Marseille 2007
| Abstract #291 - Perceived stress: a detrimental psychosocial variable to treatment adherence | ||||
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Session: 24.9: Adherence (Parallel) on Monday @ 16.30-18.30 in HC Chaired by Ana Josefina Guell, Rahul Battcharya Authors: Presenting Author: Prof delmas philippe - hopital Vaugirard, France |
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| Additional Authors: Prof delmas philippe, | ||||
| Aim: Studies among patients living with HIV of the influence of psychosocial factors on treatment adherence have predominantly been conducted with Anglo-Saxon populations; the majority have focused on people with risk behaviour (Vosvick, et al., 2003). In contrast, few studies detail how it is that some people have no difficulty in complying with their daily triple therapy, and hardly any of those have been amongst francophone HIV patients. In view of this, we performed a longitudinal study of patients in France using the Lazarus and Folkman (1984) theoretical model. We had two objectives: to document the psychosocial characteristics of HIV patients who do comply with treatment and to examine differences between patients who remained adherent and those who became non-adherent in the evolution of psychosocial variables over a six-month period | ||||
| Method / Issue: Our sample was constituted from the HIV population availing themselves of relevant services in six cities in the Midi-Pyrenees. We retained the following variables: stress (Stress Appraisal Measure, Peacock &Wong, 1990); social support (Social Provision Scale, Cutrona & Russel, 1987); perceived state of health (Echelle Visuelle Analogique, Davies, et al., 1975); secondary effects (Scale, Justice, et al., 2001), coping strategies (Ways of Coping Questionnaire, Lazarus & Folkman, 1984); and quality of life (Medical Outcomes Study, Wu, et al., 1991). Our inclusion criteria were both objective (i.e., viral load of less than 50 copies) and subjective (i.e., a self-evaluation questionnaire, Godin, et al.,2003). Sample size at T0 was 133 and 110 at 6 months (T1), which meets standard statistical requirements (alpha risk 5%, power 80%, SD 20). To address the various questions of the study, we collected descriptive and correlational statistics at the two times. | ||||
| Results / Comments: Results show that, at T0, complying patients had average stress levels, used a variety of strategies to adapt to their situation and benefited from good social support; this resulted in a normal quality of life. The symptom they most frequently reported feeling restricted by was fatigue. At T0, three psychosocial variables explained 66.2% of the change in their quality of life: perceived stress (50.17%), secondary effects (9.82%) and social support (6.22%). Results at T1 (6 months) show that there is a significant decline in mental health among patients who continued complying, and in their perceptions of their actual state of health. On the other hand, patients who had not continued to comply after six months had higher levels of perceived stress | ||||
| Discussion: . Evidently, for those patients who have positive adherence behaviour, living with HIV has repercussions over time that bring on fragility in their mental states. However, reducing perceived stress seems to be a key variable in building up and maintaining treatment adherence | ||||
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