Topic
Psychological intervention
About: Psychological intervention is a research topic. Over the lifetime, 82654 publications have been published within this topic receiving 2608356 citations.
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TL;DR: Health and mental health professionals working with individuals and families impacted by HIV could benefit from an enhanced understanding of correlates of HIV-related stigma, which will inform assessments, interventions and treatment plans.
Abstract: HIV-related stigma may negatively impact the health, quality of life, social support and well-being of people living with HIV (PLHIV). Previous studies have used diverse samples and a multitude of measurement instruments to examine demographic and health correlates of HIV-related stigma, highlighting the importance of synthesizing findings across different studies to gain a better understanding of these associations. This study examined the relationships between HIV-related stigma and a range of demographic, social, physical and health characteristics. A meta-analysis was conducted to assess the overall strength and direction of these relationships. Twenty-four studies of PLHIV, conducted in North America and published in peer-reviewed journals between January of 2000 and November of 2007, were examined and their findings integrated. The heterogeneity of reported results was also assessed and examined. Our review revealed substantial variability in the ways researchers measure participants' HIV-related stigma as well as their physical, emotional and mental health. In spite of this variability, high stigma level was consistently and significantly associated with low social support (r = -0.369, p<0.0005), poor physical health (r = -0.324, p<0.0005), poor mental health (r = -0.402, p<0.0005), age (-0.066, p<0.05) and income (-0.172, p<0.005). These correlations were of a medium size, which would be recognized by the individual in daily life. Health and mental health professionals working with individuals and families impacted by HIV could benefit from an enhanced understanding of correlates of HIV-related stigma, which will inform assessments, interventions and treatment plans. The association between HIV-related stigma and physical health has potential implications for treatment, care and support for people at different stages of HIV infection. AIDS Service Organizations are also encouraged to integrate findings into HIV stigma interventions and social support programs. Additionally, HIV-related stigma scales should be developed and validated, so that future studies using them are able to report findings that are operationally and conceptually consistent.
427 citations
TL;DR: Satisfied patients, patients with fulfilled information needs, and patients who experience less information barriers, in general have a better health-related quality of life (HRQoL) and less anxiety and depression.
426 citations
TL;DR: Interventions targeting PWLH are efficacious in reducing unprotected sex and acquisition of sexually transmitted diseases and should be incorporated into community HIV prevention efforts and further evaluated for effectiveness.
Abstract: Objective To conduct a meta-analytic review of HIV interventions for people living with HIV (PLWH) to determine their overall efficacy in reducing HIV risk behaviours and identify intervention characteristics associated with efficacy. Methods Comprehensive searches included electronic databases from 1988 to 2004, hand searches of journals, reference lists of articles, and contacts with researchers. Twelve trials met the stringent selection criteria: randomization or assignment with minimal bias, use of statistical analysis, and assessment of HIV-related behavioural or biologic outcomes at least 3 months after the intervention. Random-effects models were used to aggregate data. Results Interventions significantly reduced unprotected sex [odds ratio (OR), 0.57; 95% confidence interval (CI) 0.40-0.82] and decreased acquisition of sexually transmitted diseases (OR, 0.20; 95% CI, 0.05-0.73). Non-significant intervention effects were observed for needle sharing (OR, 0.47, 95% CI, 0.13-1.71). As a whole, interventions with the following characteristics significantly reduced sexual risk behaviours: (1) based on behavioural theory; (2) designed to change specifically HIV transmission risk behaviours; (3) delivered by health-care providers or counsellors; (4) delivered to individuals; (5) delivered in an intensive manner; (6) delivered in settings where PLWH receive routine services or medical care; (7) provided skills building, or (8) addressed a myriad of issues related to mental health, medication adherence, and HIV risk behaviour. Conclusion Interventions targeting PWLH are efficacious in reducing unprotected sex and acquisition of sexually transmitted diseases. Efficacious strategies identified in this review should be incorporated into community HIV prevention efforts and further evaluated for effectiveness.
426 citations
TL;DR: The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades.
Abstract: Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence. The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of personcentered care and evidencebased medicine. Using medication is an active process that involves complex decision making and a chance to work through decisional conflicts. It requires a partnership between two experts: the client and the practitioner. Shared decision making provides a model for them to assess a treatment’s advantages and disadvantages within the context of recovering a life after a diagnosis of a major mental disorder. (Psychiatric Services 57: 1636–1639, 2006) A lthough the exact definitions of compliance and noncompliance remain a topic of debate, Weiden and Rao (1) suggested that the most common definition of the word is “a deviation or cessation of a medication regimen that is less than what was recommended by the doctor.” Compliance interventions are often designed to increase clients’ behavioral conformity to a practitioner’s view of optimal treatment. Shared decision making diverges radically from compliance because it assumes that two experts—the client and the practitioner—must share their respective information and determine collaboratively the optimal treatment. Contemporary evidence-based approaches to the management of long-term medical illnesses are based on the process of shared decision making. Similarly high standards should be adopted in psychiatry. In this Open Forum, we present a rationale for adoption of the shared decision-making approach in psychiatry from both the client and practitioner points of
425 citations
TL;DR: Treatment targeted at specific anxiety disorders, individual psychotherapy, and psychotherapy with older children and adolescents had effect sizes which were larger than effect sizes for treatments targeting a range of anxiety disorders; however, quality ratings were higher for more recently published studies.
425 citations