Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While there is still much to be learned about depression in the context of HIV illness, studies over the past decade are generally reassuring. True, low-grade depressive symptoms are frequent among both HIV-positive and at-risk HIV-negative adults, but depressive disorders are the exception and not the rule, occurring in about 1 of 10 individuals. Similar to non-HIV populations, these depressive disorders are more likely to occur among those HIV-infected adults with severe personality problems, with a history of previous depressions, and with limited current social support. Although rates of depression may slightly increase with development of more severe physical symptoms, even then the clinician should not consider the presence of a depressive disorder as understandable, justified, and therefore "normal." Rather, depressive symptoms accompanied by suicidal ideation are signals for further evaluation and treatment. When antidepressant treatment is indicated, the weight of current evidence suggests that standard therapies can be safely and effectively prescribed for HIV-infected adults. For outpatients without severe physical illness, antidepressant medications are generally well tolerated in recommended dosages and do not increase immunosuppression. For those with more severe physical impairment, the adage for geriatric populations is applicable: "Start low and go slow." If lethargy and cognitive slowing is a major component of the depression, especially among those in later stages of disease, then psychostimulants may be helpful. When concerns about drug abuse preclude such a prescription, an activating antidepressant may be just as helpful to improve both mood and energy. For severe or refractory depressions, such as delusional affective disorders. ECT has been safely given to HIV-infected patients. And finally, accumulated clinical experience and a couple of systematic studies suggest that psychotherapy, alone or in combination with antidepressant drug therapy, can be remarkably beneficial. In sum, data support the fact that we have much to offer our depressed HIV-infected patients. Our task is to make sure that we identify their depressions when present and counter their feelings of hopelessness by ensuring that effective antidepressant treatments are provided.
 ...
PMID:HIV-related depression. 811 15

This nonexperimental study used the Beck Depression Inventory (BDI), the Hopelessness Scale (HS), and a Demographic Data Sheet (DDS) to collect data on a convenience sample of 80 HIV-positive subjects. Subjects were classified into three groups; HIV-positive asymptomatic (19, 24%), HIV-positive symptomatic (26, 33%), and AIDS (35, 43%). A significant difference was seen between HIV-positive symptomatic subjects (means = 9.6923, n = 26), subjects with AIDS (means = 8.8571, n = 35), and subjects who were HIV-positive asymptomatic (means = 13.2105, n = 19) on measures of suicidal intent. HIV-positive symptomatic subjects (means = 23.1538, n = 26) and subjects with AIDS (means = 23.1286, n = 35) were significantly more depressed than HIV-positive asymptomatic subjects (means = 14.8421, n = 19).
 ...
PMID:The relationship between HIV classification and depression and suicidal intent. 813 Mar 67

Self-care behaviors may be positive (healthy) or negative (unhealthy). Many factors may influence whether individuals choose healthy or unhealthy self-care behaviors. This study examined the relationships of perceived impact of HIV status, distress, and subsequent changes in self-care activities among men and women who were at risk for or infected with HIV. Significant findings included a positive correlation between the number of symptoms experienced and both depression and change toward unhealthy self-care behaviors. The impact of event avoidance and depression were associated with changes to unhealthy self-care behaviors, although hopelessness was associated with fewer unhealthy changes.
 ...
PMID:Self-care, psychological distress, and HIV disease. 813 Mar 66

The presence of HIV spectrum illness stimulates a powerful emotional reaction from a patient's family and friends. Grief and shock over the infection, and its implications are frequent observations. Sadness, anxiety, helplessness and anger are also common. Health care staff should address these responses in order to strengthen coping skills and maximize interpersonal comfort. Stigmatization and isolation are major stressors. Bereavement is complicated by fear, shame, dependency and hopelessness. Therefore, a task in counselling is to maintain the integrity and supportiveness of the patient's social unit by encouraging open communications between those involved and by educating about AIDS. Information should be provided on HIV transmission, self-protection, and illness progression as well as the safety of causal contacts and the practices of 'safer sex'. The significant others should retain outside interests and be encouraged to seek help for patients from supportive social agencies. Instillation of hope lends benefit to patient, family and friends. Kind, non-judgmental counselling and good quality medical care should be made available, especially since HIV-related disorders are increasingly becoming a chronic disease. Advocacy for the significant others translates into better adjustment and it enhances the patient's medical prognosis.
 ...
PMID:AIDS and the family: implications for counselling. 846 63

The study examined the relationship between coping and psychosocial variables (psychological stress symptoms, locus of control, emotional repression, and social support) among 108 human immunodeficiency virus (HIV)-infected patients. The authors administered several tests, including one that measures fighting spirit and degree of hopelessness, to assess each patient's individual coping style. The patients who were adjusting well to their HIV-positive status tended to have a higher level of fighting spirit and lower degree of hopelessness than those patients who were not adjusting well to their HIV-positive status. A coping style based on incapacity to face and confront HIV infection was associated with symptoms of psychological stress, repression of anger, external locus of control, and low social support in the latter group. These patients showed symptoms indicating maladjustment to HIV infection (43% of the sample) and differed from the "noncases" (the well-adjusted patients) in that the former group reported inadequate coping responses (lower fighting spirit and higher hopelessness, fatalistic attitude, and anxious preoccupation) and poorer social support, and had a greater tendency to repress anger and express sadness. The data support the hypothesis that coping with HIV infection is a complex phenomenon involving multiple and interacting variables. Interventions aimed at improving the coping style for many HIV patients are needed.
 ...
PMID:Coping styles and psychosocial-related variables in HIV-infected patients. 969 4

Identifies environmental markers, situational appraisals, perceived ability to mediate situations and outcomes, primary coping strategies, and purposes served by religion and spirituality in 10 HIV-positive women recruited from a regional health care clinic. Findings indicated that the women experienced a disintegration of family during their early developmental years, yielding feelings of hopelessness and isolation; that their sexual development was marked by rape and incest, and their early adulthood was characterized by failed relationships, pregnancies, drugs, and alcohol. Reports that the women's religious influences were predominantly maternal and provided a model for intercessory prayer. Notes that prior to their diagnosis of HIV, participants described their coping as escapist, while after diagnosis they believed there was a divine intercession renewing their spiritual growth and connectedness with others. Reports that the women's personal spirituality was greatly influenced by prayer, television ministries, and reading the Bible. Suggests the interventions that actively recruit women into social support services, health care systems, and faith congregations are needed and that television ministries may serve as access points for connecting women with necessary services.
 ...
PMID:Developmental stages and spiritual coping responses among economically impoverished women living with HIV disease. 1018 55

When individuals must deal with potentially fatal diseases their lives change in many ways. This qualitative study was designed to investigate this critical life event. The authors interviewed a convenience sample (N = 15) of 10 women with cancer and 5 men with HIV/AIDS. Findings suggest that spirituality is an essential component to feelings of health and well-being. Many of the subjects viewed spirituality as a bridge between hopelessness and meaningfulness in life. Those who had found meaning in their disease thought they had a better quality of life now than they had before the diagnosis.
 ...
PMID:Spirituality and people with potentially fatal diagnoses. 1042 12

Non-adherence to medical regimens is a critical threat to the health of HIV-infected individuals. Patients who do not adhere to routine medical care cannot fully benefit from the increasingly efficacious treatments available to them. Consistent attendance at medical appointments plays a central role in both prolonging life and enhancing quality of life for persons living with HIV/AIDS. By identifying why many patients do not reliably attend medical services, interventions can be undertaken to improve appointment-keeping. The primary purpose of the present study was to identify factors predictive of HIV-related medical appointment attendance. One-hundred-and-forty-four outpatients in a public hospital ambulatory care HIV clinic were followed for seven months. Demographic, medical care and psychosocial factors were measured in order to prospectively predict the percentage of missed clinic appointments by persons with HIV disease. Greater outpatient appointment non-attendance was associated with younger age, minority status, less severe illness and lower perceived social support. Treatment duration, provider consistency, hopelessness and religious coping did not emerge as significant predictors of outpatient appointment-keeping in this sample. Practical and theoretical implications of these findings are discussed in light of recent medical advances in HIV/AIDS care.
 ...
PMID:Predictors of outpatient medical appointment attendance among persons with HIV. 1047 34

The purpose of this study was to describe voluntary caregivers' observations on the dynamics of hope across the continuum of HIV/AIDS. Three focus group interview sessions were conducted with 10 voluntary caregivers in 1998. The data were analyzed using the grounded theory method described originally by Glaser and Strauss. Closing and opening emerged as the core categories in the dynamics of hope. Closing means closing down in despair and to the process of life, whereas opening means opening up to hope and the process of life. Nursing interventions that prevent closing and enable opening are helpful for these people. Conceptual clarification and the differentiation between the concepts of hope, wish, despair, and hopelessness presented in this study require further elaboration. Further research on the dynamics of hope in fearing HIV/AIDS or living with HIV/AIDS and being a significant other to a person with HIV/AIDS from different perspectives is also needed.
 ...
PMID:Voluntary caregivers' observations on the dynamics of hope across the continuum of HIV/AIDS: a focus group study. 1129 33

With the introduction of protease inhibitors and combination therapies, and the dramatic health improvements related to these drugs, psychologists expected to see dramatic improvement in HIV-infected persons with regard to their feelings of hopelessness and depression. Several months after the Vancouver conference in 1996, a curious phenomenon was noted. The clinical manifestations included an initial phase of excitement and hope. Then, as patients began to deal with the psychological changes involved in planning a future rather than a funeral, many began (unconsciously or not) to become noncompliant with their medications. In Dallas, physicians validated this phenomenon, some reporting up to 75% non-compliance rates. This article will address the change from a terminally ill person to one that is chronically ill, and the psychological, social, and existential changes that occur during this shift in identity. It will specifically focus on the fears involved with losing support, disability income, having to possibly reenter the work force (after having not worked and losing job skills), the special issues of women with HIV and, finally, the decision that women are making to get pregnant, expecting a normal life span, and, (with the use of multiple drug therapies during pregnancy) having a healthy, noninfected child.
 ...
PMID:Understanding "post-AIDS survivor syndrome": a record of personal experiences. 1136 96


<< Previous 1 2 3 4 5 6 7 8 Next >>