New Insight into HIV-Related Psychological Distress: A Concept Analysis

Abstract

Psychological distress is a frequently reported outcome measure in HIV research. However, because of its poor conceptualization, many studies only partially capture it because they focus solely on depression or anxiety based on symptoms. This study undertook a concept analysis of HIV-related psychological distress (HRPD) using Walker and Avant’s method. The findings include HRPD’s (a) attributes, including changes to emotional status, symptom burden, HIV disclosure distress and HIV-related stigma; (b) antecedents, including HIV-related stressors, cognitive appraisal of stressors and difficulty coping with the disease or treatment; and (c) consequences, including poor health outcomes and posttraumatic growth. Lazarus and Folkman’s theory and the conservation of resources theory were adapted to further understand HRPD. This article provides insight into HRPD and increases the awareness of how to screen and assess HRPD at an early stage. The findings indicate the need to develop specific and rigorous measures and to provide appropriate interventions.

Development and Validation of a New Comprehensive Assessment Scale of HIV-Related Psychological Distress in China: A Methodological Study

“…Thus, whether to disclose one's HIV status has been described as a dilemma. As a result, the contemplation of this process becomes a form and source of HRPD (Ma et al, 2023). For clinical medical staff, the first step is to recognize that disclosure distress is a manifestation of HRPD in behavior, and the second step is to provide professional guidance and services, such as encouraging patients to strategically disclose the condition and making selective notifications to obtain the social support of family and friends.…”

“…The terms that are frequently used to describe the perceptions and experience of living with HIV were included in the item pool list. For the literature review, we undertook concept analysis of HRPD using Walker and Avant's method (Ma et al, 2023). This method is widely used and provides a structure for creating conceptual clarity, which is useful for reducing ambiguities and supporting the development of clear understanding.…”

“…“HIV-related psychological distress (HRPD) is a continuous, persistent, and occult psychological burden generated among people living with HIV (PLWH) in coping with the disease, reflecting a multifaceted concept involving physical, psychological, social, and spiritual distressful experience” (Ma et al, 2023, p 8). An extensive review of the literature revealed that the experience of HRPD is common among PLWH (Parcesepe et al, 2018) and that HRPD has become a complex concern because antiretroviral therapy (ART) has changed HIV infection from an acute to a chronic disease, allowing for a longer life expectancy (Ma et al, 2022a).…”

“…An extensive review of the literature revealed that the experience of HRPD is common among PLWH (Parcesepe et al, 2018) and that HRPD has become a complex concern because antiretroviral therapy (ART) has changed HIV infection from an acute to a chronic disease, allowing for a longer life expectancy (Ma et al, 2022a). The findings of a concept analysis suggested that the construct of HRPD is multidimensional in the context of HIV infection, involving aspects of cognition (i.e., identity distress), behavior (i.e., HIV disclosure distress, treatment adherence distress, and social interaction distress), and emotion (i.e., changes to emotional status ranging from common normal feelings to mental health issues; Ma et al, 2023). Evidence has shown that low levels of CD4 + T cells, excessive negative life events, concealment of HIV infection, and lack of social support are independent risk factors for HRPD (Krueger et al, 2020; Moges et al, 2021), and these factors can accelerate the development of the disease course by reducing the adherence of patients to ART (Parcesepe et al, 2018; Pierce et al, 2023).…”

Health Equity, Diversity, and Inclusion: Fundamental Considerations for Improving Patient Care

“…This issue of Clinical Nursing Research seeks to explore some of the ways researchers can amplify patient voices and experiences in the receipt of care, through diversity of inquiry, study population, and method. In a concept analysis of HIV-related psychological distress, Ma et al (2023) particularly consider this experience within the constellation of HIV-related symptoms, concerns, and medication side effects; they account for the ways in which these also interact with HIV-related stigma. The analysis by Ma et al (2023) powerfully demonstrates how HIV is not a singular illness in a singular population, but an experiential and in fact existential condition, factoring into both health inequities and patient functioning on a daily basis.…”