Pilot Randomized Trial of Education to Improve Self-Management Skills of Men With Symptomatic HIV/AIDS

Gifford, Allen L.; Laurent, Diana; Gonzales, Virginia; Chesney, Margaret A.; Lorig, Kate

doi:10.1097/00042560-199806010-00005

Cited by 112 publications

(89 citation statements)

References 29 publications

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“…The results are consistent with other studies of interventions to enhance self-care that have found improvement in pain management [57,58], better knowledge about pain [59][60][61], improved pain control [58,59,62,63] and less pain interference with daily activities [62,63] although the form, content and context of these interventions were different and were administered among cancer patients. Our findings are different from those of a study conducted among HIV/AIDS patients [64] that found decreased quality of life when medication reminders were given, and to a trial that found no effect of an educational intervention to enhance self-management skills [65]. Our finding of improved knowledge about pain among people with HIV/AIDS is consistent with a large trial [66] that found significant improvement in knowledge among HIV/ AIDS participants following an HIV medication adherence intervention.…”

Section: Discussioncontrasting

confidence: 99%

An Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial

Nkhoma

Seymour

Arthur

2015

Journal of Pain and Symptom Management

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Section: Discussioncontrasting

confidence: 99%

An Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial

Nkhoma

Seymour

Arthur

2015

Journal of Pain and Symptom Management

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“…Dissertation Abstracts International 1998;59:5067. [Lutgendorf, 1994] Appendix 2 Gifford et al (1998) N =58, 0% F 76% W, 10% B, 7% H Theory-based, 7-session (ETD = 960 minutes) group intervention emphasizing HIV/AIDS education (including rationale for stress management), nutrition, exercise, and adherence education and/or planning/practice, coping skills, active intrapersonal skills, and active practice of mental and physical relaxation exercises. WL/NT control.…”

Section: Discussionmentioning

confidence: 99%

Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

Scott-Sheldon¹,

Kalichman²,

Carey³

et al. 2008

Health Psychology

198

155

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Objective: Numerous studies document that stress accelerates disease processes in a variety of diseases including HIV. As a result, investigators have developed and evaluated interventions to reduce stress as a means to improve health among persons living with HIV. Therefore, the current meta-analysis examines the impact of stress-management interventions at improving psychological, immunological, hormonal, and other behavioral health outcomes among HIV+ adults.Design-This meta-analytic review integrated the results of 35 randomized controlled trials examining the efficacy of 46 separate stress-management interventions for HIV+ adults (N = 3,077).Main Outcome Measures-Effect sizes were calculated for stress processes (coping and social support), psychological/psychosocial (anxiety, depression, distress, and quality of life), immunological (CD4+ counts and viral load), hormonal (cortisol, dehydroepiandrosterone sulfate [DHEA-S], cortisol/DHEA-S ratio, and testosterone) and other behavioral health outcomes (fatigue).Results-Compared to controls, stress-management interventions reduce anxiety, depression, distress, and fatigue and improve quality of life (d + s = 0.16 to 0.38). Stress-management interventions do not appear to improve CD4+ counts, viral load, or hormonal outcomes compared with controls.Conclusion-Overall, stress-management interventions for HIV+ adults significantly improve mental health and quality of life but do not alter immunological or hormonal processes. The absence of immunological or hormonal benefits may reflect the studies' limited assessment period (measured typically within 1-week post-intervention), participants' advanced stage of HIV (HIV+ status known for an average of 5 years), and/or sample characteristics (predominately male and Caucasian participants). Future research might test these hypotheses and refine our understanding of stress processes and their amelioration. Coping with a chronic, life-threatening disease, however, is not without consequence as disease progression often involves a series of psychological and physical stressors that may impair daily functioning and quality of life. These stressors may involve a variety of physical symptoms, pain, concerns over disclosure of and stigma associated with HIV, and distress regarding one's own mortality (Derlega, Winstead, Greene, Serovich, & Elwood, 2002;Kalichman & Catz, 2000). NIH Public AccessResearch has demonstrated that such psychological and physical stressors can alter physiological processes and undermine health (see Kemeny, 2003;McEwen, 1998;Tosevski & Milovancevic, 2006;Vanable, Carey, Blair, & Littlewood, 2006). Although acute activation of these physiological processes is adaptive, chronic activation may lead to negative health effects including impaired immune functioning (see Segerstrom and Miller, 2004). Indeed, increased stress associated with chronic medical diseases such as HIV/AIDS appears to accelerate immune impairment, including reduced lymphocyte circulation and increased cortisol levels and a m...

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“…While the impact of specific interventions, that is, stimulation of patients' willingness to ask questions during the Physician -patient communicationmedical interview or general health education programmes, on patient self-efficacy, has been studied in several patient groups (Gifford et al, 1998;Tennstedt, 2000), we are not aware of any studies specifically investigating the association between physician communication style and self-efficacy of cancer patients. Cancer patients, who report greater efficacy with respect to their capacity to cope with the disease and its treatment, are better adjusted, experience greater quality of life, and are less distressed than patients who feel less efficacious (Bandura, 1997;Merluzzi et al, 2001), and further investigations of the importance of physician communication for self-efficacy of cancer patients are needed.…”

Section: Discussionmentioning

confidence: 99%

Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease

et al. 2003

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The aim of the study was to investigate the association of physician communication behaviours as perceived by the patient with patient reported satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease in cancer patients. Questionnaires measuring distress, self-efficacy, and perceived control were completed prior to and after the consultation by 454 patients attending an oncology outpatient clinic. After the consultation, the patients also rated the physicians' communicative behaviours by completing a patient -physician relationship inventory (PPRI), and the physicians were asked to estimate patient satisfaction. The overall results showed that higher PPRI scores of physician attentiveness and empathy were associated with greater patient satisfaction, increased self-efficacy, and reduced emotional distress following the consultation. In contrast, lower PPRI scores were associated with reduced ability of the physician to estimate patient satisfaction. The results confirm and expand previous findings, suggesting that communication is a core clinical skill in oncology.

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Pilot Randomized Trial of Education to Improve Self-Management Skills of Men With Symptomatic HIV/AIDS

Cited by 112 publications

References 29 publications

An Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial

An Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial

Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease

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