TELEPHONE BASED COPING PROGRAM FOR RURAL PEOPLE WITH HIV

许多研究已经描绘了心理和社会的模式， 艾滋病毒感染者的痛苦， 关于艾滋病毒感染者心理健康干预措施的若干报告 经历压力和科平问题。然而，这项研究依赖于 大量使用来自艾滋病毒感染率高的大都市地区的样本 血清阳性率 在一系列的初步研究中， 在过去的两年里，研究人员已经检查，表征， 确定了应对问题、心理社会困扰的患病率， 降低艾滋病毒/艾滋病感染者生活质量的因素， 小城镇和农村社区。 这些初步研究表明 感染艾滋病毒的农村居民感到非常孤立， 与艾滋病有关的歧视的反复发作，缺乏情感 家庭成员和朋友的支持，缺乏医疗和 心理健康从业人员。 其中许多因素可能会阻碍 艾滋病病毒感染者的应对和适应努力。 的 拟议的4年研究将检查一个对照， 电话传递，有效的应对小组干预，以改善 疾病相关的应对方式，提高生活质量， 农村社区艾滋病毒感染者的精神痛苦 两个比较条件。 360个艾滋病毒携带者- 受感染的农村居民将被随机分配到三个 条件：（1）标准护理条件（SC），其中参与者 获得艾滋病服务机构提供的常规生活护理服务 （2）SC加上参与电话传递，应对 有效性计划基于广泛接受的认知行为 模型的压力应对，或（3）SC加参与电话- 联系小组教育干预，参与者接受 与艾滋病毒/艾滋病感染者有关的当代主题的信息 （作为注意力控制组）。 测试前和测试后的测量， 沿着6个月时收集的12个月随访评估 后测后的时间间隔，将评估三种药物的相对疗效。 条件 参与者将完成每天评估的措施 压力源，疾病相关的应对策略临床抑郁症， 整体精神痛苦，健康相关生活质量， 社会支持和物质使用的感知水平。 如果成功， 计划中的研究将确定提供心理健康的战略， 对美国农村社区艾滋病毒感染者的干预， 群体规模不断扩大，其生活护理需求尚未得到 在迄今为止的研究文献中得到了充分的解决。

Many studies have delineated patterns of psychological and social distress among persons living with HIV infection, and there have been several reports of mental health interventions for HIV-infected persons experiencing stress and copping problems. However, this research relies heavily on samples from large metropolitan areas with high HIV seroprevalence. Across a series of preliminary studies conducted over the past 2 years, the investigators have examined, characterized, and determined the prevalence of coping problems, psychosocial distress, and factors that reduce the life quality of persons living with HIV/AIDS in small towns and rural communities. These preliminary studies indicate that HIV-infected rural residents feel very isolated, experience recurrent episodes of AIDS-related discrimination, lack emotional support from family members and friends, and lack access to medical and mental health practitioners. Many of these factors are likely to impede the coping and adjustment efforts of HIV-infected rural residents. The proposed 4-year study will examine the effects of a controlled, telephone-delivered, effective coping group intervention to improve illness-related coping styles, increase quality of life, and reduce psychiatric distress among HIV-infected persons in rural communities in relation to two comparison conditions. Three hundred and sixty HIV- infected rural residents will be randomly assigned to one of three conditions: (1) a standard care condition (SC) in which participants have access to customary life-care services provided by AIDS service organizations; (2) SC plus participation in telephone-delivered, coping effectiveness program based on a widely accepted cognitive-behavioral model of stress coping, or (3) SC plus participation in a telephone- linked group educational intervention in which participants receive information on contemporary topics related to living with HIV/AIDS (serving as an attention control group). Pretest and posttest measures, along with followup assessments collected for 12 months at 6-month intervals after posttest, will assess the relative efficacy of the three conditions. Participants will complete measures assessing daily stressors, illness-related coping strategies clinical depression, measures of global psychiatric distress, health-related quality of life, perceived levels of social support, and substance use. If successful, the planned study will identify strategies to provide mental health intervention to HIV-infected persons in America's rural communities, a group increasing in size and whose life-care needs have not been adequately addressed in the research literature to date.