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Journal ArticleDOI

A pilot theory-based intervention to improve resilience, psychosocial well-being, and quality of life among people living with HIV in rural China.

01 Jan 2014-Journal of Sex & Marital Therapy (Taylor & Francis Group)-Vol. 40, Iss: 1, pp 1-16
TL;DR: The authors found that the HIV-positive participants increased their levels of resilience, social support, and quality of life and that they reported fewer symptoms of depression, anxiety, and stress at the completion of the intervention; most of these changes were sustained at the 3-month follow-up.
Abstract: This pilot study aimed at fostering resilience among people living with HIV and improving the HIV-negative participants' acceptance of people living with HIV. A group of 75 people living with HIV who were former blood/plasma donors and 36 HIV-negative fellow villagers in rural China participated in the intervention. The 8 sessions lasted for 4 months and were facilitated by trained local family-planning officers. Efficacy of the intervention was assessed using a pre- and postprogram study design; measurements were made at baseline, at completion, and 3 months afterward completion. The authors found that the HIV-positive participants increased their levels of resilience, social support, and quality of life and that they reported fewer symptoms of depression, anxiety, and stress at the completion of the intervention; most of these changes were sustained at the 3-month follow-up. Such participants also reported subjective improvements on problem-solving skills, self-confidence, and a feeling of being cared for by others. In addition, the HIV-negative participants' discriminatory attitudes toward people living with HIV were reduced after completing the intervention. The majority of the participants was satisfied with the intervention and would recommend it to others. The train-the-trainer approach was used effectively. Positive effects of the intervention have been revealed and future randomized controlled studies are warranted.
Citations
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Journal ArticleDOI
TL;DR: In this article, the authors propose a testable, empirically grounded framework for understanding diverse partnered sexualities, separate from solitary sexualities and discuss a sexual diversity lens as a way to study the particularities and generalities of diverse sexualities without privileging either.
Abstract: Sexual orientation typically describes people's sexual attractions or desires based on their sex relative to that of a target. Despite its utility, it has been critiqued in part because it fails to account for non-biological gender-related factors, partnered sexualities unrelated to gender or sex, or potential divergences between love and lust. In this article, I propose Sexual Configurations Theory (SCT) as a testable, empirically grounded framework for understanding diverse partnered sexualities, separate from solitary sexualities. I focus on and provide models of two parameters of partnered sexuality--gender/sex and partner number. SCT also delineates individual gender/sex. I discuss a sexual diversity lens as a way to study the particularities and generalities of diverse sexualities without privileging either. I also discuss how sexual identities, orientations, and statuses that are typically seen as misaligned or aligned are more meaningfully conceptualized as branched or co-incident. I map out some existing identities using SCT and detail its applied implications for health and counseling work. I highlight its importance for sexuality in terms of measurement and social neuroendocrinology, and the ways it may be useful for self-knowledge and feminist and queer empowerment and alliance building. I also make a case that SCT changes existing understandings and conceptualizations of sexuality in constructive and generative ways informed by both biology and culture, and that it is a potential starting point for sexual diversity studies and research.

371 citations

Journal ArticleDOI
TL;DR: Employment, immunological status, presence of symptoms, depression, social support and adherence to antiretroviral therapy were most frequently and consistently reported to be associated with HRQoL among people living with HIV.
Abstract: Background: As infection with the Human Immunodeficiency Virus (HIV) has evolved to a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. Literature discusses different factors influencing HRQoL in this population, however, currently no consensus exists about the main determinants. In this review a clear, up-to-date overview of the determinants influencing HRQOL among people living with HIV is provided. Methods: All studies published before July 2013 that identified determinants of HRQoL among people living with HIV in high-income countries, were considered in this narrative review. PubMed, Web of Science and The Cochrane Library were consulted using the keywords ‘determinants’, ‘quality of life’, ‘HIV’ and ‘AIDS’. To be included, studies should have reported overall health and/or physical/mental health scores on a validated instrument and performed multivariable regression analyses to identify determinants that independently influence perceived HRQoL. Results: In total, 49 studies were included for further analysis and they used a variety of HRQoL instruments: Medical Outcomes Study Short Form-36 or variants, Medical Outcomes Study-HIV, HIV Cost and Services Utilization Study measure, Multidimensional Quality of Life Questionnaire, HIV targeted quality of life instrument, Functional Assessment of Human Immunodeficiency Virus Infection, HIV Overview of Problems Evaluation System, EuroQol, Fanning Quality of Life scale, Health Index and PROQOL-HIV. In this review, the discussed determinants were thematically divided into socio-demographic, clinical, psychological and behavioural factors. Employment, immunological status, presence of symptoms, depression, social support and adherence to antiretroviral therapy were most frequently and consistently reported to be associated with HRQoL among people living with HIV. Conclusions: HRQoL among people living with HIV is influenced by several determinants. These determinants independently, but simultaneously impact perceived HRQoL. Most HRQoL instruments do not capture all key determinants. We recommend that the choice for an instrument should depend on the purpose of the HRQoL assessment.

174 citations

Journal ArticleDOI
TL;DR: These findings can be used to develop interventions incorporating an increased understanding of factors that are associated with both resilience and mastery, and were independently associated with psychological health-related quality of life.
Abstract: Purpose of the study Adults with HIV infection are living into old age. It is critical we investigate positive constructs such as resilience and mastery to determine factors associated with psychological well-being. We examine HIV-related factors, adverse conditions, and psychosocial characteristics that are associated with resilience (the ability to bounce back) and mastery (sense of self-efficacy). Design and methods We analyzed 2014 data from the longitudinal study Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), focusing on a subsample of 335 gay and bisexual older men. Multivariate linear regression was used to identify factors that contributed or detracted from resilience and mastery in the sample recruited from 17 sites from across the United States. Results Resilience and mastery were independently associated with psychological health-related quality of life. In multivariate analysis, adjusting for demographic characteristics, previous diagnosis of depression was negatively associated with resilience. Time since HIV diagnosis was positively associated with mastery whereas victimization was negatively associated with mastery. Social support and community engagement were positively associated with both resilience and mastery. Implications Individual and structural-environmental characteristics contributed to resilience and mastery. These findings can be used to develop interventions incorporating an increased understanding of factors that are associated with both resilience and mastery.

69 citations

Journal ArticleDOI
01 Jan 2015
TL;DR: A systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings to improve effectiveness.
Abstract: People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low- and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g. depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n = 13), Asia (n = 7), and the Middle East (n = 2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n = 18), family-level (n = 2), and pharmacological (n = 2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and 11 preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.

57 citations


Cites background or methods from "A pilot theory-based intervention t..."

  • ...Most interventions were designed for delivery within groups (Jirapaet, 2000; Molassiotis et al. 2002; Chan et al. 2005; Field & Kruger, 2008; Mundell et al. 2011; Ravaei et al. 2013; Bhana et al. 2014; Petersen et al. 2014; Yu et al. 2014), one was designed for delivery with individuals (Nyamathi et al....

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  • ...Studies were included in this review if they met the following criteria: global mental health (1) Described a trial evaluating a mental health intervention (e.g. CBT, coping, cognitive functioning, and pharmacological) among PLWH, (2) Intervention was implemented in either a LMIC, as defined by the World Bank (The World Bank Group, 2015), or one of the emerging-economy Brazil, Russia, India, China, and South Africa (BRICS) countries (), (3) Trial assessed at least one negative psychological state or disorder (e.g. depression and anxiety), and (4) Outcomes were assessed pre- and post-intervention....

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  • ...…and psychological (Molassiotis et al. 2002; Chan et al. 2005; Field & Kruger, 2008; Mundell et al. 2011; Ravaei et al. 2013; Petersen et al. 2014; Yu et al. 2014) outcomes through utilization of art therapy (Field & Kruger, 2008), cognitive behavioral therapy (Molassiotis et al. 2002; Chan et…...

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  • ...A pilot theory-based intervention to improve resilience, psychosocial well-being, and quality of life among people living with HIV in rural China....

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  • ...2014) and psychological (Molassiotis et al. 2002; Chan et al. 2005; Field & Kruger, 2008; Mundell et al. 2011; Ravaei et al. 2013; Petersen et al. 2014; Yu et al. 2014) outcomes through utilization of art therapy (Field & Kruger, 2008), cognitive behavioral therapy (Molassiotis et al....

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References
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Book
01 Dec 1969
TL;DR: The concepts of power analysis are discussed in this paper, where Chi-square Tests for Goodness of Fit and Contingency Tables, t-Test for Means, and Sign Test are used.
Abstract: Contents: Prefaces. The Concepts of Power Analysis. The t-Test for Means. The Significance of a Product Moment rs (subscript s). Differences Between Correlation Coefficients. The Test That a Proportion is .50 and the Sign Test. Differences Between Proportions. Chi-Square Tests for Goodness of Fit and Contingency Tables. The Analysis of Variance and Covariance. Multiple Regression and Correlation Analysis. Set Correlation and Multivariate Methods. Some Issues in Power Analysis. Computational Procedures.

115,069 citations


"A pilot theory-based intervention t..." refers background in this paper

  • ...Effect sizes of .2, .5, and .8 were regarded respectively as being small, medium, and large, respectively (Cohen, 1988)....

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Journal ArticleDOI

49,129 citations


"A pilot theory-based intervention t..." refers background in this paper

  • ...8 were regarded respectively as being small, medium, and large, respectively (Cohen, 1988)....

    [...]

  • ...Effect sizes of .2, .5, and .8 were regarded respectively as being small, medium, and large, respectively (Cohen, 1988)....

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Journal ArticleDOI
TL;DR: A critical appraisal of resilience, a construct connoting the maintenance of positive adaptation by individuals despite experiences of significant adversity, concludes that work on resilience possesses substantial potential for augmenting the understanding of processes affecting at-risk individuals.
Abstract: This paper presents a critical appraisal of resilience, a construct connoting the maintenance of positive adaptation by individuals despite experiences of significant adversity. As empirical research on resilience has burgeoned in recent years, criticisms have been levied at work in this area. These critiques have generally focused on ambiguities in definitions and central terminology; heterogeneity in risks experienced and competence achieved by individuals viewed as resilient; instability of the phenomenon of resilience; and concerns regarding the usefulness of resilience as a theoretical construct. We address each identified criticism in turn, proposing solutions for those we view as legitimate and clarifying misunderstandings surrounding those we believe to be less valid. We conclude that work on resilience possesses substantial potential for augmenting the understanding of processes affecting at-risk individuals. Realization of the potential embodied by this construct, however, will remain constrained without continued scientific attention to some of the serious conceptual and methodological pitfalls that have been noted by skeptics and proponents alike.

7,392 citations

Journal ArticleDOI
TL;DR: The Connor‐Davidson Resilience scale (CD‐RISC) demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement.
Abstract: Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0–4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CDRISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Depression and Anxiety 18:76–82, 2003. & 2003 Wiley-Liss, Inc.

6,854 citations


Additional excerpts

  • ...The 25-item Connor–Davidson Resilience Scale assesses psychological characteristics facilitating effective coping and positive adaptation in adversity (Connor & Davidson, 2003)....

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  • ...It showed good reliability (Cronbach’s α = .89) and was associated with hardiness and social support in some clinical and community samples in the United States (Connor & Davidson, 2003)....

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Journal ArticleDOI
TL;DR: An examination of converging findings from variable-focused and person-focused investigations of resilience suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems.
Abstract: The study of resilience in development has overturned many negative assumptions and deficit-focused models about children growing up under the threat of disadvantage and adversity. The most surprising conclusion emerging from studies of these children is the ordinariness of resilience. An examination of converging findings from variable-focused and person-focused investigations of these phenomena suggests that resilience is common and that it usually arises from the normative functions of human adaptational systems, with the greatest threats to human development being those that compromise these protective systems. The conclusion that resilience is made of ordinary rather than extraordinary processes offers a more positive outlook on human development and adaptation, as well as direction for policy and practice aimed at enhancing the development of children at risk for problems and psychopathology.

5,961 citations


"A pilot theory-based intervention t..." refers background in this paper

  • ...The intervention aimed at improving the core components of resilience: self-worth, emotional control, optimism, social support, and empathy toward vulnerable people (Luthar, Cicchetti, & Becker, 2000; Masten, 2001)....

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  • ...…attention to improving one’s own health and should get better support from the family and friends), to foster constructive coping, to strengthen people’s social networks, to instill hope and optimism and to provide the opportunity to participate in community services (Masten, 2001; Rutter, 1985)....

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  • ..., one should pay more attention to improving one’s own health and should get better support from the family and friends), to foster constructive coping, to strengthen people’s social networks, to instill hope and optimism and to provide the opportunity to participate in community services (Masten, 2001; Rutter, 1985)....

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