓦纳的结构效度。关于未来后果的规模知之甚少，并包含几个项目，缺乏相关性的Batteries青少年。他们认为心理抗拒在坚持中起着重要作用，但与抗拒量表的许多组成部分没有很好的相关性。社会情感支持的测量需要关注的是父母之间的关系，而不是在这种文化背景下的同伴支持。否认感染艾滋病毒是一个出乎意料的共同主题。矛盾服用medicines也expressed.Discussion：深入访谈的Batterian青少年证实了一些西方发达的社会心理评估工具的结构效度，但在其他人表现出的局限性。以前未被充分认识的因素与艾滋病毒药物治疗的依从性，如否认和矛盾心理，应进一步探讨。
Study Objectives: Psychosocial factors such as outcome expectancy, perceived stigma, socio-emotional support, consideration of future consequences, and psychological reactance likely influence adolescent adherence to antiretroviral treatments. Culturally-adapted and validated tools for measuring these factors in African adolescents are lacking. We aimed to identify culturally-specific factors of importance to establishing local construct validity in Botswana.Methods: Using in-depth interviews of 34 HIV+ adolescents, we explored how the psychosocial factors listed above are perceived in this cultural context. We evaluated six scales that have been validated in other contexts. We also probed for additional factors that the adolescents considered important to their HIV medication adherence. Analyses were conducted with an analytic framework approach using NVivo9 software.Results: While the construct validity of some Western-derived assessment tools was confirmed, other tools were poorly representative of their constructs in this cultural context. Tools chosen to evaluate HIV-related outcome expectancy and perceived stigma were well-understood and relevant to the adolescents. Feedback from the adolescents suggested that tools to measure all other constructs need major modifications to obtain construct validity in Botswana. The scale regarding future consequences was poorly understood and contained several items that lacked relevance for the Batswana adolescents. They thought psychological reactance played an important role in adherence, but did not relate well to many components of the reactance scale. Measurement of socio-emotional support needs to focus on the adolescent-parent relationship, rather than peer-support in this cultural context. Denial of being HIV-infected was an unexpectedly common theme. Ambivalence about taking medicines was also expressed.Discussion: In-depth interviews of Batswana adolescents confirmed the construct validity of some Western-developed psychosocial assessment tools, but demonstrated limitations in others. Previously underappreciated factors related to HIV medication adherence, such as denial and ambivalence, should be further explored.