A Coping Intervention for HIV-Infected Older Adults

针对感染艾滋病毒的老年人的应对干预措施

• 批准号: 6879201
• 负责人: Timothy Glenn Heckman
• 金额: $ 63.2万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6879201
• 关键词: AIDS; HIV infections; aging; behavior test; behavior therapy; behavioral /social science research tag; clinical research; comorbidity; coping; depression; group therapy; health care service utilization; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; interview; longitudinal human study; patient oriented research; psychological aspect of aging; psychological stressor; quality of life; self care; social support network; therapy compliance

This revised application is in response to PA-97-069 "AIDS and Aging: Behavioral Sciences Prevention Research" and requests support to evaluate a Coping Improvement Group Intervention for persons 50 years of age and older living with HIV disease. Through December 2001, more than 90,000 persons living with AIDS in the United States were 50 years of age or older at the time of their AIDS diagnosis (CDC, 2001). Unfortunately, because most AIDS mental health research has focused on younger individuals, geropractitioners know little about the mental health needs of HIV-infected older adults. Across a series of preliminary studies supported by NIH, our study team has characterized levels of psychological distress and coping difficulties in late middle-aged and older adults living with HIV/AIDS. These studies portend that many HIV-infected older adults experience elevated levels of depression and suicidal ideation, confront complex barriers to medical and mental health care services, and lack social support resources. These and other dilemmas not only reduce one's life quality but may also lead to health-compromising behaviors in this group, such as poor adherence to HIV treatment regimens and the continued practice of high HIV-transmission risk behaviors. The proposed three-year study will evaluate the impact of a face-toface Coping Improvement Group Intervention on the adjustment efforts of HIV-infected persons 50-plus years of age in relation to two comparison conditions. Three hundred (N=300) HIV-infected older adults will be randomly assigned to either: (1) a face-to-face, Coping Improvement Group Intervention based on Lazarus and Folkman's (1984) Transactional Model of Stress and Coping; (2) a face-to-face, Information-Support Group Intervention; or (3) a Standard of Care Comparison Condition. Pre- and post-intervention measures, along with follow-up assessments collected 4- and 8-months post-intervention, will assess the relative efficacy of the three conditions. Participants will complete measures assessing comorbid health conditions, cognitive functioning, sources of life stress, ways of coping, psychological distress, social support, health services utilization, treatment adherence, and quality of life. At the current time, there are few--if any--age appropriate mental health interventions for HIV-infected older adults. However, the planned research may yield a culturally-contextualized coping improvement intervention for this vulnerable population, and this innovation would contribute significantly to the AIDS care and gerontological fields.

本修订申请是对PA-97-069“艾滋病与老龄化：行为科学预防研究”的回应，并请求支持评估50岁及以上艾滋病毒感染者的应对改善小组干预措施。截至2001年12月，美国有90，000多名艾滋病患者在被诊断为艾滋病时年龄在50岁或以上（CDC，2001）。不幸的是，由于大多数艾滋病心理健康研究都集中在年轻人身上，老年护理人员对感染艾滋病毒的老年人的心理健康需求知之甚少。在NIH支持的一系列初步研究中，我们的研究小组描述了中年晚期和老年艾滋病毒/艾滋病患者的心理困扰和应对困难的水平。这些研究预示着 许多感染艾滋病毒的老年人经历抑郁和自杀意念水平升高，面临医疗和精神卫生保健服务的复杂障碍，缺乏社会支持资源。这些和其他困境不仅会降低一个人的生活质量，而且还可能导致该群体的健康损害行为，例如对艾滋病毒治疗方案的依从性差以及继续实施艾滋病毒传播高风险行为。拟议的三年期研究将评估面对面应对改善小组干预对50岁以上艾滋病毒感染者在两种比较条件下调整努力的影响。300名（N=300）艾滋病毒感染的老年人将被随机分配到：（1）一个面对面的，应对改善小组干预，基于 Lazarus和Folkman（1984）的压力和应对的transmittance模型;（2）面对面，信息支持小组干预;或（3）护理标准比较条件。干预前和干预后的措施，沿着随访评估收集干预后4个月和8个月，将评估这三个条件的相对疗效。参与者将完成评估共病健康状况，认知功能，生活压力来源，应对方式，心理困扰，社会 支持、卫生服务利用、治疗依从性和生活质量。目前，针对感染艾滋病毒的老年人的适合年龄的心理健康干预措施很少（如果有的话）。然而，计划中的研究可能会产生一个文化背景下的应对改善干预这一弱势群体，这一创新将大大有助于艾滋病护理和老年学领域。